Maternal and Paternal Risk Factors for Cryptorchidism and Hypospadias: A Case–Control Study in Newborn Boys

Abstract

Little is known on environmental risk factors for cryptorchidism and hypospadias, which are among the most frequent congenital abnormalities. The aim of our study was to identify risk factors for cryptorchidism and hypospadias, with a focus on potential endocrine disruptors in parental diet and occupation. In a case–control study nested within a cohort of 8,698 male births, we compared 78 cryptorchidism cases and 56 hypospadias cases with 313 controls. The participation rate was 85% for cases and 68% for controls. Through interviews, information was collected on pregnancy aspects and personal characteristics, lifestyle, occupation, and dietary phytoestrogen intake of both parents. Occupational exposure to potential endocrine disruptors was classified based on self-reported exposure and ratings of occupational hygienists based on job descriptions. Our findings indicate that paternal pesticide exposure was associated with cryptorchidism [odds ratio (OR) = 3.8; 95% confidence interval (95% CI), 1.1–13.4]. Smoking of the father was associated with hypospadias (OR = 3.8; 95% CI, 1.8–8.2). Maternal occupational, dietary, and lifestyle exposures were not associated with either abnormality. Both abnormalities were associated with suboptimal maternal health, a lower maternal education, and a Turkish origin of the parents. Being small for gestational age was a risk factor for hypospadias, and preterm birth was a risk factor for cryptorchidism. Because paternal pesticide exposure was significantly associated with cryptorchidism and paternal smoking was associated with hypospadias in male offspring, paternal exposure should be included in further studies on cryptorchidism and hypospadias risk factors.

The influence of antenatal exposure to phthalates on subsequent female reproductive development in adolescence: a pilot study

“…Strong evidence exists from animal models that exposure to endocrine disrupters can exert adverse effects on reproductive outcomes in the offspring. Some pesticides and phthalates have the potential to cause cryptorchidism and decreased sperm production (Pierik et al 2004).…”

Response to ‘Dr Raymond David, BASF Corporation’

“…The JEM was also applied in a Dutch nested case-control study of 56 cases of hypospadias and 78 cases of cryptorchism and 313 controls selected from a cohort of 8,698 male newborns. No association was found between estimated occupational exposure to potential endocrine disrupting agents and these outcomes (Pierik et al 2004). In a study on contamination of breast milk with phthalates no association was found between breast milk phthalate monoester levels and cryptorchidism, but other potential anti-androgenic metabolites were not measured (Main et al 2006).…”

Is male infertility a forerunner to cancer?

“…One potent source of synthetic estrogen exposure is pesticides, which are known to possess estrogenic, anti-androgenic, and aromatase inhibiting effects in vivo. It has been shown that maternal exposure to pesticides during pregnancy is associated with an increased risk of cryptorchidism in male infants (36). A separate study also found that women who worked in greenhouses while pregnant gave birth to sons with significant reproductive health impairment, particularly a three-fold greater risk of cryptorchidism (37).…”