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Rania L, Djalila C, Brahim D, Rayene A, Meroua H, Souhem T, Zoubir A, Hichem C, Asma B, Dalila S, Karima S. Potential risk factors for hypospadias and negative correlation with DICER1 (rs3742330) A>G variant in Algerian population: A case-control study. Birth Defects Res 2024; 116:e2365. [PMID: 38801237 DOI: 10.1002/bdr2.2365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/20/2024] [Accepted: 05/08/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Hypospadias continues to be a prevalent congenital anomaly affecting the male external genitalia, characterized by an unclear origin and complex treatment approaches. This study aimed to investigate the risk factors associated with hypospadias and explore its genetic link with the DICER1 rs3742330 variant. METHODS The study involved two groups: 105 male children with hypospadias and 111 healthy male children as matched controls. Detailed history and physical examinations were conducted for all patients and controls. PCR-restriction fragment length polymorphism was utilized to identify the DICER1 rs3742330 variant, analyzing genotype distribution and allele frequency. Logistic regression analysis estimated the risk factors for hypospadias. RESULTS The mean age in the hypospadias group was 4.56 ± 2.50 years. The most prevalent type of hypospadias observed was the anterior type in 60 children (57.14%). Intrauterine growth restriction, advanced maternal age, and gestational hypertension were identified as significant risk factors for hypospadias (p = .011, p = .016, and p = .041, respectively). Regarding the genetic study, no significant difference was found in both genotype and allele frequencies of the DICER1 rs3742330 variant between case and control groups. CONCLUSIONS The rs3742330 variant in the DICER1 gene showed no association with hypospadias cases in the Algerian population. However, multivariate logistic regression analysis identified preterm birth, low birth weight, intrauterine growth restriction, advanced maternal age, gestational diabetes, and rural residence as the most significant independent predictors for hypospadias.
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Affiliation(s)
- Laouar Rania
- Laboratory of Molecular and Cellular Biology, Department of Animal Biology, Faculty of Natural and Life Science, University Of Mentouri Constantine 1, Constantine, Algeria
| | - Chellat Djalila
- Laboratory of Molecular and Cellular Biology, Department of Animal Biology, Faculty of Natural and Life Science, University Of Mentouri Constantine 1, Constantine, Algeria
| | - Djoudi Brahim
- LIRE Laboratory, University of Mentouri Constantine 1, Constantine, Algeria
| | - Achou Rayene
- Laboratory of Molecular and Cellular Biology, Department of Animal Biology, Faculty of Natural and Life Science, University Of Mentouri Constantine 1, Constantine, Algeria
| | - Horchi Meroua
- Laboratory of Molecular and Cellular Biology, Department of Animal Biology, Faculty of Natural and Life Science, University Of Mentouri Constantine 1, Constantine, Algeria
| | | | - Atrih Zoubir
- Pediatric Surgery Department, Specialized Mother and Child Hospital, Constantine, Algeria
| | - Choutri Hichem
- Department of Medicine, Pediatric Surgery Service, University Ferhat Abbas, Setif, Algeria
| | - Boukri Asma
- Endocrinology-Diabetology Service, University Hospital Center of Constantine, Constantine, Algeria
| | - Satta Dalila
- Laboratory of Molecular and Cellular Biology, Department of Animal Biology, Faculty of Natural and Life Science, University Of Mentouri Constantine 1, Constantine, Algeria
| | - Sifi Karima
- Laboratory of Biology and Molecular Genetics, Faculty of Medicine, University Of Constantine 3, Constantine, Algeria
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2
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Endo T, Iida M, Ichihashi Y, Oishi M, Ikenoue S, Kasuga Y, Sato T, Hida M, Ishii T, Asanuma H, Hasegawa T, Tanaka M, Ochiai D. Fetal growth restriction and a single umbilical artery are independent predictors of hypospadias during pregnancy. Placenta 2022; 130:53-59. [DOI: 10.1016/j.placenta.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/14/2022] [Accepted: 11/02/2022] [Indexed: 11/08/2022]
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3
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Sakemi Y, Shono T, Nakashima T, Yamashita H, Sugino N, Bonno M. Abnormal placental cord insertion, hypertensive disorders of pregnancy and birth length may be involved in development of hypospadias in male fetuses. Birth Defects Res 2022; 114:271-276. [PMID: 35218598 PMCID: PMC9303294 DOI: 10.1002/bdr2.1995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/30/2021] [Accepted: 02/17/2022] [Indexed: 02/06/2023]
