ArticlePloS one2016
Sexual Dimorphism in Adverse Pregnancy Outcomes - A Retrospective Australian Population Study 1981-2011.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 4 of them syntheses that pooled it.
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Who cites it
51 citing papers in PubMed, 4 syntheses or guidelines pooled it, 98 citations in OpenAlex.
- The influence of fetal sex on maternal blood pressure in pregnancy.BMC medicine · 2025Pooled it
- Sex differences in the effects of prematurity and/or low birthweight on neurodevelopmental outcomes: systematic review and meta-analyses.Biology of sex differences · 2023Pooled it
- Another piece of the Zika puzzle: assessing the associated factors to microcephaly in a systematic review and meta-analysis.BMC public health · 2020Pooled it
- Fetal sex and maternal pregnancy outcomes: a systematic review and meta-analysis.Biology of sex differences · 2020Pooled it
- Fetal sex shapes placental inflammatory responses to extracellular mitochondrial DNA.bioRxiv : the preprint server for biology · 2026Article
- High folic acid supplementation is associated with vaginal bleeding in early pregnancy in a fetal sex-specific manner: findings from two prospective cohort studies.Reproductive health · 2026Article
- Analysis of prenatal medication use and placental epigenetic gestational age in extremely low gestational age newborns (ELGANs) highlight relationships to aspirin use during pregnancy.Clinical epigenetics · 2025Article
- Roles of chromosomal and gonadal sex in the fetal and placental responses to maternal food restriction in mice.Molecular human reproduction · 2025Article
- Sex-specific phenotypical, functional and metabolic profiles of human term placenta macrophages.Biology of sex differences · 2024Article
- Sexually dimorphic DNA methylation and gene expression patterns in human first trimester placenta.Biology of sex differences · 2024Article
- Sex-specific associations between placental corticotropin releasing hormone and problem behaviors in childhood.Psychoneuroendocrinology · 2024Article
- Fetal Sexual Dimorphism and Preeclampsia Among Twin Pregnancies.Hypertension (Dallas, Tex. : 1979) · 2024Article
- Overexpression of Human sFLT1 in the Spongiotrophoblast Is Sufficient to Induce Placental Dysfunction and Fetal Growth Restriction in Transgenic Mice.International journal of molecular sciences · 2024Article
- Article
- The influence of fetal sex on antenatal maternal glucose and insulin dynamics.Frontiers in clinical diabetes and healthcare · 2024Review
- High-Dose Vitamin D Supplementation Significantly Affects the Placental Transcriptome.Nutrients · 2023Article
- Fetal sexual dimorphism and preeclampsia among twin pregnancies.medRxiv : the preprint server for health sciences · 2023Article
- Adverse birth outcomes are associated with circulating matrix metalloproteinases among pregnant women in Puerto Rico.Journal of reproductive immunology · 2023Article
- Sex differences in placenta-derived markers and later autistic traits in children.Translational psychiatry · 2023Article
- Inequalities of Infant Mortality in Ethiopia.International journal of environmental research and public health · 2023Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesSexual inequality starts in utero. The contribution of biological sex to the developmental origins of health and disease is increasingly recognized. The aim of this study was to assess and interpret sexual dimorphisms for three major adverse pregnancy outcomes which affect the health of the neonate, child and potentially adult.
methodsRetrospective population-based study of 574,358 South Australian singleton live births during 1981-2011. The incidence of three major adverse pregnancy outcomes [preterm birth (PTB), pregnancy induced hypertensive disorders (PIHD) and gestational diabetes mellitus (GDM)] in relation to fetal sex was compared according to traditional and fetus-at-risk (FAR) approaches.
resultsThe traditional approach showed male predominance for PTB [20-24 weeks: Relative Risk (RR) M/F 1.351, 95%-CI 1.274-1.445], spontaneous PTB [25-29 weeks: RR M/F 1.118, 95%-CI 1.044-1.197%], GDM [RR M/F 1.042, 95%-CI 1.011-1.074], overall PIHD [RR M/F 1.053, 95%-CI 1.034-1.072] and PIHD with term birth [RR M/F 1.074, 95%-CI 1.044-1.105]. The FAR approach showed that males were at increased risk for PTB [20-24 weeks: RR M/F 1.273, 95%-CI 1.087-1.490], for spontaneous PTB [25-29 weeks: RR M/F 1.269, 95%-CI 1.143-1.410] and PIHD with term birth [RR M/F 1.074, 95%-CI 1.044-1.105%]. The traditional approach demonstrated female predominance for iatrogenic PTB [25-29 weeks: RR M/F 0.857, 95%-CI 0.780-0.941] and PIHD associated with PTB [25-29 weeks: RR M/F 0.686, 95%-CI 0.581-0.811]. The FAR approach showed that females were at increased risk for PIHD with PTB [25-29 weeks: RR M/F 0.779, 95%-CI 0.648-0.937].
conclusionsThis study confirms the presence of sexual dimorphisms and presents a coherent framework based on two analytical approaches to assess and interpret the sexual dimorphisms for major adverse pregnancy outcomes. The mechanisms by which these occur remain elusive, but sex differences in placental gene expression and function are likely to play a key role. Further research on sex differences in placental function and maternal adaptation to pregnancy is required to delineate the causal molecular mechanisms in sex-specific pregnancy outcome. Identifying these mechanisms may inform fetal sex specific tailored antenatal and neonatal care.
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