Akre Olof, Boyd Heather A, Ahlgren Martin, Wilbrand Kerstin, Westergaard Tine, Hjalgrim Henrik, Nordenskjöld Agneta, Ekbom Anders, Melbye Mads
Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden.
Environ Health Perspect. 2008 Aug;116(8):1071-6. doi: 10.1289/ehp.10791.
An increase in the prevalence of hypospadias has been reported, but the environmental causes remain virtually unknown.
Our goal was to assess the association between risk of hypospadias and indicators of placental function and endogenous hormone levels, exposure to exogenous hormones, maternal diet during pregnancy, and other environmental factors.
We conducted a case-control study in Sweden and Denmark from 2000 through 2005 using self-administered questionnaires completed by mothers of hypospadias cases and matched controls. The response rate was 88% and 81% among mothers of cases and controls, respectively. The analyses included 292 cases and 427 controls.
A diet during pregnancy lacking both fish and meat was associated with a more than 4-fold increased risk of hypospadias [odds ratio (OR) = 4.6; 95% confidence interval (CI), 1.6-13.3]. Boys born to obese [body mass index (BMI) > or = 30] women had a more than 2-fold increased risk of hypospadias (OR = 2.6; 95% CI, 1.2-5.7) compared with boys born to mothers with a normal weight (BMI = 20-24). Maternal hypertension during pregnancy and absence of maternal nausea increased a boy's risk of hypospadias 2.0-fold (95% CI, 1.1-3.7) and 1.8-fold (95% CI, 1.2-2.8), respectively. Nausea in late pregnancy also appeared to be positively associated with hypospadias risk (OR = 7.6; 95% CI, 1.1-53).
A pregnancy diet lacking meat and fish appears to increase the risk of hypospadias in the offspring. Other risk associations were compatible with a role for placental insufficiency in the etiology of hypospadias.
已有报道称尿道下裂的患病率有所上升，但环境病因几乎仍不明确。
我们的目标是评估尿道下裂风险与胎盘功能指标、内源性激素水平、外源性激素暴露、孕期母亲饮食及其他环境因素之间的关联。
2000年至2005年期间，我们在瑞典和丹麦开展了一项病例对照研究，采用由尿道下裂病例的母亲和匹配对照自行填写的问卷。病例组母亲和对照组母亲的应答率分别为88%和81%。分析纳入了292例病例和427名对照。
孕期饮食中既缺乏鱼类又缺乏肉类与尿道下裂风险增加4倍以上相关[比值比（OR）=4.6；95%置信区间（CI），1.6 - 13.3]。肥胖[体重指数（BMI）≥30]女性所生男孩患尿道下裂的风险比体重正常（BMI = 20 - 24）母亲所生男孩增加2倍以上（OR = 2.6；95% CI，1.2 - 5.7）。孕期母亲患高血压以及母亲无恶心症状分别使男孩患尿道下裂的风险增加2.0倍（95% CI，1.1 - 3.7）和1.8倍（95% CI，1.2 - 2.8）。妊娠晚期恶心似乎也与尿道下裂风险呈正相关（OR = 7.6；95% CI，1.1 - 53）。
孕期饮食缺乏肉类和鱼类似乎会增加后代患尿道下裂的风险。其他风险关联与胎盘功能不全在尿道下裂病因学中的作用相符。
