JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

ISSN: Active
eISSN: 2636-8579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Submit Manuscript

Index
Original Article
Impact of fetal sex combinations on maternal, pregnancy, and neonatal outcomes in dichorionic twin pregnancies
Abstract
Aims: The aim of this study was to investigate the impact of concordance and discordance in fetal sex on maternal, pregnancy, and neonatal outcomes in dichorionic twin pregnancies.
Methods: This retrospective cohort analysis includes DCDA twin pregnancies delivered at Ankara Etlik City Hospital from January 2023 to December 2024. Pregnancies were categorized into three distinct groups according to the combinations of fetal gender: male-male (group 1), female-female (group 2), and male-female (group 3). Maternal demographic, pregnancy, and neonatal outcome data were compared. Composite adverse perinatal outcome (CAPO) was defined as severe neonatal complications. Chi-square, one-way ANOVA, Kruskal-Wallis, and post-hoc analyses were applied with confounder adjustment.
Results: Male-male pregnancies were also characterized by significantly increased maternal age, BMI, parity, and diabetic disease rates compared with female-female pregnancies (p<0.05). Neonatal outcomes indicated a considerable increase in biparietal diameter, head circumference, and abdominal circumference in group 1 and group 3 pregnancies compared with group 2 pregnancies (p<0.01). Additionally, male babies from discordant pregnancies weighed considerably more at birth compared to children born from concordant pregnancies (p=0.04); no notable differences were seen in female infants (p=0.84). Gestational age at birth, preterm labor percentages, and neonatal intensive care unit admission were comparable among groups (p>0.05). CAPO rates did not vary between groups significantly (p=0.396).
Conclusion: Fetal sex combinations impact neonatal and maternal outcomes of dichorionic twin gestations in varying patterns that differ in male-male versus male-female pregnancies. Greater multicenter numbers are necessary to validate the observations and investigate more fully their consequences for maximally optimizing antenatal treatment and further enhancing perinatal outcome for twin pregnancy.

Keywords : Fetal sex combinations, dichorionic twin pregnancies, maternal and neonatal outcomes

Download Article


1. Hiersch L, Attali E, Melamed N. Special considerations regarding antenatal care and pregnancy complications in dichorionic twin pregnancies. Am J Obstet Gynecol MFM. 2022;4(2S):100500. doi:10.1016/ j.ajogmf.2021.100500
2. Miremberg H, Nassar M, Herman HG, et al. Is there an impact of fetal sex in dichorionic discordant twins on placental histopathological abnormalities? Eur J Obstet Gynecol Reprod Biol. 2022;274:166-170. doi: 10.1016/j.ejogrb.2022.05.030
3. Shaked AB, Pariente G, Wainstock T, Sheiner E. The association between gender in dichorionic-diamniotic twin pregnancies and the risk for long-term respiratory morbidity. Am J Obstetr Gynecol. 2023;228(1):S81. doi:10.1016/j.ajog.2022.11.177
4. Al-Qaraghouli M, Fang YMV. Effect of fetal sex on maternal and obstetric outcomes. Front Pediatr. 2017;5:144. doi:10.3389/fped.2017.00144
5. Di Renzo GC, Rosati A, Sarti RD, Cruciani L, Cutuli AM. Does fetal sex affect pregnancy outcome? Gend Med. 2007;4(1):19-30. doi:10.1016/s1550-8579(07)80004-0
6. Paul M, Zakar T, Phung J, et al. 20&alpha;-hydroxysteroid dehydrogenase expression in the human myometrium at term and preterm birth: relationships to fetal sex and maternal body-mass index. Reprod Sci. 2023;30(8):2512-2523. doi:10.1007/s43032-023-01183-2
7. Retnakaran R, Kramer CK, Ye C, et al. Fetal sex and maternal risk of gestational diabetes mellitus: the impact of having a boy. Diabetes Care. 2015;38(5):844-851. doi:10.2337/dc14-2551
8. Muhcu M, &Ouml;zdamar &Ouml;, G&uuml;n İ, &Ouml;zden O, M&uuml;ngen E, Atay V. The impact of the fetal gender on ultrasonographic fetal biometric parameters. Zeynep Kamil Tıp B&uuml;lteni. 2014;45(2):55-60.
9. B&uuml;lb&uuml;l Baytur Y, Yıldız H, &Ouml;zler A, İnceboz &Uuml;s, &Ccedil;ağlar H. Cinsiyetin fetal ultrason &ouml;l&ccedil;&uuml;mleri &uuml;zerine etkisi: cinsiyete &ouml;zg&uuml; b&uuml;y&uuml;me eğrileri gerekli mi? Perinatol Derg. 2006;14(1):26-30.
10. Banjac L, Kotur-Stevuljevic J, Gojkovic T, Bokan-Mirkovic V, Banjac G, Banjac G. Relationship between insulin-like growth factor type 1 and intrauterine growth. Acta Clin Croat. 2020;59(1):91-96. doi:10.20471/acc.2020.59.01.11
11. Stenhouse C, Bazer FW, Ashworth CJ. Sexual dimorphism in placental development and function: comparative physiology with an emphasis on the pig. Molecul Reproduct Devel. 2023;90(7):684-696. doi:10.1002/mrd.23573
12. Wilms FF, Vis JY, Oudijk MA, et al. The impact of fetal gender and ethnicity on the risk of spontaneous preterm delivery in women with symptoms of preterm labor. J Matern Fetal Neonatel Med. 2016;29(21): 3563-3569. doi:10.3109/14767058.2016.1139566
13. Melamed N, Yogev Y, Glezerman M. Fetal gender and pregnancy outcome. J Matern Fetal Neonatal Med. 2010;23(4):338-344. doi:10.3109/ 14767050903300969
14. Jelenkovic A, Sund R, Yokoyama Y, et al. Birth size and gestational age in opposite-sex twins as compared to same-sex twins: an individual-based pooled analysis of 21 cohorts. Scientific Reports. 2018;8(1):6300. doi:10.1038/s41598-018-24634-2
15. Bayraktar B, Vural T, G&ouml;lbaşı C, G&ouml;lbaşı H, Bayraktar MG. Effect of co-twin fetal sex on fetal anthropometry and birth time in twin pregnancies. J Obstet Gynaecol Can. 2021;43(10):1153-1158. doi:10.1016/j.jogc.2021.02.113
Article available in :
Volume 8, Issue 2, 2025
Page : 313-318
https://doi.org/10.32322/jhsm.1628682
Article Information
Received : 28 Oca 2025
Accepted : 26 Şub 2025
Published : 21 Mar 2025
Corresponding Author :

Nazan Vanlı Tonyalı: Department of Perinatology, Ankara Etlik City Hospital, Ankara, Turkiye

[email protected]
Citation : Vanlı Tonyalı, Karabay G, Tokgöz Çakır B, et al. Impact of fetal sex combinations on maternal, pregnancy, and neonatal outcomes in dichorionic twin pregnancies. J Health Sci Med. 2025;8(2):313-318.

Read: 17
Cited: 0
Download : 17
_Footer