Cross sectional study in China: fetal gender has adverse perinatal outcomes in mainland China.
Cross sectional study in China: fetal gender has adverse perinatal outcomes in mainland China.
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DOI：
10.1186/s12884-014-0372-4
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发表时间：
2014-10-26
影响因子：
3.1
通讯作者：
Zhang W
中科院分区：
文献类型：
--
作者：
Hou L;Wang X;Li G;Zou L;Chen Y;Zhang W
胎儿性别与妊娠结局之间的关联已在西方人群中得到充分证明。然而，这种关联在中国还没有完整的记录。本研究的主要目的是确定不良妊娠和分娩结果与男性胎儿的关联是否适用于中国人群。这项以医院为基础的横断面回顾性调查收集了 2011 年中国大陆 39 家医院的数据。总共包括 109,722 名妊娠 28 周后分娩的单胎妊娠妇女。在这些怀孕中，男女性别比为1.2。男性新生儿的早产率（男性7.3%，女性6.5%）和巨大胎儿（男性8.3%，女性5.1%）发生率较高，而女性母亲的胎儿生长受限（女性8.0%，男性5.4%）和胎先露异常（女性4.3%，男性3.6%）发生率更高。男性胎儿与手术阴道分娩（男性 1.3%，女性 1.1%）、剖腹产（男性 55.0%，女性 52.9%）和头盆不称/进展失败（男性 10.0%，女性 9.2%）的发生率增加相关。即使在对混杂因素进行调整后（调整后的比值比 1.3，95% CI 1.1-1.5，调整后的比值比 1.4，95% CI 1.1-1.8），男性也与较低的 Apgar 评分（5 分钟时<7，调整后的比值比 1.3，95% CI 1.0-1.6）以及新生儿重症监护病房入住和新生儿死亡显着相关。我们证实我们的人群中存在明显的新生儿性别偏见以及男性胎儿在怀孕和分娩期间的不良结局。需要进一步的研究来了解这种现象的机制和临床意义。本文的在线版本 (doi:10.1186/s12884-014-0372-4) 包含补充材料，可供授权用户使用。
The association between fetal gender and pregnancy outcomes has been thoroughly demonstrated in western populations. However, this association has not been thoroughly documented in China. The primary objective of the present study is to determine whether the association of adverse pregnancy and labour outcomes with male fetuses applies to the Chinese population. This cross-sectional hospital-based retrospective survey collected data from thirty-nine hospitals in 2011 in mainland China. A total of 109,722 women with singleton pregnancy who delivered after 28 weeks of gestation were included. Of these pregnancies, the male-to-female sex ratio was 1.2. The rates of preterm birth (7.3% for males, 6.5% for females) and fetal macrosomia (8.3% for males, 5.1% for females) were higher for male newborns, whereas fetal growth restriction (8.0% for females, 5.4% for males) and malpresentation (4.3% for females, 3.6% for males) were more frequent among female-bearing mothers. A male fetus was associated with an increased incidence of operative vaginal delivery (1.3% for males, 1.1% for females), caesarean delivery (55.0% for males, 52.9% for females), and cephalopelvic disproportion/failure to progress (10.0% for males, 9.2% for female). Male gender was also significantly associated with lower Apgar scores (<7 at 5 min, adjusted odds ratio 1.3, 95% CI 1.0-1.6), as well as a neonatal intensive care unit admission and neonatal death, even after adjustments for confounders (adjusted odds ratio 1.3, 95% CI 1.1-1.5, adjusted odds ratio 1.4, 95% CI 1.1-1.8). We confirm the existence of obvious neonatal gender bias and adverse outcomes for male fetuses during pregnancy and labour in our population. Further research is required to understand the mechanisms and clinical implications of this phenomenon. The online version of this article (doi:10.1186/s12884-014-0372-4) contains supplementary material, which is available to authorized users.
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作者：
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DOI：
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通讯作者：
Turner, MJ