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Fetal sex and maternal pregnancy outcomes: a systematic review and meta-analysis.

Authors :
Broere-Brown ZA
Adank MC
Benschop L
Tielemans M
Muka T
Gonçalves R
Bramer WM
Schoufour JD
Voortman T
Steegers EAP
Franco OH
Schalekamp-Timmermans S
Source :
Biology of sex differences [Biol Sex Differ] 2020 May 11; Vol. 11 (1), pp. 26. Date of Electronic Publication: 2020 May 11.
Publication Year :
2020

Abstract

Background: Since the placenta also has a sex, fetal sex-specific differences in the occurrence of placenta-mediated complications could exist.<br />Objective: To determine the association of fetal sex with multiple maternal pregnancy complications.<br />Search Strategy: Six electronic databases Ovid MEDLINE, EMBASE, Cochrane Central, Web-of-Science, PubMed, and Google Scholar were systematically searched to identify eligible studies. Reference lists of the included studies and contact with experts were also used for identification of studies.<br />Selection Criteria: Observational studies that assessed fetal sex and the presence of maternal pregnancy complications within singleton pregnancies.<br />Data Collection and Analyses: Data were extracted by 2 independent reviewers using a predesigned data collection form.<br />Main Results: From 6522 original references, 74 studies were selected, including over 12,5 million women. Male fetal sex was associated with term pre-eclampsia (pooled OR 1.07 [95%CI 1.06 to 1.09]) and gestational diabetes (pooled OR 1.04 [1.02 to 1.07]). All other pregnancy complications (i.e., gestational hypertension, total pre-eclampsia, eclampsia, placental abruption, and post-partum hemorrhage) tended to be associated with male fetal sex, except for preterm pre-eclampsia, which was more associated with female fetal sex. Overall quality of the included studies was good. Between-study heterogeneity was high due to differences in study population and outcome definition.<br />Conclusion: This meta-analysis suggests that the occurrence of pregnancy complications differ according to fetal sex with a higher cardiovascular and metabolic load for the mother in the presence of a male fetus.<br />Funding: None.

Details

Language :
English
ISSN :
2042-6410
Volume :
11
Issue :
1
Database :
MEDLINE
Journal :
Biology of sex differences
Publication Type :
Academic Journal
Accession number :
32393396
Full Text :
https://doi.org/10.1186/s13293-020-00299-3