Abstract
Objectives Hypospadias is a congenital disease characterized by morphological abnormalities of the penis, including abnormal urethral opening and penile flexion, which cause urination disorders and/or sexual intercourse difficulty. Various factors have been suggested to cause this anomaly, but evidence concerning risk factors causing this anomaly is insufficient. We evaluated the etiology of hypospadias in Japan using the Common Database of the National Hospitals' Neonatal study group. Study design We retrospectively evaluated 7,865 male neonates registered in the NICU Common Database of the National Hospitals' Neonatal study group. The subjects were divided into two groups by the presence (n = 43) or absence (n = 7,822) of hypospadias. Statistical analyses were performed to compare nominal variables between the groups by Fisher's direct establishment calculation method and logistic regression analyses. Results A univariate analysis showed significant between‐group differences in hypertensive disorders in pregnancy (odds ratio [OR]: 4.02, 95% confidence interval [CI]: 1.95–7.90), placental weight <−1.28 standard deviation (SD; OR: 5.06, 95% CI: 2.45–10.32), abnormal placental cord insertion (OR: 4.7, 95% CI: 2.62–9.76), birth length <−2SD (OR: 10.56, 95% CI: 5.00–21.1) and birth weight <−2SD (OR: 8.17, 95% CI: 4.17–15.68). A multivariate analysis showed a significant between‐group difference in hypertensive disorders of pregnancy (adjusted OR [AOR]: 2.30, 95% CI: 1.09–4.85), abnormal placental cord insertion (AOR: 3.69, 95% CI: 1.83–7.44) and birth length <−2SD (AOR: 3.44, 95% CI: 1.26–9.42). Conclusion Abnormal placental cord insertion, hypertensive disorders of pregnancy and birth length may be involved in hypospadias development in male neonates in conjunction with placental dysfunction in early pregnancy.
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Affiliation(s)
- Yoshihiro Sakemi
- Division of Pediatrics, National Hospital Organization Kokura Medical Center, Fukuoka, Japan
| | - Takeshi Shono
- Division of Pediatric Surgery and Pediatric Urology, National Hospital Organization Kokura Medical Center, Fukuoka, Japan
| | - Toshinori Nakashima
- Division of Pediatrics, National Hospital Organization Kokura Medical Center, Fukuoka, Japan
| | - Hironori Yamashita
- Division of Pediatrics, National Hospital Organization Kokura Medical Center, Fukuoka, Japan
| | - Noriko Sugino
- Division of Pediatrics, National Hospital Organization Mie-Chuou Medical Center, Mie, Japan
| | - Motoki Bonno
- Division of Pediatrics, National Hospital Organization Mie-Chuou Medical Center, Mie, Japan
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4
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Akay MA, Yıldız GE. Impact of gestational and parental factors and maternal intake of progesterone on the development of hypospadias: A retrospective case-control study. Taiwan J Obstet Gynecol 2021; 60:894-898. [PMID: 34507668 DOI: 10.1016/j.tjog.2021.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE Impact of environmental, maternal, paternal, and fetal factors on the development of hypospadias have been questioned in association with disrupted hormonal balance. We aimed to examine the association between maternal progesterone use and the associated risk factors and hypospadias. MATERIALS AND METHODS There were 429 male children as the cases with hypospadias (n = 280, Group 1) and the controls without hypospadias (n = 149, Group 2). Those working in agriculture and industry, cleaners, and hairdressers were determined as risky occupational groups concerning the exposure of estrogenic endocrine disrupters. The association of progestin usage and the other risk factors with hypospadias were the study outcomes. RESULTS The median gestational age was significantly lower in Group 2 (p = 0.019). Prematurity was more common in Group 1 (p = 0.043). Although the median birth weight in Group 1 was significantly lower (p < 0.001), there was no significant difference between the ratios of low birth weight babies in the groups. The risky occupations were more frequently detected in Group 2 (p = 0.001). The rate and duration of progestin usage in Group 1 were significantly higher than that in Group 2 (p < 0.001). CONCLUSION Low birth weight and the use and duration of progestins during pregnancy were significantly associated with increased hypospadias risk.
