A Joint International Study on the Epidemiology of Hypospadias

Kallgn, Bengt; Bertollini, Roberto; Castilla, Eduardo E.; Czeizel, Andr̀ew E.; Knudsen, Lisbeth B.; Martı́nez-Frı́as, María Luisa; Mastroiacovo, Pierpaolo; Mutchinick, Osvaldo M.

doi:10.1111/j.1651-2227.1986.tb14935.x

Cited by 150 publications

(95 citation statements)

References 28 publications

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“…We have shown variable quality of surveillance data in Europe. We are aware of two previous studies that have validated the quality of surveillance data (Aho et al 2000;Kallen et al 1986), also finding considerable problems. We recommend caution in interpreting international trends (Paulozzi 1999), whether for all hypospadias or "severe" hypospadias.…”

Section: Discussionmentioning

confidence: 99%

Toward the effective surveillance of hypospadias.

Dolk

Vrijheid

Scott

et al. 2004

Environ Health Perspect

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Concern about apparent increases in the prevalence of hypospadias--a congenital male reproductive-tract abnormality--in the 1960s to 1980s and the possible connection to increasing exposures to endocrine-disrupting chemicals have underlined the importance of effective surveillance of hypospadias prevalence in the population. We report here the prevalence of hypospadias from 1980 to 1999 in 20 regions of Europe with EUROCAT (European Surveillance of Congenital Anomalies) population-based congenital anomaly registers, 14 of which implemented a guideline to exclude glanular hypospadias. We also report data from the England and Wales National Congenital Anomaly System (NCAS). Our results do not suggest a continuation of rising trends of hypospadias prevalence in Europe. However, a survey of the registers and a special validation study conducted for the years 1994-1996 in nine EUROCAT registers as well as NCAS identified a clear need for a change in the guidelines for registration of hypospadias. We recommend that all hypospadias be included in surveillance, but that information from surgeons be obtained to verify location of the meatus, and whether surgery was performed, in order to interpret trends. Investing resources in repeated special surveys may be more cost-effective than continuous population surveillance. We conclude that it is doubtful whether we have had the systems in place worldwide for the effective surveillance of hypospadias in relation to exposure to potential endocrine-disrupting chemicals.

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Section: Discussionmentioning

confidence: 99%

Toward the effective surveillance of hypospadias.

Dolk

Vrijheid

Scott

et al. 2004

Environ Health Perspect

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“…Familial clustering is seen in about 10% of the cases [12][13][14][15], and the recurrence risk in the male siblings of an affected patient is about 15% [16][17][18]. Seven percent of the fathers of children with hypospadias are also affected [19].…”

Section: Genetic Backgroundmentioning

confidence: 99%

Hypospadias: Interactions between environment and genetics

Kalfa

Philibert

Baskin

et al. 2011

Molecular and Cellular Endocrinology

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“…Several hypotheses have been proposed for the aetiology of this urogenital anomaly, including genetic [6±8], environmental [9] and maternal risk factors, including an early age at menarche [10], maternal age and parity [11]. Kallen et al [11] showed that increasing maternal age (particularly of primiparae) was associated with a higher prevalence of hypospadias. Exposure to drugs in pregnancy, particularly involving sex hormones, was also a signi®cant risk factor in several studies [9,10,12].…”

Section: Introductionmentioning

confidence: 99%

“…However, there is ®rm evidence for an increase in cancer of the testis [4] and suggestions of an increased prevalence of defects of the male genitalia, including hypospadias [5]. Several hypotheses have been proposed for the aetiology of this urogenital anomaly, including genetic [6±8], environmental [9] and maternal risk factors, including an early age at menarche [10], maternal age and parity [11]. Kallen et al [11] showed that increasing maternal age (particularly of primiparae) was associated with a higher prevalence of hypospadias.…”

Section: Introductionmentioning

confidence: 99%

A maternal vegetarian diet in pregnancy is associated with hypospadias

2000

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Objective To investigate the possible role of the maternal diet, particularly vegetarianism and consumption of phytoestrogens, in the origin of hypospadias, which is reported to be increasing in prevalence. Subjects and methods Detailed information was obtained prospectively from mothers, including previous obstetric history, lifestyle and dietary practices, using structured self-completed questionnaires during pregnancy. Previously recognized associations with environmental and parental factors were examined, focusing particularly on the hypothesized hormonal link. Multivariate logistic regression was used to identify independent associations. Results Of 7928 boys born to mothers taking part in the Avon Longitudinal Study of Pregnancy and Childhood, 51 hypospadias cases were identi®ed. There were no signi®cant differences in the proportion of hypospadias cases among mothers who smoked, consumed alcohol or for any aspect of their previous reproductive history (including the number of previous pregnancies, number of miscarriages, use of the contraceptive pill, time to conception and age at menarche). Signi®cant differences were detected for some aspects of the maternal diet, i.e. vegetarianism and iron supplementation in the ®rst half of pregnancy. Mothers who were vegetarian in pregnancy had an adjusted odds ratio (OR) of 4.99 (95% con®dence interval, CI, 2.10±11.88) of giving birth to a boy with hypospadias, compared with omnivores who did not supplement their diet with iron. Omnivores who supplemented their diet with iron had an adjusted OR of 2.07 (95% CI, 1.00±4.32). The only other statistically signi®cant association for hypospadias was with in¯uenza in the ®rst 3 months of pregnancy (adjusted OR 3.19, 95% CI 1.50±6.78). Conclusion As vegetarians have a greater exposure to phytoestrogens than do omnivores, these results support the possibility that phytoestrogens have a deleterious effect on the developing male reproductive system.

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A Joint International Study on the Epidemiology of Hypospadias

Cited by 150 publications

References 28 publications

Toward the effective surveillance of hypospadias.

Toward the effective surveillance of hypospadias.

Hypospadias: Interactions between environment and genetics

A maternal vegetarian diet in pregnancy is associated with hypospadias

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