Intrauterine exposure to mild analgesics during pregnancy and the occurrence of cryptorchidism and hypospadia in the offspring: the Generation R Study

Recently, over-the-counter mild analgesic use during pregnancy has been suggested to influence the risk of reproductive disorders in the offspring. We examined the influence of maternal exposure to mild analgesics during pregnancy on the occurrence of cryptorchidism and hypospadia in their offspring...

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Published in:Human reproduction (Oxford) 2012-04, Vol.27 (4), p.1191-1201
Main Authors: Snijder, Claudia A., Kortenkamp, Andreas, Steegers, Eric A.P., Jaddoe, Vincent W.V., Hofman, Albert, Hass, Ulla, Burdorf, Alex
Format: Article
Language:English
Subjects:
Analgesics - adverse effects
Biological and medical sciences
Cohort Studies
Cryptorchidism - chemically induced
Cryptorchidism - epidemiology
Female
Fetal Development - drug effects
Gynecology. Andrology. Obstetrics
Humans
Hypospadias - chemically induced
Hypospadias - epidemiology
Infant, Newborn
Logistic Models
Male
Medical sciences
Netherlands
Odds Ratio
Pregnancy
Pregnancy Trimester, First
Pregnancy Trimester, Second
Pregnancy Trimester, Third
Prenatal Exposure Delayed Effects
Prevalence
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Summary:Recently, over-the-counter mild analgesic use during pregnancy has been suggested to influence the risk of reproductive disorders in the offspring. We examined the influence of maternal exposure to mild analgesics during pregnancy on the occurrence of cryptorchidism and hypospadia in their offspring. METHODS Associations between maternal exposure to mild analgesics during pregnancy and cryptorchidism or hypospadia in the offspring were studied in 3184 women participating in a large population-based prospective birth cohort study from early pregnancy onwards in the Netherlands (2002–2006), the Generation R Study. Cryptorchidism and hypospadia were identified during routine screening assessments performed in child health care centres by trained physicians. The use of mild analgesics was assessed in three prenatal questionnaires in pregnancy, resulting in four periods of use, namely, periconception period, first 14 weeks of gestation, 14–22 weeks of gestation and 20–32 weeks of gestation. Logistic regression analyses were used to study the associations between maternal exposure to mild analgesics and cryptorchidism and hypospadia. RESULTS The cumulative prevalence over 30 months of follow up was 2.1% for cryptorchidism and 0.7% for hypospadia. Use of mild analgesics in the second period of pregnancy (14–22 weeks) increased the risk of congenital cryptorchidism [adjusted odds ratio (OR) 2.12; 95% confidence interval (CI) 1.17–3.83], primarily due to the use of acetaminophen (paracetamol) (adjusted OR 1.89; 95% CI 1.01–3.51). Among mothers of cryptorchid sons, 33.8% reported (23 of 68) the use of mild analgesics during pregnancy, compared with 31.8% (7 of 22) of mothers with a boy with hypospadia and 29.9% (926 of 3094) of mothers with healthy boys. CONCLUSIONS Our results suggest that intrauterine exposure to mild analgesics, primarily paracetamol, during the period in pregnancy when male sexual differentiation takes place, increases the risk of cryptorchidism.
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/der474