Maternal Age as a Risk Factor for Hypospadias

Fisch, Harry; Golden, Richard M.; LIBERSEN, GARY L.; Hyun, Grace; Madsen, Pamela; New, Maria I.; Hensle, Terry W.

doi:10.1016/s0022-5347(05)66578-0

Cited by 94 publications

(41 citation statements)

References 20 publications

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“…Taken together, it is becoming increasingly clear that advanced maternal age is associated to hypospadias. Our finding is also consistent with previous studies showing that the risk is higher for having a child with hypospadias Type II or III than for Type I [9, 20–21]. But the exact nature of this association still needs to be determined; is it related to genetic defects associated to aging, to subfertility, or any other factor?…”

Section: Discussionsupporting

confidence: 92%

“…A case-control population study in Sweden for the time period 1983–1993 found that the odds ratio (OR) of having a child with hypospadias among mothers > 40 years of age was 1.30 with a 95% confidence interval (CI) between 0.67-2.53 [8]. In the USA, it has been reported that OR for mothers > 35 years of age in the state of California was 1.2 (95% CI: 1.1-1.4) for the time period 1983–89, whereas the odds of having a child with severe hypospadias for years 1990–95 in that state was 1.5 (95% CI: 1.2-1.7) [9]. The same study established that the OR for the state of New York was 1.2 (95% CI: 1.1-1.3) for years 1983–96 [9].…”

Section: Discussionmentioning

confidence: 99%

“…In the USA, it has been reported that OR for mothers > 35 years of age in the state of California was 1.2 (95% CI: 1.1-1.4) for the time period 1983–89, whereas the odds of having a child with severe hypospadias for years 1990–95 in that state was 1.5 (95% CI: 1.2-1.7) [9]. The same study established that the OR for the state of New York was 1.2 (95% CI: 1.1-1.3) for years 1983–96 [9]. In the case of Washington State (1987–1997), OR for mothers > 40 years of age was 1.70 (95% CI: 1.17-2.48) [10].…”

Section: Discussionmentioning

confidence: 99%

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Age of the Mother as a Risk Factor and Timing of Hypospadias Repair According to Severity

Jorge¹,

Perez-Brayfield

Torres

et al. 2016

JURNOA

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Background & Objectives Hypospadias is characterized by a displacement of the urethral opening in males that can change from the typical position within the glans penis to a subcoronal position (Type I), to anywhere along the ventral shaft (Type II), to penoscrotal, scrotal, or perineal positions (Type III). We and others have previously reported that age of the mother (≥ 40 years old) is a risk factor for having a child with hypospadias, but there is a scarcity of reports on whether such risk is higher for having a child with the mild (Type I) or the more severe forms (Types II and III). In addition, we aimed to assess the timing of hypospadias repair according to severity. Methods Parents of children with hypospadias were interviewed by using a series of questionnaires (n = 128 cases). Severity was confirmed in the clinic and age of the mother was self-reported. Number of surgeries, age of child by the first and the last intervention was also assessed. Ordered logistic regression and the Brant test were employed to calculate risk between mild (Type I) and severe cases (Types II and III), and the assumption of proportional odds, respectively. The Mann-Whitney U Test was used to compare number of surgeries and age by the last repair between mild and severe cases. One-way ANOVA was employed to compare age of the child at the time of first surgery across severities (Types I - III). Results Women ≥ 40 years of age are 3.89 times [95% CI: 1.20-12.64] at a higher risk for having a child with the more severe forms of the condition than younger women. Repair of Type I was accomplished with 1 intervention whereas more severe cases required 1 – 4 (2 ± 0.5) surgical interventions. The timing for hypospadias repair of Type I cases occurred at an average age of 16.2 ± 4.88 months, of Type II cases occurred at an average age of 20.3 ± 8.15 months whereas the average age of the first hypospadias repair among Type III cases was 12.68 ± 2.52 months. Number of surgeries according to severity (p ≤ 0.0018, z-ratio = 2.91) and age difference for the timing of last repair (p ≤ 0.045, z-ratio = 1.69) were statistically different, but not the age difference for the first repair. Conclusions Increased maternal age is associated with the most severe forms of hypospadias. There is room for improvement for the timing of hypospadias repair according to severity.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Age of the Mother as a Risk Factor and Timing of Hypospadias Repair According to Severity

Jorge¹,

Perez-Brayfield

Torres

et al. 2016

JURNOA

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“…These anomalies may be caused by placental insufficiency, which may result from many factors, including maternal age, parity, and multiple births 12. Advanced maternal age was found to be associated with an increased incidence of structural birth defects, including urethral abnormalities 13. Similarly, we observed significant relationships between hypospadias and maternal age extremes.…”

Section: Discussionsupporting

confidence: 58%

Risk factors for hypospadias in China

Liang

Lipianskaya

et al. 2014

Asian J Androl

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This case-controlled study was designed to evaluate the association between various baseline parental factors and the risk of hypospadias in China. Patients were selected from tertiary referral hospitals in Anhui, a province in mid-eastern China. A questionnaire was given to the parents of each patient. The final database included 193 cases and 835 controls. The incidence of additional coexistent anomalies was 13.0%, primarily cryptorchidism (9.8%). Ten patients (5.1%) were from families with genital anomaly, including five families (2.6%) with hypospadias. The risks of hypospadias was higher for children of mothers > 35 (odds ratio [OR] =1.47) and < 18 (OR = 2.95) years of age, and in mothers who had consumed alcohol (OR = 2.67), used drugs (OR = 1.53) and had an infection (OR = 1.87) during pregnancy. The risk of hypospadias was also higher when mothers (OR = 1.68) and fathers (OR = 1.74) were engaged in agriculture. Other factors assessed were not associated with the risk of hypospadias.

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“…In rural areas where only a smaller population is considered, variations within the population cohort may be problematic, leading to an apparently reduced association with deprivation. Fisch et al 9 have recently reported that the risk of genital anomaly increases with increasing maternal age. Our data suggest that this risk may be independent of socioeconomic status.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of hypospadias and other genital anomalies among singleton births, 1988-1997, in Scotland

Ahmed

Dobbie²,

Finlayson³

et al. 2004

Archives of Disease in Childhood - Fetal and Neonatal Edition

106

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Maternal Age as a Risk Factor for Hypospadias

Abstract: Hypospadias is significantly associated with increasing maternal age. Women who elect to delay childbearing until their mid 30s or later should be aware that their offspring are at increased risk of hypospadias.

Cited by 94 publications

References 20 publications

Age of the Mother as a Risk Factor and Timing of Hypospadias Repair According to Severity

Age of the Mother as a Risk Factor and Timing of Hypospadias Repair According to Severity

Risk factors for hypospadias in China

Prevalence of hypospadias and other genital anomalies among singleton births, 1988-1997, in Scotland

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