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Affiliation(s)
- Mustafa Alper Akay
- Kocaeli University School of Medicine, Department of Pediatric Surgery, Kocaeli, Turkey.
| | - Gülşen Ekingen Yıldız
- Kocaeli University School of Medicine, Department of Pediatric Surgery, Kocaeli, Turkey.
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5
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Wang X, Zhu H, Lei L, Zhang Y, Tang C, Wu JX, Zhou JR, Xiao XR. Integrated Analysis of Key Genes and Pathways Involved in Fetal Growth Restriction and Their Associations With the Dysregulation of the Maternal Immune System. Front Genet 2021; 11:581789. [PMID: 33584788 PMCID: PMC7873903 DOI: 10.3389/fgene.2020.581789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/30/2020] [Indexed: 11/26/2022] Open
Abstract
Fetal growth restriction (FGR) is a common pregnancy complication and a risk factor for infant death. Most patients with FGR have preeclampsia, gestational diabetes mellitus, or other etiologies, making it difficult to determine the specific molecular mechanisms underlying FGR. In this study, an integrated analysis was performed using gene expression profiles obtained from Gene Expression Omnibus. Differentially expressed genes (DEGs) between healthy and FGR groups were screened and evaluated by functional enrichment and network analyses. In total, 80 common DEGs (FDR < 0.05) and 17 significant DEGs (FDR < 0.005) were screened. These genes were enriched for functions in immune system dysregulation in the placenta based on Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses. Among hub genes identified as candidates for FGR and fetal reprogramming, LEP, GBP5, HLA–DQA1, and CTGF were checked by quantitative polymerase chain reaction, immunohistochemistry, and western blot assays in placental tissues. Immune imbalance could cause hypoxia environment in placenta tissues, thus regulating the fetal-reprogramming. A significant association between CTGF and HIF-1α levels was confirmed in placenta tissues and HTR8 cells under hypoxia. Our results suggest that an immune imbalance in the placenta causes FGR without other complications. We provide the first evidence for roles of CTGF in FGR and show that CTGF may function via HIF-1α-related pathways. Our findings elucidate the pathogenesis of FGR and provide new therapeutic targets.
