Maternal progestin intake and risk of hypospadias.
ABSTRACT Previous studies have suggested that maternal intake of progestins during early pregnancy may be associated with an increased risk of hypospadias. Progesterone and its derivatives are commonly prescribed during early pregnancy, for example, in cases of luteal phase dysfunction and in conjunction with ovulation stimulation drugs.
To examine whether risk of hypospadias was associated with periconceptional progestin intake.
The National Birth Defects Prevention Study, a population-based, multistate, case-control study including deliveries that had estimated due dates from October, 1997 to December, 2000.
Participation in the study was 71% among case mothers and 68% among control mothers. This analysis included 502 subjects diagnosed with second- or third-degree hypospadias (ie, the urethra opened at the penile shaft, scrotum, or perineum) and 1286 male, live-born, nonmalformed control subjects.
Forty-two case mothers (8.4%) and 31 control mothers (2.4%) reported any pregnancy-related progestin intake from 4 weeks before through 14 weeks after conception, resulting in an odds ratio of 3.7 (95% confidence interval [CI], 2.3-6.0). Analyses stratified by several potential covariates also suggested elevated risks. For example, among the 10 cases and 13 controls who did not report any fertility-related procedures or treatments other than progestins, the odds ratio was 2.2 (95% CI, 1.0-5.0). Progestin intake for the purpose of contraception was not associated with increased risk.
This study found that pregnancy-related intake of progestins was associated with increased hypospadias risk.
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ABSTRACT: Hypospadias is one of the most common birth defects among males. Although the birth prevalence of hypospadias has been reported as increasing in some geographic regions, inconsistencies in ascertainment of mild cases and variability in reporting standards are likely contributing to these apparent trends. While hypospadias is highly heritable, there is limited knowledge about the specific genetic and epigenetic factors that play a role in its etiology. Risk factors for hypospadias include family history, older maternal age, nulliparity, high maternal prepregnancy body mass index, hypertension or preeclampsia, multiple gestations, reduced birth weight, and small for gestational age. Of the various prenatal exposures to medications that have been studied, the strongest evidence supports valproic acid as a contributor to hypospadias. Studies evaluating the impact of assisted reproductive technologies (ART) on hypospadias are inconclusive because of potential confounding by subfertility. Many causes of hypospadias may act through a few shared pathways, such as placental dysfunction.01/2015; 2(1). DOI:10.1007/s40471-014-0034-0
Chapter: Endocrine Disruption in Mammals[Show abstract] [Hide abstract]
ABSTRACT: The United States presently uses more than 80 000 chemicals, a number that is estimated to grow by 2000 chemicals each year. Although generally not considered toxic at current exposure levels, many of these chemicals interfere with the endocrine system and may have profound effects on reproduction. Exposure to endocrine-disrupting chemicals (EDCs) is associated with an earlier onset of puberty, decreased fecundity and fertility, altered sexual behavior, and increased incidence of abnormalities and cancers of the reproductive tract in humans and in laboratory animals. Importantly, it appears that developing organisms may be particularly sensitive to slight variations in the hormonal milieu that occurs after exposure to some chemicals. In this chapter we review the sources and mechanisms of several well-studied EDCs and the evidence that exposure to these chemicals affects many aspects of mammalian reproduction.Hormones and Reproduction of Vertebrates, Mammals edited by David O. Norris, Kristin H. Lopez, 01/2010: chapter 14: pages 329-371; Elsevier Publishing., ISBN: 978-0-12-374928-4
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ABSTRACT: This article reviews the current evidence and knowledge of the aetiology of hypospadias. Hypospadias remains a fascinating anomaly of the male phallus. It may be an isolated occurrence or part of a syndrome or field defect. The increasing use of assisted reproductive techniques and hormonal manipulation during pregnancy may have been associated with an apparent rise in the incidence of hypospadias. Genetic studies and gene analysis have suggested some defects that could result in hypospadias. New light has also been thrown on environmental factors that could modulate candidate genes, causing altered development of the male external genitalia.Pediatric Surgery International 03/2015; DOI:10.1007/s00383-015-3686-z · 1.06 Impact Factor