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Monday, 23 October, 2000, 23:21 GMT 00:21 UK
Boys 'still the weaker sex'
prem baby
Premature boys do less well than girls
Boys born prematurely are much more likely to die or suffer major complications than girls, despite major medical advances.

A US study of more than 6,500 premature babies found that a death rate of 22% for boys compared with 15% for girls.

Boys were also more likely to have breathing problems and suffer from brain haemorrhages and urinary tract infections, according to researchers from Stanford University.

Little explanation can be found medically for the differences, leading researchers to speculate that it is just a case of nature taking its course.

Differences in mortality between boys and girls persist, despite the availability of specialist equipment, drugs and techniques which save many babies who would have died just 10 years ago.

Researchers studied babies weighing under 1.5kg admitted to 12 centres in the US.

They concluded, in their study published in the Archives of Disease in Childhood that "boys had a higher risk for most adverse outcomes".

"Despite technological advances in new born care, including the widespread introduction and improvement in mechanical ventilation, use of antenatal steroids, and more recently surfactant therapy, the male disadvantage has persisted," they noted.

Natural selection

They suggest that "natural selection" may be at work, weeding out the weakest boys early.

Or it could be a case of sparing the girls needed to give birth to the next generation.

Boys suffered more from complications of prematurity such as respiratory distress syndrome and were more likely to need a ventilator or need to be resuscitated.

Girls, on the other hand were more likely to have received steroids through injections given to the mother and were more likely to have been delivered by caesarean section.

Giving mothers in premature labour steroids helps mature the lungs of the baby and avoid breathing difficulties after birth.

The benefit of caesareans has also been noted before but was not explored by the researchers.

The difference in death rates became apparent as early as three days after birth.

It seens inherently genetic and everybody accepts that slightly more boys are born because fewer of them will survive.

Dr Liz Draper, University of Leicester
For both boys and girls other risk factors were confirmed by the research: the smaller the baby and the earlier the earlier the birth, the greater the risk of death or complications.

Dr Liz Draper, senior research fellow in perinatal epidemiology at the University of Leicester said the study reinforced work conducted in the Trent region.

"When we produced charts predicting the survival of premature babies we found an inherent difference between girls and boys - before 32 weeks there was a difference of 5%," she said.

"It seens inherently genetic and everybody accepts that slightly more boys are born because fewer of them will survive."

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