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Impact of fetal versus perinatal hypoxia on sex differences in childhood outcomes: developmental timing matters

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Abstract

Purpose

To examine how the timing of hypoxic exposure results in specific childhood outcomes and whether there is a differential effect by sex.

Methods

A sample of 10,879 prospectively followed pregnancies was drawn from the Boston and Providence sites (New England, NE) of the National Collaborative Perinatal Project. Based on placental pathology, we developed and validated a measure of probable chronic placental hypoxia (CHP) and contrasted the effects of acute perinatal hypoxia on age 7 emotional, behavioral, and cognitive outcomes.

Results

Perinatal hypoxia had a significant impact on multiple behavioral and cognitive outcomes in boys and girls by age 7, in contrast to probable CHP which had a differential effect on girls and boys such that there was decreased verbal IQ and increased inhibition in females alone.

Conclusions

Findings underscore the importance of considering the timing of obstetric complications and offspring sex in investigations of the impact of fetal and perinatal hypoxia on offspring’s outcomes throughout the life course.

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Acknowledgments

The work was supported by National Institute of Mental Health Office of Research on Women’s Health (P50 MH082679 to JMG) and National Institute of Mental Health (RO1 MH56956 to JMG). M.A.’s work was supported by the Connors Center for Women’s Health & Gender Biology at Brigham and Women’s Hospital. The authors would like to thank Stephen Buka, Sc.D. for his help on previous versions of this work and his substantial commitment to using the New England cohorts of the NCPP to understand fetal and early antecedents to disorders throughout one’s lifetime. We would also like to thank the Co-PI’s of P50 MH082679 (Stuart Tobet, Ph.D. and Robert Handa, Ph.D.) for their insightful comments on the findings in this study.

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Author notes

  1. Carolyn M. Salafia

    Present address: Cicatelli Associates Inc., New York, NY, USA

Authors and Affiliations

  1. Division of Women’s Health, Department of Medicine, Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital (BWH), One Brigham Circle, 3rd Floor, 1620 Tremont Street, Boston, MA, 02120, USA

    Michael Anastario & Jill M. Goldstein

  2. Cicatelli Associates Inc., New York, NY, USA

    Michael Anastario

  3. New York University, New York, NY, USA

    Carolyn M. Salafia

  4. McLean Hospital, Belmont, MA, USA

    Garrett Fitzmaurice

  5. Department of Psychiatry, Harvard Medical School, Boston, USA

    Garrett Fitzmaurice & Jill M. Goldstein

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  1. Michael Anastario
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  2. Carolyn M. Salafia
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  4. Jill M. Goldstein
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Correspondence to Jill M. Goldstein.

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Anastario, M., Salafia, C.M., Fitzmaurice, G. et al. Impact of fetal versus perinatal hypoxia on sex differences in childhood outcomes: developmental timing matters. Soc Psychiatry Psychiatr Epidemiol 47, 455–464 (2012). https://doi.org/10.1007/s00127-011-0353-0

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