Correlation of gender with neonatal outcome in babies born to mothers with hypertensive disorder of pregnancy

Olivia Jean Mathias; Simran Vachhani; A. R. Rajan; Deepak Joshi

doi:10.18203/2349-3291.ijcp20260402

Authors

Olivia Jean Mathias Symbiosis Medical College for Women & Symbiosis University Hospital & Research Centre, Symbiosis International (Deemed University), Lavale, Pune, Maharashtra, India https://orcid.org/0009-0003-3896-6759
Simran Vachhani Symbiosis Medical College for Women & Symbiosis University Hospital & Research Centre, Symbiosis International (Deemed University), Lavale, Pune, Maharashtra, India https://orcid.org/0000-0001-8021-6925
A. R. Rajan Department of Paediatrics Symbiosis Medical College for Women & Symbiosis University Hospital & Research Centre, Symbiosis International (Deemed University), Lavale, Pune, Maharashtra, India
Deepak Joshi Department of Paediatrics Symbiosis Medical College for Women & Symbiosis University Hospital & Research Centre, Symbiosis International (Deemed University), Lavale, Pune, Maharashtra, India https://orcid.org/0000-0002-6532-2356

DOI:

https://doi.org/10.18203/2349-3291.ijcp20260402

Keywords:

Gender, Hypertensive disease of pregnancy, Neonatal outcomes

Abstract

Background: Hypertensive disease of pregnancy (HDOP) has a prevalence of 6.9%. The study analysed the correlation between gender and neonatal outcomes in mothers with HDOP.

Methods: A retrospective descriptive study analysed 203 neonates born to mothers with HDOP in a tertiary care hospital.

Results: During the study period 3259 deliveries were conducted of which 203 deliveries met our inclusion criteria (106 male and 97 female). In 142 neonates (69.95%) mode of delivery was LSCS with male gender being significantly higher (p<0.05). Of 203 neonates, 65 (32.02 %) needed NICU care. Respiratory distress syndrome (61.11%) was the commonest morbidity. The mean period of gestation in male neonates was 262.17 days and 262.29 in females. The mean birth weight for male neonates was 2186.52 grams, while for female neonates was 2507.53 grams (p<0.05). Of the 203 neonates in our study, 93 were found to be small for gestational age. The mean duration of NICU stay for neonates was 5.08 days for males and 1.55 days for females. (p<0.05). The mean duration of hospital stay for male neonates was 13.52 days and for female neonates was 7.74 days (p<0.05). The mean placental weight for the female gender was 386.29 g and for the male gender was 390.69 g.

Conclusions: Male gender showed statistically significant positive correlation (p<0.05) for low birth weight, mode of delivery and duration of both NICU and Hospital stay.

Metrics

Metrics Loading ...

References

Chowdhury Collins HE, Alexander BT, Care AS, Davenport MH, Davidge ST, Eghbali M, et al. Guidelines for assessing maternal cardiovascular physiology during pregnancy and postpartum. Am J Physiol Heart Circ Physiol. 2024;1;327(1):191-220. DOI: https://doi.org/10.1152/ajpheart.00055.2024

Poon LC, Nguyen-Hoang L, Smith GN, Bergman L, O'Brien P, Hod M, et al. FIGO Committee on Impact of Pregnancy on Long-term Health and the FIGO Division of Maternal and Newborn Health. Hypertensive disorders of pregnancy and long-term cardiovascular health: FIGO Best Practice Advice. Int J Gynaecol Obstet. 2023;160(1):22-34. DOI: https://doi.org/10.1002/ijgo.14540

Qu H, Khalil RA. Vascular mechanisms and molecular targets in hypertensive pregnancy and preeclampsia. Am J Physiol Heart Circ Physiol. 2020;319(3):661-81. DOI: https://doi.org/10.1152/ajpheart.00202.2020

Mathew R, Devanesan BP, Srijana, Sreedevi NS. Prevalence of hypertensive disorders of pregnancy, associated factors and pregnancy complications in a primigravida population. Gynecol Obstet Clin Med. 2023;3(2):119–23. DOI: https://doi.org/10.1016/j.gocm.2023.01.002

Cunningham FG, Leveno KJ, Dashe JS, Hoffman BL, Spong CY, Casey BM. Preeclampsia syndrome. Am J Obstet Gynecol. 2022;6:74.

Dhinwa M, Gawande K, Jha N, Anjali M, Bhadoria AS, Sinha S. Prevalence of hypertensive disorders of pregnancy in India: a systematic review and meta-analysis. J Med Evid. 2021;2(2):105–12. DOI: https://doi.org/10.4103/JME.JME_168_20

Garovic VD, White WM, Vaughan L, Saiki M, Parashuram S, Garcia-Valencia O, et al. Incidence and Long-Term Outcomes of Hypertensive Disorders of Pregnancy. J Am Coll Cardiol. 2020;12;75(18):2323-34. DOI: https://doi.org/10.1016/j.jacc.2020.03.028

Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020;135(6):237-60. DOI: https://doi.org/10.1097/AOG.0000000000003891

Hercus JC, Metcalfe KX, Christians JK. Sex differences in growth and mortality in pregnancy-associated hypertension. PLoS One. 2024;19(1):296853. DOI: https://doi.org/10.1371/journal.pone.0296853

Lorente-Pozo S, Parra-Llorca A, Torres B, Torres-Cuevas I, Nuñez-Ramiro A, Cernada M, et al. Influence of Sex on Gestational Complications, Fetal-to-Neonatal Transition and Postnatal Adaptation. Front Pediatr. 2018;23:63. DOI: https://doi.org/10.3389/fped.2018.00063

