Sex differences in 2-Year Neurodevelopmental Outcomes in High-risk Infants

Ines Kathrin Weyand*, Denise Hart**, Brigitte Vollmer***
Southampton, Childrens Hospital, Southampton University*, Southampton, Childrens Hospital, Southampton University**, Southampton, Children’s Hospital, Southampton University***
In the last decades, neonatal treatment improved immensely. However the incidence of neurological impairments in NICU suvivors did not improve simultaneously1. Standardized follow-up programmes promise early, reliable detection of neurological and developmental dysfunctions1,2,3. Existing studies in preterm born (PT) children, e.g. EPICURE study4, suggest sex differences in outcomes.

We were interested to investigate this in our PT infants and also to explore potential sex differences in infants with HIE (T-HIE).
We investigated outcomes at two years corrected in 122 (71 PT, 32 girls; 41 T-HIE, 16 girls) of a total of 134 children (12 children with Cerebral Palsy, 7 T-HIE and 5 PT, were excluded), who had been treated at Princess Anne Hospital, Southampton. Cognitive, language and motor outcomes were assessed with the Bayley Scales of Infant and Toddler Development-III(BSITD)5.
Mean BSITD composite scores for PT infants were: cognitive 103.68 (SD21.16), language 98.16 (SD16.74), motor 105.44 (SD17.43). In T-HIE born infants mean BSITD composite scores were: cognitive 103.62 (SD17.52), language 98.04 (SD14.49), motor 106.48 (SD20.70). Girls had overall higher scores than boys. On all three scales, PT girls had significantly higher scores compared to boys as follows: cognitive female: 109.62 SD25.73, male: 98.71 SD15.11; language female: 100.08 (SD18.22), male: 96.45 (SD15.56); motor female: 107.92 (SD19.93), male: 103.21 (SD14.85). In the T-HIE group, sex differences were not significant. However, there was a trend for T-HIE girls having higher scores in cognitive and motor composite scores.
Both groups showed sex differences in cognitive, language and motor developmental outcome at age two years. This was more pronounced in the PT group. Consistent with the literature, there were significant sex differences in the PT group (e.g. Peacock et al4). In contrast, in the HIE group, no significant sex differences were seen; this needs to be confirmed by larger studies.
References :
  1. Stevenson DK, Benitz WE, Sunshine P, Hintz SR, Druzin ML. Fetal and Neonatal Brain Injury. 4th ed. Cambridge: Cambridge University Press; 2009.
  2. Van Schie PEM., Schijns J., Becher JG., Barkhof F., van Weissenbruch MM., Vermeulen RJ. Long-term motor and behavioral outcome after perinatal hypoxic-ischemic encephalopathy. European Journal of Paediatric Neurology. 2015; 1:1-6
  3. Peacock JL, Marston L, Marlow N, Calvert SA, Greenough A. Neonatal and infant outcomes in boys and girls born very prematurely. Nature. 2012; 71(3):305-310. doi:10.1038/pr.2011.50 .
  4. Marlow N, Wolke D, Bracewell MA, Samara M; EPICure Study Group. Neurologic and developmental disability at six years of age after extremely preterm birth. New England Journal of Medicine. 2005; 352(1):9-19. doi: 10.1056/NEJMoa041367.
  5. Pearson Clinical. Bayley Scale for Infants and Toddler Development Third Edition (Bayley-II); (last access: April 4th 2015).

DOI: 10.7199/ped.oncall.2015.4S
How to Cite URL :
Weyand K I, Hart D, Vollmer B.. Available From :
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