359 - Gender Dimorphism in Neonatal Encephalopathy

Poster Number: 359
Publication Number: 359.132

Lynne A. Kelly, University of Dublin, Trinity College, Dublin, Dublin, Ireland; Lida Fallah, Trinity College Dublin, Ireland, Maynooth, Kildare, Ireland; Saima Aslam, Chi crumlin, Dublin, Dublin, Ireland; Eleanor J Molloy, Trinity college the university of dublin, Dublin, Dublin, Ireland; Deirdre Sweetman, National Maternity Hospital, Dublin, Dublin, Ireland

Background: Neonatal encephalopathy (NE) is a devastating outcome of an otherwise healthy term delivery. Gender dimorphism exists in the neonatal period and throughout life in terms of morbidity and mortality. Perinatal brain damage, cerebral palsy, congenital deformities, stillbirth, meningitis and neonatal sepsis are more common in boys. Gender disparity has not been previously explored in NE infants regarding inflammation and outcome.

Objective: Our aim was to explore the cytokine expression between male and female infants with NE in terms of MRI and developmental outcome.

Design/Methods: Infants with neonatal encephalopathy were recruited from The National Maternity Hospital, Dublin with written informed consent. Serum biomarkers (EPO, VEGF, IL-8 and GM-CSF) were serially evaluated during the first 5 days of life and compared with MRI brain injury and Bayley Scales of Infant development (Bayley-III). Statistical analysis was carried out using R version 3.6.2.

Results: One hundred and eighty-four infants with NE were recruited and had serums samples analysed. EPO at D3-5 strongly correlated with the Bayley-III language score(p < 0.002) and the interaction effect of language and cognitive score. The language score for GMCSF and Il-8 at D3-5 was also highly significant (p < 0.012 and p < 0.01 respectively).  
When stratified to gender, on Day 1, language score was highly associated with the VEGF values on Day1-2 for females (p < 0.0273) and day 3-5 (p < 0.03), in contrast to the male population.
On Day 3-5, Language score (p < 0.03289) and the interaction effect of language and cognitive score (p < 0.00561) showed strong associations with the EPO levels in females, in contrast to male population.
On Day 3-5, language score and MRI were only slightly greater than 0.05 and were significant at the level 0.1 for GM-CSF in the male population only.Conclusion(s): Gender differences are evident in cytokine expression when measured in respect to neonatal outcomes of MRI and Bayley Scale of Infant development. Further research in the mechanisms of these observed sex differences in neonates is warranted with a view to consider gender as an important variable for treatment and improved outcomes.