极早早产儿神经发育结局性别差异的趋势

Trends in sex differences in neurodevelopmental outcomes among extremely preterm infants.

作者信息

Boghossian Nansi S, Mack Nicole A, Bell Edward F, Tan Sylvia, Stoll Barbara J, Rysavy Matthew A, Ambalavanan Namasivayam, Tyson Jon E, Das Abhik, Hintz Susan R

机构信息

Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA

Biostatistics and Epidemiology Division, RTI International, Research Triangle Park, North Carolina, USA.

出版信息

Arch Dis Child Fetal Neonatal Ed. 2025 Apr 17;110(3):269-278. doi: 10.1136/archdischild-2024-327239.

DOI:10.1136/archdischild-2024-327239

PMID:39288987

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11922790/

Abstract

OBJECTIVE

To examine whether changes in survival without moderate or severe neurodevelopmental impairment (NDI) at 18-26 months' corrected age from 1999 to 2018 differed between male and female infants.

DESIGN

This retrospective cohort study used data from the NICHD Neonatal Research Network hospitals. Robust Poisson regression models were used to estimate adjusted relative risks (aRRs) and 95% CIs for survival without moderate or severe NDI between males and females. Interactions between sex and time were assessed to evaluate temporal differences in the outcome by sex. Variables adjusted for included centre, maternal age, ethnicity/race, gestational age and small for gestational age.

PATIENTS

Inborn infants with gestational age of 22-26 weeks at NICHD Neonatal Research Network hospitals from 1999 to 2018.

MAIN OUTCOME MEASURE

Change over time in survival without moderate or severe NDI at 18-26 months' corrected age between male and female infants.

RESULTS

Of 26 307 infants, 13 045 (49.6%) were male. Survival without moderate or severe NDI declined for both sexes over time, from 32.9% to 30.6% for males and from 47.4% to 40.0% for females, between 1999-2003 and 2014-2018. Males were less likely than females to survive without moderate or severe NDI (aRR=0.80; 95% CI 0.78 to 0.83). Changes in survival without moderate or severe NDI did not differ between males and females.

CONCLUSION

There were no differential changes in survival without moderate or severe NDI between male and female infants.

摘要

目的

研究1999年至2018年期间，18至26个月矫正年龄时无中度或重度神经发育障碍（NDI）的存活情况在男婴和女婴之间是否存在差异。

设计

这项回顾性队列研究使用了美国国立儿童健康与人类发展研究所（NICHD）新生儿研究网络医院的数据。稳健泊松回归模型用于估计男女性别间无中度或重度NDI存活情况的调整相对风险（aRRs）和95%置信区间（CIs）。评估性别与时间之间的相互作用，以评估按性别划分的结果随时间的差异。调整的变量包括中心、母亲年龄、种族/民族、胎龄和小于胎龄。

患者

1999年至2018年期间在NICHD新生儿研究网络医院出生的胎龄为22至26周的婴儿。

主要结局指标

男婴和女婴在18至26个月矫正年龄时无中度或重度NDI存活情况随时间的变化。

结果

在26307名婴儿中，13045名（49.6%）为男性。随着时间的推移，两性无中度或重度NDI的存活率均有所下降，在1999 - 2003年至2014 - 2018年期间，男性从32.9%降至30.6%，女性从47.4%降至40.0%。男性无中度或重度NDI存活的可能性低于女性（aRR = 0.80；95% CI 0.78至0.83）。男女性别间无中度或重度NDI存活情况的变化没有差异。