578 DISCORDANCE BETWEEN MALE/FEMALE DEATHS DUE TO THE RESPIRATORY DISTRESS SYNDROME (RDS): IS IT REAL?

Abstract

Despite a marked diminution in national and Wisconsin (WISC) neonatal mortality rates (NNMR), RDS has remained the leading cause of death in 9 of 11 years previously analyzed, accounting for 19.5% of fatalities. Male/female (M/F) ratios of 1.35 for NNMR and 1.6 for RDS deaths support the contention that there is a distinct male disadvantage to premature birth. To better elucidate this assertion, we examined all relevant birth-weight-linked mortality statistics for the State of Wise, from 1979 through 1982. 5.3% of the average 74,500 births/year in Wise. (M/F ratio = 1.05) occurred at <2.5 kg. The data below indicate that neonatal deaths secondary to RDS are consistently greater in males and that the discordance between males and females occurrs most predominantly between 1-1.5 kg birthwelght. These significant differences are independent of mode of delivery, maternal age, and associated diagnoses (i.e. asphyxia). This epidemiologic survey coupled with recent animal research suggests that delivery within a limited “window” during gestation Increases male susceptibility to fatal RDS.

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