Fetal sex-specific differences in gestational age at delivery in pre-eclampsia: a meta-analysis

Sarah Schalekamp-Timmermans, Lidia R. Arends, Elin Alsaker, Lucy Chappell, Stefan Hansson, Nina K. Harsem, Maya Jälmby, Arundhathi Jeyabalan, Hannele Laivuori, Debbie A. Lawlor, Corrie Macdonald-Wallis, Per Magnus, Jenny Myers, Jørn Olsen, Lucilla Poston, Christopher W. Redman, Anne C. Staff, Pia Villa, James M. Roberts, Eric A. SteegersGlobal Pregnancy Collaboration:

Research output: Contribution to journalArticle (Academic Journal)peer-review

33 Citations (Scopus)
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Abstract

Background: Pre-eclampsia (PE) is a major pregnancy disorder complicating up to 8% of pregnancies. Increasing evidence indicates a sex-specific interplay between the mother, placenta and fetus. This may lead to different adaptive mechanisms during pregnancy.

Methods: We performed an individual participant data meta-analysis to determine associations of fetal sex and PE, with specific focus on gestational age at delivery in PE. This was done on 219 575 independent live-born singleton pregnancies, with a gestational age at birth between 22.0 and 43.0 weeks of gestation, from 11 studies participating in a worldwide consortium of international research groups focusing on pregnancy.

Results: Of the women, 9033 (4.1%) experienced PE in their pregnancy and 48.8% of the fetuses were female versus 51.2% male. No differences in the female/male distribution were observed with respect to term PE (delivered ≥ 37 weeks). Preterm PE (delivered < 37 weeks) was slightly more prevalent among pregnancies with a female fetus than in pregnancies with a male fetus [odds ratio (OR) 1.11, 95% confidence interval (CI) 1.02-1.21]. Very preterm PE (delivered < 34 weeks) was even more prevalent among pregnancies with a female fetus as compared with pregnancies with a male fetus (OR 1.36, 95% CI 1.17-1.59).

Conclusions: Sexual dimorphic differences in the occurrence of PE exist, with preterm PE being more prevalent among pregnancies with a female fetus as compared with pregnancies with a male fetus and with no differences with respect to term PE.

Original languageEnglish
Pages (from-to)632-642
Number of pages11
JournalInternational Journal of Epidemiology
Volume46
Issue number2
Early online date6 Sep 2016
DOIs
Publication statusPublished - Apr 2017

Keywords

  • ALSPAC
  • placenta
  • pre-eclampsia
  • sex ratio
  • Sexual dimorphism

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