Sex Differences Between Female and Male Newborn Piglets During Asphyxia, Resuscitation, and Recovery.

Ramin P La Garde,Maryna Yaskina,Tze-Fun Lee,Georg M Schmölzer,Po-Yin Cheung,Megan O'Reilly

doi:10.3389/fped.2019.00290

Ramin P La Garde, Maryna Yaskina + Show 4 more

Open Access

https://doi.org/10.3389/fped.2019.00290

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Abstract

Background: Male and female newborns have differences in their fetal development, fetal-to-neonatal transition, and postnatal morbidity. However, the cardiovascular fetal-to-neonatal adaption is similar between sexes. No study has examined sex differences in newborns during hypoxia, asphyxia, cardio-pulmonary resuscitation, or post-resuscitation recovery.Methods: Secondary analysis (two previous publications and two studies currently under peer-review) of 110 term newborn mixed breed piglets (1–3 days of age, weighing 2.0 ± 0.2 kg), which were exposed to 30 min normocapnic hypoxia followed by asphyxia until asystole, which was achieved by disconnecting the ventilator and clamping the endotracheal tube. This was followed by cardio-pulmonary resuscitation. For the analysis piglets were divided into female and male groups. Cardiac function, carotid blood flow, and cerebral and renal oxygenation were continuously recorded throughout the experiment.Results: A total of 35/41 (85%) female and 54/69 (78%) male piglets resuscitated achieved ROSC (p = 0.881). The median (IQR) time to achieve return of spontaneous circulation in females and males was 111 (80–228) s and 106 (80–206) s (p = 0.875), respectively. The 4-h survival rate was similar between females and males with 28/35 (80%) and 49/54 (91%) piglets surviving (p = 0.241), respectively.Conclusions: No difference between female and male newborn piglets was observed during hypoxia, asphyxia, resuscitation, and post-resuscitation recovery.

Highlights

Male and female newborns have differences in their fetal development, fetal-to-neonatal transition, and postnatal morbidity [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16]
Secondary analysis of 110 term newborn mixed breed piglets (1–3 days of age, weighing 2.0 ± 0.2 kg), which were exposed to 30 min normocapnic hypoxia followed by asphyxia until asystole, which was achieved by disconnecting the ventilator and clamping the endotracheal tube
No difference between female and male newborn piglets was observed during hypoxia, asphyxia, resuscitation, and post-resuscitation recovery

Summary

Introduction

Male and female newborns have differences in their fetal development, fetal-to-neonatal transition, and postnatal morbidity [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16]. Male infants are more commonly born premature [12], have neonatal respiratory disease (e.g., respiratory distress or chronic lung disease) [5], higher newborn and infant mortality [4, 12], and worse long-term outcomes [13]. Sex Differences During Neonatal Resuscitation female infants are born with improved organ maturation, which translates into improved lung development [18], surfactant phospholipid composition, and surfactant function [2, 3, 13]. The male disadvantage cannot be explained by difference in the cardiovascular fetal-to-neonatal adaption [1]. Male and female newborns have differences in their fetal development, fetal-to-neonatal transition, and postnatal morbidity. No study has examined sex differences in newborns during hypoxia, asphyxia, cardio-pulmonary resuscitation, or post-resuscitation recovery

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