Abstract
Fetal sex has been identified as an important factor influencing pregnancy outcomes, but its impact on fetal heart rate (FHR) variability in uncomplicated pregnancies is still unclear. The objective of the study was to assess short-term variability (STV) and other computerized cardiotocography (cCTG) parameters in relation to fetal sex during fetal antepartum surveillance. We retrospective compared cCTG parameters of male and female fetuses in uncomplicated singleton pregnancies at term. In addition to univariate analysis, a multivariate analysis was performed taking into account maternal characteristics. A total of 689 cCTG recordings were analyzed: 335 from male fetuses and 354 from female fetuses. Analysis of cCTG results by fetal sex showed no significant difference in percentage of signal loss, number of contractions, movements, accelerations and decelerations, long-term variability (LTV), and STV at both uni-and multivariate analysis. There was a statistically significant difference for baseline FHR at the univariate analysis, which was not confirmed by a multivariate analysis. Our results suggest that fetal sex did not affect cCTG parameters in uncomplicated term singleton pregnancies, and therefore it does not need to be taken into account when interpreting cCTG in physiological conditions.
Highlights
Fetal sex has been identified as an important factor influencing both fetal and maternal outcome.The hormonal secretion of various substances during pregnancy is influenced by fetal sex [1,2,3].some placental functions are sex-specific with different pathways of gene expression, proteins, and steroids according to the sex of the fetus
Analysis of computerized cardiotocography (cCTG) results by fetal sex showed no significant difference in percentage of signal loss, number of contractions, movements, accelerations and decelerations, long-term variability (LTV), and short-term variability (STV) at both uni- and multivariate analysis
There was a statistically significant difference for the baseline fetal heart rate (FHR) at the univariate analysis (Table 2, p < 0.05), which was not confirmed by a multivariate analysis
Summary
Some placental functions are sex-specific with different pathways of gene expression, proteins, and steroids according to the sex of the fetus This sex-specific difference in the feto-placental immune system results in the adoption of different strategies by males and females to face the same adverse maternal environment. Males have a greater risk of adverse outcome because of minimal placental adjustment with the aim of ensuring continued growth [4]. Many studies support this statement, showing an increased risk of preterm birth, cesarean delivery, failed induction of labor, perinatal mortality, and gestational diabetes in pregnant women with male fetuses [4,5]. The multiple placental adaptations in gene and protein expression in female fetuses result in increased survival, at the expense of reduced fetal growth and resulting in an increased risk of developing
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