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Review
. 2023 Oct 25:14:1243364.
doi: 10.3389/fimmu.2023.1243364. eCollection 2023.

Sex differences in neonatal brain injury and inflammation

Lynne A Kelly  1   2   3 , Aoife Branagan  1   2   3   4 , Gergana Semova  1   2   3 , Eleanor J Molloy  1   2   3   4   5   6
Affiliations
Review

Sex differences in neonatal brain injury and inflammation

Lynne A Kelly et al. Front Immunol. .

Abstract

Neonatal brain injury and associated inflammation is more common in males. There is a well-recognised difference in incidence and outcome of neonatal encephalopathy according to sex with a pronounced male disadvantage. Neurodevelopmental differences manifest from an early age in infancy with females having a lower incidence of developmental delay and learning difficulties in comparison with males and male sex has consistently been identified as a risk factor for cerebral palsy in epidemiological studies. Important neurobiological differences exist between the sexes with respect to neuronal injury which are especially pronounced in preterm neonates. There are many potential reasons for these sex differences including genetic, immunological and hormonal differences but there are limited studies of neonatal immune response. Animal models with induced neonatal hypoxia have shown various sex differences including an upregulated immune response and increased microglial activation in males. Male sex is recognized to be a risk factor for neonatal hypoxic ischemic encephalopathy (HIE) during the perinatal period and this review discusses in detail the sex differences in brain injury in preterm and term neonates and some of the potential new therapies with possible sex affects.

Keywords: brain injury; inflammation; neonatal encephalopathy; neonate; sex.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Immune differences in males and females with brain injury. Sex differences presents in many aspects of the brain. While male neonates have increased seizure burden, cognitive defects and larger infarct sizes, females have increased Treg cells, chemokine levels and immune-regulating genes on the X chromosome. Created with BioRender.com.
See this image and copyright information in PMC

References

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