Meta-analysis on sex differences in mortality and neurodevelopment in congenital heart defects

Abstract Given the increasing survival rates among congenital heart disease (CHD) patients and the growing emphasis on their quality of life, there is a need to comprehensively assess the impact of surgical interventions on neurodevelopmental outcomes. With increasing awareness in sex-related dispar...

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Main Authors: Alyssa K. Crain, Zhia N. Lim, Chloe J. Sarfatis, Magela Arias, Travis Holder, Alvaro G. Moreira, Antonio F. Corno, Tina O. Findley
Format: Article
Language:English
Published: Nature Portfolio 2025-03-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-025-92894-w
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author Alyssa K. Crain
Zhia N. Lim
Chloe J. Sarfatis
Magela Arias
Travis Holder
Alvaro G. Moreira
Antonio F. Corno
Tina O. Findley
author_facet Alyssa K. Crain
Zhia N. Lim
Chloe J. Sarfatis
Magela Arias
Travis Holder
Alvaro G. Moreira
Antonio F. Corno
Tina O. Findley
author_sort Alyssa K. Crain
collection DOAJ
description Abstract Given the increasing survival rates among congenital heart disease (CHD) patients and the growing emphasis on their quality of life, there is a need to comprehensively assess the impact of surgical interventions on neurodevelopmental outcomes. With increasing awareness in sex-related disparities in CHD, there is a need to explore potential differences in surgical mortality and neurodevelopmental outcomes between male and female patients. In this systematic review, we adhered to PRISMA guidelines and PROSPERO registration (#CRD42021225610). Articles published from 2015 to 2021 were searched using MeSH descriptors in three major databases (MEDLINE Ovid, Elsevier Embase, and Cochrane Library). Study selection criteria focused on pediatric (< 18 years of age) CHD patients undergoing primary cardiac surgery. A total of 163 articles that met inclusion criteria were reviewed. The definition and assessment of neurodevelopmental impairment, data extraction, risk of bias assessment, and statistical analysis methods were adhered by blinded reviewers. Previous studies have reported higher rates of early childhood mortality in female patients and higher rates of neurodevelopmental impairment in male patients with CHD requiring surgery. Our meta-analysis suggests that these differences may no longer be valid in contemporary surgical cohorts. However, it is unclear if sex-related risk factors have truly been mitigated with current surgical and medical approaches Our meta-analysis does underscore the need for further research considering sex as a variable and for additional investigative efforts in long term neurodevelopmental outcomes.
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spelling doaj-art-abdb48cf217942c6a207889ddd12c0982025-08-20T02:56:15ZengNature PortfolioScientific Reports2045-23222025-03-0115111010.1038/s41598-025-92894-wMeta-analysis on sex differences in mortality and neurodevelopment in congenital heart defectsAlyssa K. Crain0Zhia N. Lim1Chloe J. Sarfatis2Magela Arias3Travis Holder4Alvaro G. Moreira5Antonio F. Corno6Tina O. Findley7Division of Neonatal-Perinatal Medicine, Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center in Houston and Children’s Memorial Hermann HospitalGreat Ormond Street Institute of Child Health, University College LondonDivision of Neonatal-Perinatal Medicine, Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center in Houston and Children’s Memorial Hermann HospitalNova Southeastern College of Osteopathic MedicineResearch Medical Library, University of Texas MD Anderson Cancer CenterDepartment of Pediatrics, Neonatology Regenerative and Precision Medicine Laboratory, University of Texas Health Science Center at San AntonioSchool of Engineering, University of LeicesterDivision of Neonatal-Perinatal Medicine, Department of Pediatrics, McGovern Medical School at the University of Texas Health Science Center in Houston and Children’s Memorial Hermann HospitalAbstract Given the increasing survival rates among congenital heart disease (CHD) patients and the growing emphasis on their quality of life, there is a need to comprehensively assess the impact of surgical interventions on neurodevelopmental outcomes. With increasing awareness in sex-related disparities in CHD, there is a need to explore potential differences in surgical mortality and neurodevelopmental outcomes between male and female patients. In this systematic review, we adhered to PRISMA guidelines and PROSPERO registration (#CRD42021225610). Articles published from 2015 to 2021 were searched using MeSH descriptors in three major databases (MEDLINE Ovid, Elsevier Embase, and Cochrane Library). Study selection criteria focused on pediatric (< 18 years of age) CHD patients undergoing primary cardiac surgery. A total of 163 articles that met inclusion criteria were reviewed. The definition and assessment of neurodevelopmental impairment, data extraction, risk of bias assessment, and statistical analysis methods were adhered by blinded reviewers. Previous studies have reported higher rates of early childhood mortality in female patients and higher rates of neurodevelopmental impairment in male patients with CHD requiring surgery. Our meta-analysis suggests that these differences may no longer be valid in contemporary surgical cohorts. However, it is unclear if sex-related risk factors have truly been mitigated with current surgical and medical approaches Our meta-analysis does underscore the need for further research considering sex as a variable and for additional investigative efforts in long term neurodevelopmental outcomes.https://doi.org/10.1038/s41598-025-92894-w
spellingShingle Alyssa K. Crain
Zhia N. Lim
Chloe J. Sarfatis
Magela Arias
Travis Holder
Alvaro G. Moreira
Antonio F. Corno
Tina O. Findley
Meta-analysis on sex differences in mortality and neurodevelopment in congenital heart defects
Scientific Reports
title Meta-analysis on sex differences in mortality and neurodevelopment in congenital heart defects
title_full Meta-analysis on sex differences in mortality and neurodevelopment in congenital heart defects
title_fullStr Meta-analysis on sex differences in mortality and neurodevelopment in congenital heart defects
title_full_unstemmed Meta-analysis on sex differences in mortality and neurodevelopment in congenital heart defects
title_short Meta-analysis on sex differences in mortality and neurodevelopment in congenital heart defects
title_sort meta analysis on sex differences in mortality and neurodevelopment in congenital heart defects
url https://doi.org/10.1038/s41598-025-92894-w
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