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Affiliation(s)
- Xue Wang
- Despartment of Obstetrics and Gynecology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hong Zhu
- Despartment of Obstetrics and Gynecology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Lei
- Department of Obstetrics and Gynecology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yang Zhang
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Chao Tang
- Department of Pharmacology, Zhejiang University Medical School, Hangzhou, China
| | - Jia-Xing Wu
- Despartment of Obstetrics and Gynecology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie-Ru Zhou
- Despartment of Obstetrics and Gynecology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi-Rong Xiao
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
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6
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Mohammad‐Hasani A, Hosseinzadeh Colagar A, Fallah A. Association of the human aryl hydrocarbon receptor repressor (
AhRR
)‐c.565C>G transversion with male infertility: A case‐control study from Iran. J Cell Biochem 2018; 120:8999-9005. [DOI: 10.1002/jcb.28171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 11/08/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Azadeh Mohammad‐Hasani
- Department of Molecular and Cell Biology Faculty of Basic Sciences, University of Mazandaran Babolsar Iran
| | | | - Ali Fallah
- Department of Molecular and Cell Biology Faculty of Basic Sciences, University of Mazandaran Babolsar Iran
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7
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Sifakis S, Androutsopoulos VP, Pontikaki A, Velegrakis A, Papaioannou GI, Koukoura O, Spandidos DA, Papantoniou N. Placental expression of PAPPA, PAPPA-2 and PLAC-1 in pregnacies is associated with FGR. Mol Med Rep 2018. [PMID: 29532882 PMCID: PMC5928614 DOI: 10.3892/mmr.2018.8721] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Fetal growth restriction (FGR) is a gynecological disorder of varying etiology. In the present study, an expression analysis of pregnancy-associated plasma protein A (PAPPA), pregnancy-associated plasma protein A2 (PAPPA2) and placenta-specific-1 (PLAC-1) was conducted in pregnancies with FGR and control pregnancies. Placental tissues were collected from pregnancies with FGR (n=16) and control pregnancies (n=16) and the expression of the genes of interest was examined by qPCR. The mean expression levels of PAPPA and PAPPA2 were significantly lower (P<0.001) in placental tissues from FGR pregnancies compared with tissues from healthy subjects, whereas the opposite pattern was observed for PLAC-1 (P<0.001). PAPPA and PLAC-1 expression in FGR and control subjects correlated with birth weight (P<0.001). The findings suggest a possible pathophysiological link between the development of FGR and the expression of PAPPA, PAPPA2 and PLAC-1.
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Affiliation(s)
- Stavros Sifakis
- Department of Obstetrics and Gynecology, University Hospital of Heraklion, 71110 Heraklion, Greece
| | | | - Artemis Pontikaki
- Department of Obstetrics and Gynecology, University Hospital of Heraklion, 71110 Heraklion, Greece
| | - Alexis Velegrakis
- Department of Obstetrics and Gynecology, Venizeleion Hospital, 71409 Heraklion, Greece
| | - George I Papaioannou
- Department of Obstetrics and Gynecology, Attikon University Hospital, University of Athens, 12462 Athens, Greece
| | - Ourania Koukoura
- Department of Obstetrics and Gynecology, University of Thessalia, 41110 Larissa, Greece
| | - Demetrios A Spandidos
- Department of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Nikos Papantoniou
- Department of Obstetrics and Gynecology, Attikon University Hospital, University of Athens, 12462 Athens, Greece
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8
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Toufaily MH, Roberts DJ, Westgate MN, Hunt AT, Holmes LB. Hypospadias, Intrauterine Growth Restriction, and Abnormalities of the Placenta. Birth Defects Res 2017; 110:122-127. [PMID: 28755466 DOI: 10.1002/bdr2.1087] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 06/16/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Hypospadias is more common among male infants with growth restriction, defined as a birth weight less than the 10th centile, than in infants with a normal birth weight. Intrauterine growth retardation (IUGR) has been associated, also, with abnormalities of the placenta, such as maternal vascular malperfusion. In a consecutive sample of newborn infants, the association between hypospadias, IUGR and abnormalities of the placenta could be analyzed. METHODS Affected infants were identified among 289,365 liveborn and stillborn infants in the Active Malformations Surveillance Program between 1972 and 2012. The four anatomic locations of the ectopic urethral opening, based on the recorded physical examination findings, were: (1) glandular; (2) subcoronal; (3) penile; (4) penoscrotal. Affected infants with associated malformations, a chromosome abnormality, teratogenic exposure, maternal diabetes mellitus, or multiple gestations were excluded. RESULTS Three hundred sixteen affected