Zhou C, Yan Q, Zou QY, Zhong XQ, Tyler CT, Magness RR, et al. Sexual Dimorphisms of Preeclampsia-Dysregulated Transcriptomic Profiles and Cell Function in Fetal Endothelial Cells. Hypertension. 2019;74(1):154-63. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.118.12569

Jeong DS, Lee JY, Kim MH, Oh JH. Regulation of sexually dimorphic placental adaptation in LPS exposure-induced intrauterine growth restriction. Mol Med. 2023;18;29(1):114. DOI: https://doi.org/10.1186/s10020-023-00688-5

Bromfield SG, Ma Q, DeVries A, Inglis T, Gordon AS. The association between hypertensive disorders during pregnancy and maternal and neonatal outcomes: a retrospective claims analysis. BMC Pregnancy Childbirth. 2023;14;23(1):514. DOI: https://doi.org/10.1186/s12884-023-05818-9

Taylor BD, Ness RB, Klebanoff MA, Tang G, Roberts JM, Hougaard DM, et al. The impact of female fetal sex on preeclampsia and the maternal immune milieu. Pregnancy Hypertens. 2018;12:53-57. DOI: https://doi.org/10.1016/j.preghy.2018.02.009

Antonakou A, Papoutsis D. The Effect of Fetal Gender on the Delivery Outcome in Primigravidae Women with Induced Labours for all Indications. J Clin Diagn Res. 2016;10(12):22-5. DOI: https://doi.org/10.7860/JCDR/2016/22099.9104

van Esch JJA, van Heijst AF, de Haan AFJ, van der Heijden OWH. Early-onset preeclampsia is associated with perinatal mortality and severe neonatal morbidity. J Matern Fetal Neonatal Med. 2017;30(23):2789-94. DOI: https://doi.org/10.1080/14767058.2016.1263295

Broere-Brown ZA, Adank MC, Benschop L, Tielemans M, Muka T, Gonçalves R, et al. Fetal sex and maternal pregnancy outcomes: a systematic review and meta-analysis. Biol Sex Differ. 2020;11(1):26. DOI: https://doi.org/10.1186/s13293-020-00299-3

Funaki S, Ogawa K, Ozawa N, Hosoya S, Okamoto A, Urayama KY, et al. Association between fetal sex and pregnancy outcomes among women with twin pregnancies: a multicenter cross-sectional study. Arch Gynecol Obstet. 2023;307(5):1397-405. DOI: https://doi.org/10.1007/s00404-022-06623-z

Lee JY, Lee SH. Hypertensive disorders of pregnancy: advances in understanding and management. Clin Hypertens. 2025;2:31. DOI: https://doi.org/10.5646/ch.2025.31.e1

Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al. International Society for the Study of Hypertension in Pregnancy (ISSHP). The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens. 2018;13:291-310. DOI: https://doi.org/10.1016/j.preghy.2018.05.004

Di Renzo GC, Rosati A, Sarti RD, Cruciani L, Cutuli AM. Does fetal sex affect pregnancy outcome? Gend Med. 2007;4(1):19-30. DOI: https://doi.org/10.1016/S1550-8579(07)80004-0

Cidade-Rodrigues C, Chaves C, Melo A, Novais-Araújo A, Figueiredo O, Gomes V, et al. Association between foetal sex and adverse neonatal outcomes in women with gestational diabetes. Arch Gynecol Obstet. 2024;309(4):1287-94. DOI: https://doi.org/10.1007/s00404-023-06979-w

Shah S, Gupta A. Hypertensive Disorders of Pregnancy. Cardiol Clin. 2019;37(3):345-54. DOI: https://doi.org/10.1016/j.ccl.2019.04.008

Obsa M, Wolka Woticha E, Girma Weji B. Neonatal and Fetal Outcomes of Pregnant Mothers with Hypertensive Disorder of Pregnancy at Hospitals in Wolaita Zone, Southern Ethiopia. Journal of Midwifery and Reproductive Health, 2019;7(2):1636-40.

Sheiner E, Levy A, Katz M, Hershkovitz R, Leron E, Mazor M. Gender does matter in perinatal medicine. Fetal Diagn Ther. 2004;19(4):366-9. DOI: https://doi.org/10.1159/000077967

Aibar L, Puertas A, Valverde M, Carrillo MP, Montoya F. Fetal sex and perinatal outcomes. J Perinat Med. 2012;40(3):271-6. DOI: https://doi.org/10.1515/jpm-2011-0137

Rocha de Moura MD, Margotto PR, Nascimento Costa K, Carvalho Garbi Novaes MR. Hypertension induced by pregnancy and neonatal outcome: Results from a retrospective cohort study in preterm under 34 weeks. PLoS One. 2021;16(8):255783. DOI: https://doi.org/10.1371/journal.pone.0255783

Chang KJ, Seow KM, Chen KH. Preeclampsia: Recent Advances in Predicting, Preventing and Managing the Maternal and Fetal Life-Threatening Condition. Int J Environ Res Public Health. 2023;20(4):2994. DOI: https://doi.org/10.3390/ijerph20042994

Jain A, Sharma D, Sharma V, Baweja S, Jain R. Study of placental weight in normal and pre-eclamptic pregnancies and its correlation with birth weight. Int J Med Res Rev. 2016;4(4):562-8. DOI: https://doi.org/10.17511/ijmrr.2016.i04.15

Callais NA, Morgan JA, Leggio BA, Wang Y. Association of fetal gender and the onset and severity of hypertensive disorders of pregnancy. J Matern Fetal Neonatal Med. 2022;35(12):2260-5. DOI: https://doi.org/10.1080/14767058.2020.1783654