Journal
JOURNAL OF CLINICAL MEDICINE
Volume 10, Issue 13, Pages -Publisher
MDPI
DOI: 10.3390/jcm10133000
Keywords
sex as a biological variable; sex differences; pregnancy complications; placenta; prenatal diagnosis; preeclampsia; preterm birth; fetal growth restriction; miscarriage
Categories
Funding
- Canadian Institutes of Health Research (CIHR) [SVB-158613, F19-04091]
- CIHR Research Chair in Sex and Gender Science [GSK-171375]
- BC Children's Hospital Research Institute
- CIHR Doctoral Fellowship
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Sex differences in perinatal complications, influenced by gene expression and gonadal steroid hormones, play a significant role in placental function and pregnancy outcomes. Consideration of sex differences is important when developing diagnostic or risk prediction tools for such complications.
Sex differences exist in the incidence and presentation of many pregnancy complications, including but not limited to pregnancy loss, spontaneous preterm birth, and fetal growth restriction. Sex differences arise very early in development due to differential gene expression from the X and Y chromosomes, and later may also be influenced by the action of gonadal steroid hormones. Though offspring sex is not considered in most prenatal diagnostic or therapeutic strategies currently in use, it may be beneficial to consider sex differences and the associated mechanisms underlying pregnancy complications. This review will cover (i) the prevalence and presentation of sex differences that occur in perinatal complications, particularly with a focus on the placenta; (ii) possible mechanisms underlying the development of sex differences in placental function and pregnancy phenotypes; and (iii) knowledge gaps that should be addressed in the development of diagnostic or risk prediction tools for such complications, with an emphasis on those for which it would be important to consider sex.
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