Title
Sex difference in disability and handicap at five years of age in children born at very short gestation
Author
Verloove-Vanhorick, S.P.
Veen, S.
Ens-Dokkum, M.H.
Schreuder, A.M.
Brand, R.
Ruys, J.H.
TNO Preventie en Gezondheid
Publication year
1994
Abstract
Objective. The objective of this study was to examine the relationship between sex and disabilities or handicaps at 5 years of age in infants born at less than 32 weeks gestation. Design. From the nationwide collaborative survey starting in 1983, including perinatal data obtained during routine perinatal care and follow-up assessments by the attending pediatricians, data from 1008 infants fulfilling the criteria were used. At age 5 years, a detailed assessment was performed by three specially trained pediatricians in 96% surviving infants (n = 648), of which 345 were boys. Each child was categorized as disabled or handicapped, using World Health Organization definitions. Results. The prevalence of handicaps was three times greater in boys than in girls (21% vs 7%, odds ratio 3.2). Adjustment for gestational age and birth weight (logistic regression analysis) did not change this (odds ratio 3.5). Further adjustment by including perinatal variables such as idiopathic respiratory distress syndrome did not alter the odds ratios. The male excess in handicaps was not related to lower mortality, and therefore was not a mere consequence of a higher survival rate. The excess in handicaps was found in all assessed areas. Conclusions. Infants' sex seems to be an important determinant of handicaps. The perinatal variables used in the present study do not explain the difference in handicaps. These findings emphasize the need to include the sex distribution of a study population more systematically in analyses in future studies concerning long-term outcome of very preterm birth or low birth weight.
Subject
Disabilities
Handicaps
Low birth weight
Outcome
Preschool age
Sequelae
Brain hemorrhage
Follow up
Handicapped child
Infant
Low birth weight
Major clinical study
Physical disability
Prematurity
Prevalence
Respiratory distress syndrome
Seizure
Sepsis
Sex difference
Child, Preschool
Disabled Persons
Female
Follow-Up Studies
Gestational Age
Human
Infant Mortality
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature
Male
Mortality
Odds Ratio
Sex Factors
Support, Non-U.S. Gov't
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TNO identifier
232419
ISSN
0031-4005
Source
Pediatrics, 93 (4), 576-579
Document type
article