Skip to main content
Top
Published in: Archives of Gynecology and Obstetrics 5/2020

01-05-2020 | Maternal-Fetal Medicine

Are there gender-specific differences in pregnancy outcome and placental abnormalities of pregnancies complicated with small for gestational age?

Authors: Liliya Tamayev, Letizia Schreiber, Adi Marciano, Jacob Bar, Michal Kovo

Published in: Archives of Gynecology and Obstetrics | Issue 5/2020

Login to get access

Abstract

Introduction

Adaptations to pathological intrauterine environment might differ in relation to fetal gender. We aimed to study sex-specific differences in placental pathology of pregnancies complicated by small for gestational age (SGA).

Methods

The medical records and placental histology reports of all neonates with a birth-weight ≤ 10th percentile, born between 24 and 42 weeks of gestation, during 2010–2018, were reviewed. Composite neonatal outcome was defined as one or more of early following complications: neonatal sepsis, blood transfusion, phototherapy, respiratory morbidity, cerebral morbidity, necrotizing enterocolitis, or death. Results were compared between the male and female groups of neonates. Placental lesions were classified into maternal and fetal vascular malperfusion (MVM and FVM) lesions, maternal and fetal inflammatory responses (MIR and FIR), and villitis of unknown etiology (VUE).

Results

The male SGA group (n = 380) and the female SGA group (n = 363) did not differ in regard to maternal age, BMI, smoking, associated pregnancy complications, gestational age, and mode of delivery. Neonates in the SGA male group had increased birth-weight and increased respiratory morbidity as compared to the female SGA group (p = 0.007, p = 0.005, respectively). There was no between-group differences in the rate of placental lesions. By multivariate logistic regression analysis, male gender (aOR 1.55, 95% CI 1.05–2.30, p = 0.025), FIR (aOR 4.83, 95% CI 1.07–13.66, p = 0.003), and VUE (aOR 1.89, 95% CI 1.03–3.47, p = 0.04), were found to be independently associated with adverse composite neonatal outcome.

