Sex-Specific Risk Factors and Organ Injury Patterns in Neonates: A Comprehensive Analysis of Clinical and Maternal Factors

Background: Neonatal organ injuries significantly exacerbate the burden of neonatal death and disability. This study investigates sex-specific risk factors and patterns of neonatal organ injuries, taking into account both clinical and maternal factors. Methods: We conducted a retrospective analysis of 155 mother-infant pairs admitted to Sichuan Provincial Maternity and Child Health Hospital (2020-2022). Univariate and multivariate analyses, including restricted cubic spline models, were performed to identify risk factors. Sex-specific subgroup analyses and correlation studies of organ injuries were also conducted. Results: Key results revealed distinct sex-based predictors. For male neonates, gestational age (OR=1.41, 95% CI: 1.13-1.87, P=0.007) and birth weight (OR=1.00, 95% CI: 1.00-1.00, P=0.008) were significantly associated with organ injury risk. For female neonates, initial C-reactive protein levels showed a significant association (OR=1.14, 95% CI: 1.01- 1.31, P=0.045). Strong correlations were found between various types of brain injuries, with cerebral infarction showing high co-occurrence with hemorrhagic injuries (OR range: 60.77-117.81, P<0.001). Conclusion: Our findings highlight the importance of sex-specific approaches in neonatal care and risk assessment. The complex interplay between different organ injuries, particularly in the brain, underscores the need for comprehensive monitoring strategies in neonatal intensive care units. These results provide a foundation for developing targeted preventive measures and individualized care protocols.