Maternal hypertensive disorders and subtypes of hypospadias: A Dutch case‐control study

Background Hypospadias is a frequently occurring congenital anomaly in male infants, in which the opening of the urethra is located along the ventral side of the penis. Although various studies attempted to identify its causes, the aetiology of the majority of hypospadias cases remains poorly unders...

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Bibliographic Details
Published in:Paediatric and perinatal epidemiology 2020-11, Vol.34 (6), p.687-695
Main Authors: Jamaladin, Hussein, Rooij, Iris A. L. M., Zanden, Loes F. M., Gelder, Marleen M. H. J., Roeleveld, Nel
Format: Article
Language:English
Subjects:
antihypertensive medication use
Antihypertensives
Confidence intervals
Congenital anomalies
Congenital Malformations
Disorders
Drug therapy
Heterogeneity
Hypertension
hypospadias
Infants
maternal hypertensive disorders
Original
Penis
Pharmacology
Population studies
Pre-eclampsia
Preeclampsia
Pregnancy
pregnancy complications
preeclampsia
Risk analysis
Risk factors
Statistical analysis
subtypes of hypospadias
Urethra
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Summary:Background Hypospadias is a frequently occurring congenital anomaly in male infants, in which the opening of the urethra is located along the ventral side of the penis. Although various studies attempted to identify its causes, the aetiology of the majority of hypospadias cases remains poorly understood. Maternal hypertensive disorders are believed to be associated with hypospadias, but the results of previous studies are not consistent, especially for subtypes of hypospadias. Objectives To investigate the associations between maternal hypertensive disorders, stratified by pharmacological treatment, and the occurrence of hypospadias divided into subtypes in a large population‐based case‐control study. Methods We included 887 hypospadias cases and 1005 male controls from the AGORA data‐ and biobank. Cases and controls were born in the periods 1975‐2016 and 1990‐2011, respectively. All data were collected in the period 2004‐2018. Maternal questionnaires were used to obtain information on hypertensive disorders during pregnancy, antihypertensive medication treatment, and potential confounders. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for the associations between hypertensive disorders and hypospadias were estimated using logistic regression. Results Hypertensive disorders were reported by 15.3% of the women in this study. Maternal hypertensive disorders in general, chronic hypertension, and gestational hypertension were not associated with hypospadias or its subtypes. Preeclampsia was associated with posterior hypospadias (aOR 3.09, 95% CI 1.49, 6.43), whether it was untreated (aOR 2.81, 95% CI 1.24, 6.38) or pharmacologically treated preeclampsia (aOR 4.96, 95% CI 1.08, 22.80). Conclusions Our findings indicate that preeclampsia is associated with posterior hypospadias, irrespective of pharmacological treatment. This result supports the hypothesis of aetiological heterogeneity among the subtypes of hypospadias, with pregnancy‐related risk factors being associated with the more severe types of hypospadias.
ISSN:0269-5022
1365-3016
DOI:10.1111/ppe.12683