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Table 1 Associations between fetal sex and maternal pregnancy outcomes

From: Fetal sex and maternal pregnancy outcomes: a systematic review and meta-analysis

First author Statistical analyses Subgroups Tendency towards which sex (M/F/=) Crude effect estimate (95% CI) p value Covariate adjustment Adjusted effect estimate (95% CI) p value
Gestational hypertension
 Andersen et al. 2016 [15] Logistic regression   F 0..69 (0..38–1..25) 0.22    
 Baibergenova et al. 2006 [16] Logistic regression   F 1.06 (0.55–2.50) 0.87    
 Campbell et al. 1983 [17] Logistic regression   M 1.18 (1.09–1.27) < 0.0001    
 Chien et al. 2011 [18] Logistic regression   M 0.97 (0.96–0.98) < 0.0001    
 Engel et al. 2008 [19] Chi-square Total M 1.04 (0.94–1.14) 0.46    
   Mild M 1.04 (0.94–1.16) 0.44    
   Moderate F 0.99 (0.80–1.24) 0.95    
   Severe F 0.94 (0.62–1.42) 0.76    
 Favilli et al. 2013 [20] Logistic regression   F 1.69 (0.63–4.57) 0.43 Maternal age > 40 years, weight gain, BMI, gestational diabetes 0.98 (0.43–2.25) 0.97
 Hou et al. 2014 [21] Logistic regression   F 0.97 (0.91–1.02) 0.25    
 Juberg et al. 1976 [22] Chi-square   M   0.03    
Li et al. 2016 [23] Logistic regression   F 0.97 (0.78–1.21) 0.79    
 Makhseed et al. 1998 [24] Logistic regression Total M 1.01 (0.86–1.20) 0.87    
   Primiparous F 0.87 (0.65–1.17) 0.36    
   Multiparous M 1.09 (0.89–1.33) 0.42    
 Persson et al. 2014 [25] Logistic regression Healthy population M 1.03 (1.01–1.06) 0.003    
   Gestational diabetes M 1.08 (0.93–1.26) 0.31    
   Diabetes mellitus type I F 0.93 (0.79–1.09) 0.35    
   Diabetes mellitus type II F 0.83 (0.44–1.57) 0.56    
 Ricart et al. 2009 [76] Logistic regression   M 1.22 (0.91–1.63) 0.19    
 Sheiner et al. 2004 [26] Logistic regression   = 1.00 (0.95–1.05) 0.96    
 Shiozaki et al. 2011 [27] Logistic regression   F 0.88 (0.83–0.92) < 0.0001    
 Sykes et al. 2014 [77 Logistic regression   M 1.33 (0.67–2.63) 0.42    
 Tundidor et al. 2012 [28] Relative risk   F 0.81 (0.55–1.20) NR    
 Valvi et al. 2017 [109] Logistic regression   M 1.03 (0.58–1.85) 0.91    
 Verburg et al. 2016 [29] Relative risk Total M 1.05 (1.03–1.07) NR    
   25–29 weeks F 0.69 (0.58–0.81) NR    
   30–33 weeks F 0.87 (0.79–0.97) NR    
   34–36 weeks F 0.93 (0.87–0.98) NR    
   37–39 weeks M 1.06 (1.04–1.09) NR    
   40–42 weeks M 1.07 (1.04–1.11) NR    
 Zheng et al. 2016 [30] Logistic regression   F 0.54 (0.26–1.14) 0.11    
Pre-eclampsia
 Aibar et al. 2012 [31] Logistic regression   F 0.99 (0.65–1.49) 0.94    
 Aliyu et al. 2012 [32] Logistic regression   F 0.90 (0.79–1.03) 0.12    
 Andersen et al. 2016 [15] Logistic regression Total F 0.95 (0.69–1.31) 0.76    
   Preterm F 1.04 (0.42–2.56) 0.94    
   Term M 1.22 (0.85–1.74) 0.29    
 Basso et al. 2001 [33] Logistic regression   M 0.94 (0.92–0.97) < 0.05    
 Brettel et al. 2008 [34] Logistic regression   F 1.17 (1.01–1.35) 0.03    
 Campbell et al. 1983 [17] Logistic regression   F 1.08 (0.94–1.24) 0.3    
 Choong et al. 1995 [35] Logistic regression   F 1.45 (1.22–1.71) < 0.0001    
 Chu et al. 2014 [36] Logistic regression   M 0.60 (0.19–1.83) 0.39    