Discussion

Male gender as well as placental FIR and VUE are independently associated with adverse neonatal outcome in SGA neonates.
Literature
1.
go back to reference Barke TL, Money KM, Du L et al (2019) Sex modifies placental gene expression in response to metabolic and inflammatory stress. Placenta 78:1–9CrossRef Barke TL, Money KM, Du L et al (2019) Sex modifies placental gene expression in response to metabolic and inflammatory stress. Placenta 78:1–9CrossRef
2.
go back to reference Mulder EJH, De Medina PGR, Huizink AC et al (2002) Prenatal maternal stress: effects on pregnancy and the (unborn) child. Early Hum Dev 70:3–14CrossRef Mulder EJH, De Medina PGR, Huizink AC et al (2002) Prenatal maternal stress: effects on pregnancy and the (unborn) child. Early Hum Dev 70:3–14CrossRef
4.
go back to reference Madden JV, Flatley CJ, Kumar S (2018) Term small-for-gestational-age infants from low-risk women are at significantly greater risk of adverse neonatal outcomes. Am J Obstet Gynecol 218(525):e1–525.e9 Madden JV, Flatley CJ, Kumar S (2018) Term small-for-gestational-age infants from low-risk women are at significantly greater risk of adverse neonatal outcomes. Am J Obstet Gynecol 218(525):e1–525.e9
5.
go back to reference Gur Z, Tsumi E, Wainstock T et al (2018) Association between delivery of small-for-gestational age neonate and long-term pediatric ophthalmic morbidity. Arch Gynecol Obstet 298:1095–1099CrossRef Gur Z, Tsumi E, Wainstock T et al (2018) Association between delivery of small-for-gestational age neonate and long-term pediatric ophthalmic morbidity. Arch Gynecol Obstet 298:1095–1099CrossRef
6.
go back to reference Spiegel E, Shoham-Vardi I, Sergienko R et al (2019) The association between birth weight at term and long-term endocrine morbidity of the offspring. J Matern Neonatal Med 32:2657–2661CrossRef Spiegel E, Shoham-Vardi I, Sergienko R et al (2019) The association between birth weight at term and long-term endocrine morbidity of the offspring. J Matern Neonatal Med 32:2657–2661CrossRef
7.
go back to reference Gabory A, Attig L, Junien C (2009) Sexual dimorphism in environmental epigenetic programming. Mol Cell Endocrinol 304:8–18CrossRef Gabory A, Attig L, Junien C (2009) Sexual dimorphism in environmental epigenetic programming. Mol Cell Endocrinol 304:8–18CrossRef
8.
go back to reference Sundrani DP, Roy SS, Jadhav AT et al (2017) Sex-specific differences and developmental programming for diseases in later life. Reprod Fertil Dev 29:2085–2099CrossRef Sundrani DP, Roy SS, Jadhav AT et al (2017) Sex-specific differences and developmental programming for diseases in later life. Reprod Fertil Dev 29:2085–2099CrossRef
9.
go back to reference Tarrade A, Panchenko P, Junien C et al (2015) Placental contribution to nutritional programming of health and diseases: Epigenetics and sexual dimorphism. J Exp Biol 218:50–58CrossRef Tarrade A, Panchenko P, Junien C et al (2015) Placental contribution to nutritional programming of health and diseases: Epigenetics and sexual dimorphism. J Exp Biol 218:50–58CrossRef
10.
go back to reference Kim DW, Young SL, Grattan DR et al (2014) Obesity during pregnancy disrupts placental morphology, cell proliferation, and inflammation in a sex-specific manner across gestation in the mouse1. Biol Reprod 90:1–11CrossRef Kim DW, Young SL, Grattan DR et al (2014) Obesity during pregnancy disrupts placental morphology, cell proliferation, and inflammation in a sex-specific manner across gestation in the mouse1. Biol Reprod 90:1–11CrossRef
11.
go back to reference Mandò C, Calabrese S, Mazzocco MI et al (2016) Sex specific adaptations in placental biometry of overweight and obese women. Placenta 38:1–7CrossRef Mandò C, Calabrese S, Mazzocco MI et al (2016) Sex specific adaptations in placental biometry of overweight and obese women. Placenta 38:1–7CrossRef
13.
go back to reference Brown ZA, Schalekamp-Timmermans S, Tiemeier HW et al (2014) Fetal sex specific differences in human placentation: a prospective cohort study. Placenta 35:359–364CrossRef Brown ZA, Schalekamp-Timmermans S, Tiemeier HW et al (2014) Fetal sex specific differences in human placentation: a prospective cohort study. Placenta 35:359–364CrossRef
14.
go back to reference Apel-Sarid L, Levy A, Holcberg G et al (2010) Term and preterm (%3c34 and %3c37 weeks gestation) placental pathologies associated with fetal growth restriction. Arch Gynecol Obstet 282:487–492CrossRef Apel-Sarid L, Levy A, Holcberg G et al (2010) Term and preterm (%3c34 and %3c37 weeks gestation) placental pathologies associated with fetal growth restriction. Arch Gynecol Obstet 282:487–492CrossRef
15.
go back to reference Lapaire O, Holzgreve W, Zanetti-daellenbach R (2007) Polyhydramnios: an update. Donald Sch J Ultrasound Obstet Gynecol 1:73–79CrossRef Lapaire O, Holzgreve W, Zanetti-daellenbach R (2007) Polyhydramnios: an update. Donald Sch J Ultrasound Obstet Gynecol 1:73–79CrossRef
16.
