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

Zoe A Broere-Brown; Maria C Adank; Laura Benschop; Myrte Tielemans; Taulant Muka; Romy Gonçalves; Wichor M Bramer; Josje D Schoufour; Trudy Voortman; Eric A P Steegers; Oscar H Franco; Sarah Schalekamp-Timmermans

doi:10.1186/s13293-020-00299-3

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

Zoe A Broere-Brown, Maria C Adank, Laura Benschop, Myrte Tielemans, Taulant Muka, Romy Gonçalves, Wichor M Bramer, Josje D Schoufour, Trudy Voortman, Eric A P Steegers, Oscar H Franco, Sarah Schalekamp-Timmermans

Amsterdam University of Applied Sciences (AUAS)

Research output: Contribution to journal › Review article › Academic › peer-review

14 Citations (Scopus)

146 Downloads (Pure)

Abstract

BACKGROUND: Since the placenta also has a sex, fetal sex-specific differences in the occurrence of placenta-mediated complications could exist.

OBJECTIVE: To determine the association of fetal sex with multiple maternal pregnancy complications.

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.

SELECTION CRITERIA: Observational studies that assessed fetal sex and the presence of maternal pregnancy complications within singleton pregnancies.

DATA COLLECTION AND ANALYSES: Data were extracted by 2 independent reviewers using a predesigned data collection form.

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.

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.

FUNDING: None.

Original language	English
Article number	26
Pages (from-to)	26
Journal	Biology of sex differences
Volume	11
DOIs	https://doi.org/10.1186/s13293-020-00299-3
Publication status	Published - 11 May 2020

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Broere-Brown, Z. A., Adank, M. C., Benschop, L., Tielemans, M., Muka, T., Gonçalves, R., Bramer, W. M., Schoufour, J. D., Voortman, T., Steegers, E. A. P., Franco, O. H., & Schalekamp-Timmermans, S. (2020). Fetal sex and maternal pregnancy outcomes: a systematic review and meta-analysis. Biology of sex differences, 11, 26. Article 26. https://doi.org/10.1186/s13293-020-00299-3

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title = "Fetal sex and maternal pregnancy outcomes: a systematic review and meta-analysis",

abstract = "BACKGROUND: Since the placenta also has a sex, fetal sex-specific differences in the occurrence of placenta-mediated complications could exist.OBJECTIVE: To determine the association of fetal sex with multiple maternal pregnancy complications.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.SELECTION CRITERIA: Observational studies that assessed fetal sex and the presence of maternal pregnancy complications within singleton pregnancies.DATA COLLECTION AND ANALYSES: Data were extracted by 2 independent reviewers using a predesigned data collection form.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.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.FUNDING: None.",

keywords = "Fetal sex, Pregnancy complications",

author = "Broere-Brown, {Zoe A} and Adank, {Maria C} and Laura Benschop and Myrte Tielemans and Taulant Muka and Romy Gon{\c c}alves and Bramer, {Wichor M} and Schoufour, {Josje D} and Trudy Voortman and Steegers, {Eric A P} and Franco, {Oscar H} and Sarah Schalekamp-Timmermans",

year = "2020",

month = may,

day = "11",

doi = "10.1186/s13293-020-00299-3",

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journal = "Biology of sex differences",

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TY - JOUR

T1 - Fetal sex and maternal pregnancy outcomes

T2 - a systematic review and meta-analysis

AU - Broere-Brown, Zoe A

AU - Adank, Maria C

AU - Benschop, Laura

AU - Tielemans, Myrte

AU - Muka, Taulant

AU - Gonçalves, Romy

AU - Bramer, Wichor M

AU - Schoufour, Josje D

AU - Voortman, Trudy

AU - Steegers, Eric A P

AU - Franco, Oscar H

AU - Schalekamp-Timmermans, Sarah

PY - 2020/5/11

Y1 - 2020/5/11

N2 - BACKGROUND: Since the placenta also has a sex, fetal sex-specific differences in the occurrence of placenta-mediated complications could exist.OBJECTIVE: To determine the association of fetal sex with multiple maternal pregnancy complications.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.SELECTION CRITERIA: Observational studies that assessed fetal sex and the presence of maternal pregnancy complications within singleton pregnancies.DATA COLLECTION AND ANALYSES: Data were extracted by 2 independent reviewers using a predesigned data collection form.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.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.FUNDING: None.

AB - BACKGROUND: Since the placenta also has a sex, fetal sex-specific differences in the occurrence of placenta-mediated complications could exist.OBJECTIVE: To determine the association of fetal sex with multiple maternal pregnancy complications.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.SELECTION CRITERIA: Observational studies that assessed fetal sex and the presence of maternal pregnancy complications within singleton pregnancies.DATA COLLECTION AND ANALYSES: Data were extracted by 2 independent reviewers using a predesigned data collection form.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.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.FUNDING: None.

KW - Fetal sex

KW - Pregnancy complications

UR - http://www.scopus.com/inward/record.url?scp=85084592974&partnerID=8YFLogxK

U2 - 10.1186/s13293-020-00299-3

DO - 10.1186/s13293-020-00299-3

M3 - Review article

C2 - 32393396

SN - 2042-6410

VL - 11

SP - 26

JO - Biology of sex differences

JF - Biology of sex differences

M1 - 26

ER -

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

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