infants were identified: 52.2% glandular, 11.7% subcoronal, 27.8% penile, and 8.2% penoscrotal. The highest frequency of IUGR (34.6%) was in the infants with the most severe hypospadias (penoscrotal). The 39 reports of placenta findings showed a high frequency of abnormalities. CONCLUSION An increased rate of occurrence of hypospadias and abnormalities of the placenta were present in infants with intrauterine growth restriction. The postulated cause of this association is a deficiency in the function of the placenta during weeks 10 to 14 of gestation when normal masculinization occurs due to an increase in the level of placental human chorionic gonadotropin and fetal testosterone. The cause of the placental deficiency has not been established. Birth Defects Research 110:122-127, 2018.© 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- M Hassan Toufaily
- Active Malformations Surveillance Program, Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Medical Genetics Unit, MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts
| | - Drucilla J Roberts
- Department of Pathology, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Marie-Noel Westgate
- Active Malformations Surveillance Program, Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Medical Genetics Unit, MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts
| | | | - Lewis B Holmes
- Active Malformations Surveillance Program, Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Medical Genetics Unit, MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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9
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Hayasaka I, Cho K, Uzuki Y, Morioka K, Akimoto T, Ishikawa S, Takei K, Yamada T, Morikawa M, Yamada T, Ariga T, Minakami H. Frequency of malformed infants in a tertiary center in Hokkaido, Japan over a period of 10 years. J Obstet Gynaecol Res 2016; 43:505-510. [DOI: 10.1111/jog.13229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/23/2016] [Accepted: 10/07/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Itaru Hayasaka
- Maternity and Perinatal Care Center; Hokkaido University Hospital; Sapporo Japan
| | - Kazutoshi Cho
- Maternity and Perinatal Care Center; Hokkaido University Hospital; Sapporo Japan
| | - Yutaka Uzuki
- Maternity and Perinatal Care Center; Hokkaido University Hospital; Sapporo Japan
| | - Keita Morioka
- Maternity and Perinatal Care Center; Hokkaido University Hospital; Sapporo Japan
| | - Takuma Akimoto
- Maternity and Perinatal Care Center; Hokkaido University Hospital; Sapporo Japan
| | - Satoshi Ishikawa
- Maternity and Perinatal Care Center; Hokkaido University Hospital; Sapporo Japan
| | - Kohta Takei
- Maternity and Perinatal Care Center; Hokkaido University Hospital; Sapporo Japan
| | - Takahiro Yamada
- Maternity and Perinatal Care Center; Hokkaido University Hospital; Sapporo Japan
| | - Mamoru Morikawa
- Maternity and Perinatal Care Center; Hokkaido University Hospital; Sapporo Japan
| | - Takashi Yamada
- Maternity and Perinatal Care Center; Hokkaido University Hospital; Sapporo Japan
| | - Tadashi Ariga
- Department of Pediatrics; Hokkaido University Hospital; Sapporo Japan
| | - Hisanori Minakami
- Maternity and Perinatal Care Center; Hokkaido University Hospital; Sapporo Japan
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10
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Andersen ABT, Ehrenstein V, Erichsen R, Frøslev T, Sørensen HT. Maternal inflammatory bowel disease and hypospadias in male offspring: a population-based study in Denmark. BMJ Open Gastroenterol 2016; 3:e000121. [PMID: 27933203 PMCID: PMC5128952 DOI: 10.1136/bmjgast-2016-000121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 10/10/2016] [Accepted: 10/21/2016] [Indexed: 01/01/2023] Open
Abstract
Background The occurrence of inflammatory bowel disease (IBD) and hypospadias has been concurrently increasing, possibly through shared environmental risk factors such as endocrine disrupting compounds. Also, maternal IBD may disturb the normal development of the fetal reproductive tract. However, whether maternal IBD increases the risk of hypospadias in male offspring is unknown. We compared hypospadias risk in sons of mothers with and without IBD. Methods We used Danish nationwide population-based registries to conduct a longitudinal prevalence study including all live-born boys from 1979 through 2009. We computed HRs, as estimates of prevalence ratios (PRs), with 95% CIs for hypospadias, using Cox proportional hazards regression, while adjusting for measured confounding. Results Among 966 038 live-born boys, 4688 (0.5%) had a mother with a history of IBD diagnosis before the relevant childbirth. Among the boys with maternal IBD, 36 (0.8%) were diagnosed with hypospadias any time after birth, whereas 6112 (0.6%) sons of mothers without IBD diagnosis had hypospadias (adjusted PR: 1.20, (95% CI 0.86 to 1.67). Adjusted PRs for maternal Crohn's disease and ulcerative colitis were 1.38 (95% CI 0.83 to 2.29) and 1.10 (95% CI 0.71 to 1.68), respectively. Analyses defining hypospadias diagnosis recorded <6 months postpartum showed similar results. Conclusions We found no convincing evidence of an association between maternal IBD and hypospadias.
