The Association between Sex and Long-Term Pediatric Cardiovascular Morbidity

Objective: To evaluate the association between sex and long-term pediatric cardiovascular morbidity.

Study design: A population-based cohort study was performed that compared the risk of long-term cardiovascular morbidity (up to the age of 18 years) of children according to sex. Deliveries occurred between the years 1991 and 2013 in a tertiary medical center. Multiple pregnancies and fetal congenital malformations were excluded. Kaplan-Meier survival curves were constructed to compare cumulative cardiovascular morbidity incidence. A Cox proportional hazards model was used to control for confounders, including gestational age at birth, birth weight, and maternal factors.

Results: During the study period, 240 953 newborns met the inclusion criteria and were included in the long-term analysis. Of them, 51.0% (n = 122 840) were male and 49.0% (n = 118 113) female. Cardiovascular morbidity up to the age of 18 years was significantly more common in male as compared with female newborns (0.3% vs 0.2%, OR 1.33, 95% CI 1.12-1.57, P = .001). In the Cox regression model, male sex exhibited an independent association with long-term cardiovascular morbidity with an adjusted hazard ratio of 1.37 (95% CI 1.16-1.63, P <.001).

Conclusion: Male newborns are at an increased risk for pediatric cardiovascular morbidity independent of gestational age at birth and birth weight.