Link: https://pubmed.ncbi.nlm.nih.gov/32061363/

J Pediatr Surg
. 2020 May;55(5):811-820. doi: 10.1016/j.jpedsurg.2020.01.016. Epub 2020 Feb 12.
Sex differences in surgically correctable congenital anomalies: A systematic review
Anna J Black 1, Daphne Yd Lu 2, Leeor S Yefet 2, Robert Baird 3
Affiliations expand
PMID: 32061363 DOI: 10.1016/j.jpedsurg.2020.01.016
Abstract
Purpose: This study aims to compare the prevalence and outcomes of surgically correctable congenital anomalies between sexes.

Methods: Upon registration on PROSPERO (CRD42019120165), a librarian aided in conducting a systematic review using PRISMA guidelines. The five largest relevant studies were included for each anomaly. Cumulative prevalence differences and confidence intervals were calculated, and the Cochran-Mantel-Haenszel test was performed.

Results: Of 42,722 identified studies, 68 were included in our analysis. All included anomalies had greater than 1000 patients except duodenal atresia (n = 787) and intestinal duplication (n = 14. Males had a significantly higher prevalence than females in 10/14 anomalies (Hirschsprung's disease, omphalomesenteric duct, congenital diaphragmatic hernia, anorectal malformation, malrotation, esophageal atresia, congenital pulmonary airway malformation, intestinal atresia, omphalocele, and gastroschisis; p < 0.001). There was no difference in the prevalence of duodenal atresia or intestinal duplication between sexes (p = 0.88 and 0.65, respectively). Females had a significantly higher prevalence of biliary anomalies (atresia and choledochal cyst).

Conclusion: Our study indicates that males have higher prevalence rates of most congenital anomalies. Further investigations are required to illuminate the embryology underlying this sex distribution and whether sex influences outcomes.

Type of study: Systematic review and meta-analysis.

Level of evidence: Prognostic study, level II.

Keywords: Birth defect; Congenital anomaly; Sex differences; Sex discrepancy; Systematic review.

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