 Hadar et al. 2017 [37] Logistic regression   F 0.99 (0.68–1.43) 0.95    
 Hou et al. 2014 [21] Logistic regression   F 0.95 (0.88–1.02) 0.13    
 Juberg et al. 1976 [22] Chi-square   M   0.06    
 Khalil et al. 2013 [38] Logistic regression Total M 1.04 (0.91–1.19) 0.57    
   Preterm F 1.53 (1.07–2.20) 0.02    
   Term M 1.08 (0.93–1.25) 0.31    
   Postterm M 3.46 (1.40–8.53) 0.007    
 Lao et al. 2011 [39] Logistic regression   F 0.92 (0.81–1.06) 0.26    
 Lao et al. 2017 [40] Logistic regression   M 1.56 (1.41–1.73) <0.0001    
 Li et al. 2016 [23] Logistic regression   F 0.66 (0.45–0.98) 0.04    
 Lisonkova et al. 2013 [41] Cox regression < 34 weeks M 1.10 (1.07–1.14) NR NR 1.10 (1.06–1.14) NR
   > 34 weeks M 1.10 (1.07–1.14) NR NR 1.10 (1.06–1.14) NR
 Liu et al. 2016 [42] Logistic regression Total   0.96 (0.88–1.04) 0.31    
   Preterm   1.15 (1.00–1.32) 0.046    
 Makhseed et al. 1998 [24] Logistic regression Total F 0.92 (0.68–1.24) 0.57    
   Nulliparous F 0.74 (0.49–1.10) 0.13    
   Multiparous M 1.20 (0.76–1.90) 0.43    
 Masoumi et al. 2017 [43] Logistic regression Total M 1.09 (0.90–1.31) 0.40    
   Severe M 1.43 (0.81–2.51) 0.21    
 Morsing et al. 2018 [44] Logistic regression   F 0.80 (0.59–1.09) 0.16    
 Myers et al. 2015 [45] Logistic regression   = 0.94 (0.65–1.36) 0.74    
 Peled et al. 2013 [46] Logistic regression   M 1.79 (0.42–7.56) 0.43    
 Persson et al. 2014 [25] Logistic regression Healthy population M 1.03 (1.01–1.06) 0.003    
   Gestational diabetes M 1.08 (0.93–1.26) 0.31    
   Diabetes mellitus type I F 0.93 (0.79–1.09) 0.35    
   Diabetes mellitus type II F 0.83 (0.44–1.57) 0.56    
 Quiñones et al. 2005 [47] Logistic regression   M 1.15 (0.77–1.70) 0.5    
 Reynolds et al. 2012 [48] Logistic regression Total F 0.85 (0.71–1.02) 0.08    
   Preterm F 1.25 (0.79–1.97) 0.34    
   Term F 0.86 (0.71–1.04) 0.13    
 Roy et al. 2015 [49] Logistic regression Total M 1.28 (0.72–2.29) 0.4    
   Preterm M 0.77 (0.33–1.81) 0.55    
   Term M 1.28 (0.66–2.46) 0.46    
 Sharifzadeh et al. 2012 [50]    F 0.88 (0.33–2.35) 0.8    
 Sheiner et al. 2004 [26] Logistic regression   = 1.00 (0.95–1.05) 0.96    
 Shiozaki et al. 2011 [27] Chi-square Pre-eclampsia F 0.84 (0.79–0.89) < 0.001    
   Pre-eclampsia with fetal death M 1.21 (0.70–1.48) 0.95    
   Severe pre-eclampsia F 1.21 (1.10–1.33) 0.001    
   Severe pre-eclampsia with fetal death F 1.14 (0.67–1.93) 0.63    
 Sykes et al. 2014 [77] Logistic regression   M 1.27 (0.64–2.51) 0.49    
 Taylor et al. 2018 [51] Logistic regression   F 0.94 (0.67–1.30) 0.70    
 Taylor et al. 2018 [51] Logistic regression PE overall F 0.89 (0.64–1.24) 0.69    
   Term (> 37 weeks) F 0.92 (0.65–1.30) 0.63    
   Preterm (<37 weeks) F 0.72 (0.37–1.39) 0.32    
   Very preterm (<34 weeks) F 0.38 (0.13–1.07) 0.07    
 Toivanen et al. 1970 [52] Logistic regression   M 1.20 (1.06–1.37) 0.005    
 Trudel et al. 2015 [53] Logistic regression   M 1.01 (0.95–1.07) 0.82    
 Vatten et al. 2004 [54] Logistic regression Total M 1.05 (1.03–1.07) < 0.0001    
   Preterm (< 37 weeks) F 1.17 (1.11–1.22) < 0.0001    
   Term (37–42 weeks) M 1.06 (1.04–1.08 < 0.0001    
