Abstract
Background: There are many pregnancy complications that are significantly associated with the gender of the fetus; one of them is preterm labour, which is an important obstetric problem that may lead to many perinatal morbidity and mortality. Objective: To find out whether there is a relation between the findings of placental pathology of premature deliveries and gender difference. Patients and Methods: Fifty deliveries before a 32 week gestational age. Obstetrical, and placental histological findings have been compared among all males (n=25), and females (n=25) premature neonates. Results: The male premature fetus had distribution rate in maternal age, gestation age at the time of delivery, placental weight, and feto-placental weight-ratio in females, but a higher birth-weight centile ([55.09±11.3] versus [43.09±8.2]). Histopathology of the placenta found no significant association of fetal-sex with acute inflammatory lesions (p=0.09), intra-placental vascular pathological findings, or utero-placental vascular pathology. However, the chronic inflammatory lesion showed a higher pathological score in male fetuses than in the females (p=0.01). Conclusion: Premature deliveries with less than thirty-two weeks, the male fetal-sex had higher placental pathological lesions, suggesting maternal immunological responses towards the invading trophoblasts. The immunological background of these pathological lesions needs further studies. Keywords: Male fetal sex, placental pathology, premature delivery
Highlights
Fetal sex and preterm birth: in most populations, there was more male gender among pre-term and early pre-term births including IVF births
The comparison between male and female gender in obstetrical history according to which preterm was anticipated were shown no significant difference in between male and female gender in preterm labour, PROM, and abruption (p-value 0.6) in preeclampsia there is lower rate [2(8%)] for male versus [3 (12%)] for female (p-value 0.7)
Antonio Farina University of Bologona Italy[7] found spontaneous preterm labour is thought to result from the pathological and untimely activation of the common terminal pathway of the partition. This current study's findings suggest that in extremely preterm fetuses, there is a significantly increased chronic inflammation in male genders at the maternal-placental interphase. This result is consistent with that of Jahanfar et al [8] who reported that inflammatory cells in the chronic chorioaminionitis have distribution in the membrane similar to that seen in acute chorioaminionitis include involvement of free fetal membrane or chorionic plate and there was a tendency toward low birth weight and high frequency of preterm labour [7,8,9,10]
Summary
Fetal sex and preterm birth: in most populations, there was more male gender among pre-term and early pre-term births including IVF births. The ratio of male-births seems to decline with the advance in gestation age. Males have higher fetal and neonatal mortality rates. Objective: To find out whether there is a relation between the findings of placental pathology of premature deliveries and gender difference. Obstetrical, and placental histological findings have been compared among all males (n=25), and females (n=25) premature neonates. Results: The male premature fetus had distribution rate in maternal age, gestation age at the time of delivery, placental weight, and feto-placental weight-ratio in females, but a higher birthweight centile ([55.09±11.3] versus [43.09±8.2]). Conclusion: Premature deliveries with less than thirty-two weeks, the male fetal-sex had higher placental pathological lesions, suggesting maternal immunological responses towards the invading trophoblasts.
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