go back to reference Khong TY, Mooney EE, Ariel I et al (2016) Sampling and definitions of placental lesions Amsterdam placental workshop group consensus statement. Arch Pathol Lab Med 140:698–713CrossRef Khong TY, Mooney EE, Ariel I et al (2016) Sampling and definitions of placental lesions Amsterdam placental workshop group consensus statement. Arch Pathol Lab Med 140:698–713CrossRef
17.
go back to reference De Onis M, Habicht JP (1996) Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee. Am J Clin Nutr 64:650–658CrossRef De Onis M, Habicht JP (1996) Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee. Am J Clin Nutr 64:650–658CrossRef
18.
go back to reference Weiner E, Schreiber L, Grinstein E et al (2016) The placental component and obstetric outcome in severe preeclampsia with and without HELLP syndrome. Placenta 47:99–104CrossRef Weiner E, Schreiber L, Grinstein E et al (2016) The placental component and obstetric outcome in severe preeclampsia with and without HELLP syndrome. Placenta 47:99–104CrossRef
19.
go back to reference ACOG Committee on Obstetric Practice. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33 (2002) American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 77, 67–75 ACOG Committee on Obstetric Practice. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33 (2002) American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 77, 67–75
20.
go back to reference Hintz SR, Kendrick DE, Vohr BR et al (2006) Gender differences in neurodevelopmental outcomes among extremely preterm, extremely-low-birthweight infants. Acta Paediatr Int J Paediatr 95:1239–1248CrossRef Hintz SR, Kendrick DE, Vohr BR et al (2006) Gender differences in neurodevelopmental outcomes among extremely preterm, extremely-low-birthweight infants. Acta Paediatr Int J Paediatr 95:1239–1248CrossRef
21.
go back to reference Hindmarsh GJ, O’Callaghan MJ, Mohay HA et al (2000) Gender differences in cognitive abilities at 2 years in ELBW infants. Early Hum Dev 60:115–122CrossRef Hindmarsh GJ, O’Callaghan MJ, Mohay HA et al (2000) Gender differences in cognitive abilities at 2 years in ELBW infants. Early Hum Dev 60:115–122CrossRef
22.
go back to reference Murphy VE, Gibson PG, Giles WB et al (2003) Maternal asthma is associated with reduced female fetal growth. Am J Respir Crit Care Med 168:1317–1323CrossRef Murphy VE, Gibson PG, Giles WB et al (2003) Maternal asthma is associated with reduced female fetal growth. Am J Respir Crit Care Med 168:1317–1323CrossRef
23.
go back to reference Stark MJ, Dierkx L, Clifton VL et al (2006) Alterations in the maternal peripheral microvascular response in pregnancies complicated by preeclampsia and the impact of fetal sex. J Soc Gynecol Investig 13:573–578CrossRef Stark MJ, Dierkx L, Clifton VL et al (2006) Alterations in the maternal peripheral microvascular response in pregnancies complicated by preeclampsia and the impact of fetal sex. J Soc Gynecol Investig 13:573–578CrossRef
24.
go back to reference Seaborn T, Simard M, Provost PR et al (2010) Sex hormone metabolism in lung development and maturation. Trends Endocrinol Metab 21:729–738CrossRef Seaborn T, Simard M, Provost PR et al (2010) Sex hormone metabolism in lung development and maturation. Trends Endocrinol Metab 21:729–738CrossRef
26.
go back to reference Lin YJ, Huang LT, Tsai CC et al (2019) Maternal high-fat diet sex-specifically alters placental morphology and transcriptome in rats: assessment by next-generation sequencing. Placenta 78:44–53CrossRef Lin YJ, Huang LT, Tsai CC et al (2019) Maternal high-fat diet sex-specifically alters placental morphology and transcriptome in rats: assessment by next-generation sequencing. Placenta 78:44–53CrossRef
27.
go back to reference Tsamou M, Martens DS, Cox B et al (2018) Sex-specific associations between telomere length and candidate miRNA expression in placenta. J Transl Med 16:1–12CrossRef Tsamou M, Martens DS, Cox B et al (2018) Sex-specific associations between telomere length and candidate miRNA expression in placenta. J Transl Med 16:1–12CrossRef
28.
go back to reference Redline RW, Faye-Petersen O, Heller D et al (2003) Amniotic infection syndrome: nosology and reproducibility of placental reaction patterns. Pediatr Dev Pathol 6:435–448CrossRef Redline RW, Faye-Petersen O, Heller D et al (2003) Amniotic infection syndrome: nosology and reproducibility of placental reaction patterns. Pediatr Dev Pathol 6:435–448CrossRef
29.
go back to reference Zanardo V, Vedovato S, Suppiej A et al (2008) Histological inflammatory responses in the placenta and early neonatal brain injury. Pediatr Dev Pathol 11:350–354CrossRef Zanardo V, Vedovato S, Suppiej A et al (2008) Histological inflammatory responses in the placenta and early neonatal brain injury. Pediatr Dev Pathol 11:350–354CrossRef
Metadata
Title
Are there gender-specific differences in pregnancy outcome and placental abnormalities of pregnancies complicated with small for gestational age?
Authors
Liliya Tamayev
Letizia Schreiber
Adi Marciano
Jacob Bar
Michal Kovo
Publication date
01-05-2020
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 5/2020
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-020-05514-5

Other articles of this Issue 5/2020

Archives of Gynecology and Obstetrics 5/2020 Go to the issue