Examining Sex-Based Inequities in Pediatric Sports Medicine Research: A Systematic Review.
Sonnier JH, Patel NM, Watson SL, Gippo I, Lew L, Durudogan EH et al. ยท Journal of pediatric orthopedics ยท 2026
Background: Inequalities in the inclusion of male and female athletes have been documented in the sports medicine literature. However, the extent to which this phenomenon exists in studies of pediatric athletes remains poorly defined. The
Purpose: of this study is to characterize the inclusion of male versus female athletes in pediatric sports medicine.
Methods: All articles published from 2020 to 2024 in 12 top interdisciplinary sports medicine journals were manually reviewed, and
Results: were reported following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocols. Inclusion criteria were: (1) full-text original research study, (2) isolated athletes, and (3) isolated a pediatric patient population. Exclusion criteria were: (1) editorial or review article, (2) case report with only one subject, and (3) cadaveric study. Data were collected to characterize
Study design: , inclusion, and outcomes of interest. Statistical analysis was performed using the asymptotic ฯ2 (Pearson) test as the default. To examine absolute inequality in the inclusion of male and female athletes, mean differences (MDs) were calculated from linear regression models for continuous outcomes.
Results Across 409 included studies, 30% enrolled only male athletes, 10% enrolled only female athletes, and 60% included both male and female athletes. The median inclusion was 61% male and 39% female (mean 64% and 36%, respectively). Among 234 studies that focused on a single sport, 48.7% included only males, 15.4% included only females, and 35.9% included both males and females (P
Conclusion: Females are underrepresented in studies of youth athletes, particularly in single-sport studies and study designs with a higher level of evidence. Clinical relevance Given that there are known differences in sex-related outcomes, future research should prioritize equity in the inclusion of male and female athletes. Levels of evidence Level IV-systematic review.