591 - Sex Differences in Health Service Utilization, Morbidity, and Prescribed Medications in Late Childhood among Children Born Preterm

Publication Number: 591.6913

Jasmine S. K.. Yip, The University of Western Ontario - Schulich School of Medicine & Dentistry, London, ON, Canada; Joseph Ting, University of Alberta, Edmonton, AB, Canada

Background: Male infants born preterm were recognized to have higher risks of negative neonatal outcomes and subsequent postnatal complications. However, there are limited population-based studies that investigate sex-specific health outcomes in late childhood for those born preterm.

Objective: To assess differences in health service utilization, childhood morbidity, and medication use between male and female children born preterm, at 5 to 10 years of age.

Design/Methods: This study examined children born between 22- and 44-weeks gestational age (GA) in British Columbia, Canada, from 2004 to 2014. Follow-up data, extending to December 2019, were derived from four linked provincial health databases, including perinatal records, outpatient visits, hospital admissions, and outpatient prescription data. Biological sex at birth was used to classify participants. To assess sex-specific health outcomes, we analyzed incidence and relative risk (RR) for health service utilization, major childhood morbidity, and medication use across GA categories (22-27, 28-33, 34-36, 37-44) employing Poisson regression.

Results: The study encompassed a total of 510,559 children, comprising 51.3% males and 48.7% females. Of these, 48,849 were born before 37 weeks of gestational age, yielding a preterm birth rate of 9.6%. [Table 1] From ages 5 to 10, male children exhibited significantly higher rates of physician service attendance and hospitalizations compared to their female peers, irrespective of GA category. Male children, irrespective of their GA at birth, were at higher risks of asthma compared to females. Except children born at GA 22-27 weeks, female children born at older GA had higher rates of urinary tract infection and lower rates of cerebral palsy, compared to male children. Males born extremely preterm were prescribed significantly less thyroid hormones (RR: 0.27, 95% CI: 0.06-0.92) than females born extremely preterm.

Conclusion(s): In comparison to females, male children born preterm had higher needs of late childhood health service and asthma care. These findings highlight the necessity of incorporating biological sex into considerations of health and development of children born preterm, especially in patient education, access to care, and future research initiatives.

TABLE 1. Health service utilization, childhood morbidity and prescribed medications among male versus female children born preterm by gestational age category from 5 to 10 years of age.