Sex differences in the association of pretransfusion haemoglobin and cognition in preterm infants

Amanda Benavides Mostek; Edward Bell; Henry Feldman; Cassandra Josephson; Michael Georgieff; Peg Nopoulos; Ravi Patel; Sean Stowell; Martha Sola-Visner; Amy Conrad

doi:10.1136/bmjpo-2024-002541

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Sex differences in the association of pretransfusion haemoglobin and cognition in preterm infants

Journal article

Open access

Peer reviewed

Sex differences in the association of pretransfusion haemoglobin and cognition in preterm infants

Amanda Benavides Mostek, Edward Bell, Henry Feldman, Cassandra Josephson, Michael Georgieff, Peg Nopoulos, Ravi Patel, Sean Stowell, Martha Sola-Visner and Amy Conrad

BMJ paediatrics open, Vol.8(1), e002541

06/08/2024

DOI: 10.1136/bmjpo-2024-002541

PMCID: PMC11163603

PMID: 38851221

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Abstract

ObjectivesTo assess sex-specific differences in the association between pre-transfusion haemoglobin values and early neurodevelopmental function.DesignObservational follow-up of infants with birth weights <1000 g and gestational ages 22–28 weeks who were enrolled in the NICHD Neonatal Research Network Transfusion of Prematures (TOP) Trial at 19 U.S. sites, 2012–2017.Main outcome measuresPretransfusion haemoglobin values were obtained longitudinally through 36 weeks’ postmenstrual age. The infant’s mean pretransfusion haemoglobin was used as a marker of degree of anaemia (n=1655 measures). Measures of brain function were obtained at 22–26 months’ corrected age using the Bayley Scales of Infant & Toddler Development, third edition (BSID-III) (n=1290 BSID-III scores). Sex-specific estimates for the linear relation between pretransfusion haemoglobin and BSID-III scores were obtained from repeated-measures regression analysis, adjusted for gestational age, birth weight, study site, clinical characteristics, and demographic covariates.ResultsThe relation of pretransfusion haemoglobin with 24-month BSID-III scores showed significant, independent interactions with both (1) sex (p=0.046) and (2) retinopathy of prematurity (ROP; p=0.004). In 614 males, BSID-III scores were higher by 1.07 points per g/dL (95% CI 1.58 to 4.33; p=0.008), not differing significantly among the three subscales (cognitive, language and motor; p=0.94). In 247 infants with ROP, BSID-III scores were higher by 2.95 points per g/dL (95% CI 0.28 to 1.87; p<0.0001), uniformly across subscales (p=0.73). These associations were non-significant in 676 females (p=0.96) and 1043 infants without ROP (p=0.81).ConclusionsThis study demonstrates sex-specific associations between mean pretransfusion haemoglobin (a marker of the severity of anaemia throughout the neonatal intensive care unit [NICU] hospitalisation) and early neurodevelopmental function at 22–26 months’ corrected age.

Anemia

Gender Differences

Birth weight

Blood

Brain research

Cognition & reasoning

Congenital diseases

Females

Gestational age

Hemoglobin

Missing data

Newborn babies

Parent educational background

Premature babies

Sepsis

Details

Title: Subtitle: Sex differences in the association of pretransfusion haemoglobin and cognition in preterm infants
Creators: Amanda Benavides Mostek - University of Iowa
Edward Bell - University of Iowa
Henry Feldman - Harvard Medical School
Cassandra Josephson - Johns Hopkins University
Michael Georgieff - University of Minnesota
Peg Nopoulos - University of Iowa
Ravi Patel - Emory University
Sean Stowell - Harvard Medical School
Martha Sola-Visner - Boston Children's Hospital
Amy Conrad - University of Iowa
Resource Type: Journal article
Publication Details: BMJ paediatrics open, Vol.8(1), e002541
DOI: 10.1136/bmjpo-2024-002541
PMID: 38851221
PMCID: PMC11163603
NLM abbreviation: BMJ Paediatr Open
eISSN: 2399-9772
Publisher: BMJ Publishing Group LTD
Language: English
Date published: 06/08/2024
Academic Unit: Neurology; Psychiatry; Pediatric Psychology; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Craniofacial Anomalies Research Center; Neonatology
Record Identifier: 9984641660102771

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