Pediatric neurology · 2025
Sex Disparities in Neonatal Arterial Ischemic Stroke: Larger Lesion Volume and More Severe Long-Term Disability in Male Infants.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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García-Alix Alfredo, Núñez Christian, Arca Gemma, Arnaez Juan, Agut Thais, Cordeiro Malaika, Boronat Nuria, Benavente-Fernández Isabel, Lubián Simón, Valverde Eva, Stephan-Otto Christian
Аннотация
BACKGROUND: To examine the relationship between sex and infarct volume in neonatal arterial ischemic stroke (NAIS) and to compare the functional outcomes of male and female infants at 2 years of age.
METHODS: A prospective observational multicenter study was conducted in 6 hospitals in Spain. Sixty-four consecutive infants with idiopathic and symptomatic NAIS were recruited. Lesion masks were created to determine NAIS volume and location. Data on acute-phase symptoms, including seizure occurrence and anticonvulsant drugs used and functional outcomes at 2 years, including need for speech therapy, were collected. Dichotomous categorical variables were compared between males and females using chi-square or logistic regression tests, while differences in continuous variables were assessed by means of t-tests. Analysis of covariance or logistic regression was performed to adjust for infarct volume.
RESULTS: Male infants presented a higher prevalence of NAIS compared to females (61% vs 39%). In addition, males showed larger infarct volumes and a differential pattern in the spatial distribution of lesions (P < 0.05). The male group also presented higher rates of postnatal epilepsy (41% vs 12%; P = 0.019), need for speech therapy (58% vs 24%; P = 0.010), and strabismus at 2 years of age (18% vs 0%).
CONCLUSIONS: Our results point to larger infarct volumes and a worse outcome in males affected by NAIS. These results, together with further studies on the differential effects associated with sex in the context of NAIS, may shape new sex-specific neuroprotective strategies and follow-up plans.
METHODS: A prospective observational multicenter study was conducted in 6 hospitals in Spain. Sixty-four consecutive infants with idiopathic and symptomatic NAIS were recruited. Lesion masks were created to determine NAIS volume and location. Data on acute-phase symptoms, including seizure occurrence and anticonvulsant drugs used and functional outcomes at 2 years, including need for speech therapy, were collected. Dichotomous categorical variables were compared between males and females using chi-square or logistic regression tests, while differences in continuous variables were assessed by means of t-tests. Analysis of covariance or logistic regression was performed to adjust for infarct volume.
RESULTS: Male infants presented a higher prevalence of NAIS compared to females (61% vs 39%). In addition, males showed larger infarct volumes and a differential pattern in the spatial distribution of lesions (P < 0.05). The male group also presented higher rates of postnatal epilepsy (41% vs 12%; P = 0.019), need for speech therapy (58% vs 24%; P = 0.010), and strabismus at 2 years of age (18% vs 0%).
CONCLUSIONS: Our results point to larger infarct volumes and a worse outcome in males affected by NAIS. These results, together with further studies on the differential effects associated with sex in the context of NAIS, may shape new sex-specific neuroprotective strategies and follow-up plans.