   Postterm (> 42 weeks) M 1.07 (0.96–1.18) 0.23    
   25–29 weeks F 1.55 (1.31–1.83) < 0.0001    
   30–33 weeks F 1.33 (1.21–1.46) < 0.0001    
   34–36 wls F 1.07 (1.01–1.14) 0.03    
   37–39 weeks F 0.98 (0.85–1.01) 0.18    
   40–42 weeks M 1.10 (1.07–1.13) < 0.0001    
 Verburg et al. 2016 [29] Relative risk Total M 1.05 (1.03–1.07) NR    
   25–29 weeks F 0.69 (0.58–0.81) NR    
   30–33 weeks F 0.87 (0.79–0.97) NR    
   34–36 weeks F 0.93 (0.87–0.98) NR    
   37–39 weeks M 1.06 (1.04–1.09) NR    
   40–42 weeks M 1.07 (1.04–1.11) NR    
 Wandabwa et al. 2010 [79] Logistic regression   F 0.65 (0.45–0.95) 0.03    
 Weinberg et al. 2017 [55] Logistic regression Total M 1.01 (0.98–1.04) 0.71    
   Term (> 37 weeks) M 1.05 (1.01–1.08) 0.01    
   Preterm (<37 weeks) F 0.89 (0.84–0.94) 0.0001    
 Zheng et al. 2016 [30] Logistic regression Total F 0.49 (0.27–0.89) 0.02    
   Mild F 0.65 (0.30–1.43) 0.29    
   Severe F 2.60 (1.18–5.73) 0.02    
Eclampsia
 Aibar et al. 2012 [31] Logistic regression   M 1.54 (0.50–4.72) 0.45    
 Aliyu et al. 2012 [32] Logistic regression   F 0.92 (0.42–2.01) 0.83    
 Campbell et al. 1983 [17] Logistic regression   F 0.89 (0.35–2.32) 0.82    
 Chien et al. 2011 [18] Logistic regression   = 1.00 (0.97–1.04) 0.89    
 Hou et al. 2014 [21] Chi-square   M   0.13    
 Llopez-Lera et al. 1990 [82] Chi-square   M   < 0.05    
 Persson et al. 2014 [25] Logistic regression Healthy population M 1.03 (1.01–1.06) 0.003    
   Gestational diabetes M 1.08 (0.93–1.26) 0.31    
   Diabetes mellitus type I F 0.93 (0.79–1.09) 0.35    
   Diabetes mellitus type II F 0.83 (0.44–1.57) 0.56    
 Wandabwa et al. 2010 [79] Logistic regression   F 0.65 (0.45–0.95) 0.03    
Gestational diabetes
 Aibar et al. 2012 [31] Logistic regression   M 1.21 (1.06–1.37) 0.0034    
 Breschi et al. 1993 [56] Logistic regression   F 0.96 (0.36–2.52) 0.93    
 Cosson et al. 2016 [57] Logistic regression   = 1.00 (0.93–1.08) 0.96    
 Ehrlich et al. 2012 [58] Logistic regression   M 1.02 (0.99–1.05) NR Maternal ethnicity 1.02 (0.99–1.05) NR
       Maternal ethnicity. education and age 1.02 (0.99–1.05) NR
 Engel et al. 2008 [19] Logistic regression   M 1.07 (0.85–1.36) 0.54    
 Favili et al. 2013 [20] Logistic regression   M 2.36 (0.58–9.61) 0.37 Maternal age > 40 years, BMI, weight gain, gestational hypertension 0.95 (0.37–2.46) 0.92
 Heckbert et al. 1988 [59] Logistic regression   F 0.97 (0.77–1.21) 0.79    
 Hou et al. 2014 [21] Logistic regression   M 1.01 (0.96–1.07) 0.61    
 Janssen et al. 1996 [60] Logistic regression   M 1.02 (0.96–1.08) 0.5    
 Kale et al. 2005 [61] Logistic regression   M 1.64 (1.12–2.40) 0.01    
 Khalil et al. 2013 [38] Logistic regression   M 1.41 (1.15–1.72) < 0.001    
 Lao et al. 2011 [39] Logistic regression   M 1.05 (0.99–1.12 0.12    
 Lao et al. 2017 [40] Logistic regression   M 1.06 (1.01–1.11) 0.08    
 Lawlor et al. 2009 [84] Logistic regression   M 1.61 (0.92–2.81) 0.09    
 Liu et al. 2016 [42] Logistic regression   M 1.08 (1.00–1.16) 0.048    
 Macaulay et al. 2018 [86] Logistic regression   M 1.16 (0.73–1.84) 0.53    
 Oken et al. 2016 [62] Logistic regression   M 1.39 (0.81–2.36) 0.23    