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Affiliation(s)
| | - Vera Ehrenstein
- Department of Clinical Epidemiology , Aarhus University Hospital , Aarhus N , Denmark
| | - Rune Erichsen
- Department of Clinical Epidemiology , Aarhus University Hospital , Aarhus N , Denmark
| | - Trine Frøslev
- Department of Clinical Epidemiology , Aarhus University Hospital , Aarhus N , Denmark
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology , Aarhus University Hospital , Aarhus N , Denmark
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11
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Agopian AJ, Hoang TT, Mitchell LE, Morrison AC, Tu D, Nassar N, Canfield MA. Maternal hypertension and risk for hypospadias in offspring. Am J Med Genet A 2016; 170:3125-3132. [PMID: 27570224 DOI: 10.1002/ajmg.a.37947] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 08/11/2016] [Indexed: 02/05/2023]
Abstract
Hypospadias is one of the most common birth defects in male infants. Maternal hypertension is a suspected risk factor; however, few previous studies have addressed the possibility of reporting bias, and several previous studies have not accounted for hypospadias severity. We analyzed data from the Texas Birth Defects Registry for 10,924 nonsyndromic cases and statewide vital records for deliveries during 1999-2009, using Poisson regression. After adjustment for potential confounders, hypospadias was associated with maternal hypertension (adjusted prevalence ratio: 1.5, 95% confidence interval: 1.4-1.7). Similar associations were observed with gestational and pregestational hypertension, including separate analyses restricted to the subset of cases with severe (second- or third-degree) hypospadias. All of these associations were also similar among the subset of cases with isolated hypospadias (without additional birth defects). To evaluate the potential for bias due to potential hypertension misclassification, we repeated our analyses using logistic regression, comparing the cases to controls with other birth defects. In these analyses, the associations with gestational hypertension were similar, but adjusted associations with pregestational hypertension were no longer observed. Our findings support an association between gestational hypertension and hypospadias in offspring, but also suggest that previously observed associations with pregestational hypertension may have been inflated due to differential misclassification of hypertension (e.g., reporting bias). As gestational hypertension is recognized after hypospadias development, more research is needed to determine if this association reflects an increase in gestational hypertension risk secondary to hypospadias or if both conditions have shared risk factors (e.g., precursors of gestational hypertension). © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- A J Agopian
- Department of Epidemiology, Human Genetics and Environmental Sciences, Human Genetics Center, University of Texas School of Public Health, Houston, Texas
| | - Thanh T Hoang
- Department of Epidemiology, Human Genetics and Environmental Sciences, Human Genetics Center, University of Texas School of Public Health, Houston, Texas
| | - Laura E Mitchell
- Department of Epidemiology, Human Genetics and Environmental Sciences, Human Genetics Center, University of Texas School of Public Health, Houston, Texas
| | - Alanna C Morrison
- Department of Epidemiology, Human Genetics and Environmental Sciences, Human Genetics Center, University of Texas School of Public Health, Houston, Texas
| | - Duong Tu
- Department of Urology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas
| | - Natasha Nassar
- Menzies Centre for Health Policy, The University of Sydney, New South Wales, Australia
| | - Mark A Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
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