 Okereke et al. 2002 [63] Logistic regression   M 1.39 (0.81–2.36) 0.23    
 Peled et al. 2013 [46] Logistic regression   M 3.24 (0.65–16.22) 0.15    
 Retnakaran et al. 2015 [64] Logistic regression   M 1.03 (1.00–1.05) 0.047    
 Retnakaran et al. 2015 [64] Logistic regression   M 1.24 (0.92–1.67) 0.16    
 Ricart et al. 2009 [76] Logistic regression   M 1.05 (0.91–1.22) 0.17    
 Sheiner et al. 2004 [26] Logistic regression   M 1.07 (1.01–1.12) 0.01    
 Spellacy et al. 1985 [65] Chi-square   M   NS    
 Strutz et al. 2018 [66] Logistic regression   M 1.80 (0.40–8.18) 0.45    
 Trudel et al. 2015 [53] Logistic regression   F 0.96 (0.90–1.04) 0.32    
 Verburg et al. 2016 [29 RR   M 1.04 (1.01–1.07) NR    
 Xiao et al. 2014 [67] Logistic regression   M 1.29 (0.58–2.89) 0.53    
Placental abruption
 Aliyu et al. 2012 [32] Logistic regression   F 0.98 (0.87–1.12) 0.8    
 Brettel et al. 2008 [34] Logistic regression   M 1.29 (0.97–1.71) 0.08    
 Engel et al. 2008 [19] Logistic regression   F 0.53 (0.28–0.99) 0.049    
 Hou et al. 2014 [21] Logistic regression   F 0.98 (0.83–1.15) 0.76    
 Jakobovits et al. 1988 [68] Chi-square Total M   NS    
   17–20 years M   < 0.001    
   21–25 years M   < 0.01    
   26–30 years F   NS    
   31–35 years M   < 0.05    
   36–40 years M   < 0.05    
   41–42 years =   NS    
 Lopez-Llera et al. 1990 [82] Logistic regression   M 0.94 (0.54–1.66) 0.84    
 Peled et al. 2013 [46] Logistic regression   M 2.90 (0.76–11.03) 0.12    
 Raissanen et al. 2013 [110 Logistic regression Total M 1.19 (1.12–1.26) < 0.0001    
   Nulliparous M 1.23 (1.12–1.36) < 0.0001 NR 1.36 (1.23–1.51)  
   Multiparous M 1.16 (1.08–1.26) 0.001 NR 1.38 (1.27–1.50)  
 Schildberger et al. 2016 [69] Logistic regression   F 0.84 (0.81–0.87) < 0.0001    
 Sheiner et al. 2002 [70] Logistic regression   F 0.98 (0.78–1.24) 0.88    
 Sheiner et al. 2004 [26] Logistic regression   M 1.15 (0.89–1.49) 0.28    
 Tikkanen et al. 2013 [90] Logistic regression   M 1.18 (1.11–1.25) < 0.0001    
 Wandabwa et al. 2005 [91] Logistic regression   M 2.20 (1.20–4.90) < 0.01 Distance to hospital. age, type of house, hypertension, previous caesarean section, previous stillbirth 1.90 (1.00–3.80) NR
 Weissmann–Brenner et al. 2015 [71] Logistic regression Total M 1.20 (0.77–1.87) 0.42    
   Age < 40 years M 1.14 (0.73–1.79) 0.56    
   Age > 40 years M 5.08 (0.24–106.0) 0.29    
Post-partum hemorrhage
 Favili et al. 2013 [20 Logistic regression Total M 1.12 (0.34–3.72) 0.85    
   Age ≥ 40 years M 2.10 (0.40–11.01) 0.38    
   Age < 40 years F 0.35 (0.04–3.37) 0.36    
 Weissmann–Brenner et al. 2015 [71] Logistic regression Total M 1.20 (0.88–1.65) 0.25    
   Age ≥ 40 years M 1.16 (0.84–1.61) 0.35    
   Age < 40 years M 4.07 (0.45–36.5) 0.21    
 Liu et al. 2016 [42] Logistic regression   F 0.91 (0.83–0.99) 0.0046    
Miscarriage
 Byrne et al. 1987 [72] Risk ratio Total M   < 0.05    
   Morphological normal M   < 0.05    
   Morphological abnormal F   > 0.05    
 Cheng et al. 2014 [73] Risk ratio   F   < 0.001    
 Del Fabro et al. 2011 [74] Risk ratio Total F   < 0.05    
   4–10 weeks F   < 0.001    
   11–15 weeks F   0.07    
   16–20 weeks F   0.06