Adams Scott V, Hastert Theresa A, Huang Yi, Starr Jacqueline R
Department of Epidemiology, University of Washington, Seattle, USA.
Birth Defects Res A Clin Mol Teratol. 2011 Apr;91(4):241-8. doi: 10.1002/bdra.20805. Epub 2011 Apr 1.
Hypospadias and cryptorchidism, two relatively common male genital anomalies, may be caused by altered maternal hormone levels, blood glucose levels, or nutritional deficiencies. Maternal obesity, which increases risk of diabetes and could influence hormone levels, may, therefore, be associated with risk of hypospadias and cryptorchidism. The purpose of this study was to assess the association between pre-pregnancy maternal obesity and hypospadias and cryptorchidism.
We conducted a case-control study of hypospadias and cryptorchidism in male singleton newborns using Washington State birth records from 1992 to 2008 linked to birth-hospitalization discharge records. Maternal pre-pregnancy body mass index (BMI) was calculated from pre-pregnancy weight and height. Adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for hypospadias or cryptorchidism were estimated by fitting multivariable logistic regression models adjusted for year of birth, and maternal age, education, parity, race, and cigarette smoking during pregnancy.
The complete-case analysis included 2219 hypospadias cases, 2563 cryptorchidism cases, and 32,734 controls. Maternal obesity (BMI ≥30 kg/m(2) ) was not associated with risk of hypospadias or cryptorchidism in male offspring: hypospadias (aOR, 1.07; 95% CI, 0.95-1.21); cryptorchidism (aOR, 0.99; 95% CI, 0.89-1.11), and no trend in risk with increasing maternal BMI was found. There was little indication of risk associated with BMI among any subgroup of mothers examined, including women with pre-existing diabetes or hypertension, women who developed preeclampsia, non-Hispanic white women, first-time mothers, or mothers aged ≥30 years.
The results of this study do not support the hypothesis that pre-pregnancy maternal obesity is a cause of hypospadias or cryptorchidism in male infants.
尿道下裂和隐睾症是两种相对常见的男性生殖器异常,可能由母体激素水平改变、血糖水平或营养缺乏引起。母体肥胖会增加患糖尿病的风险,并可能影响激素水平,因此可能与尿道下裂和隐睾症的风险相关。本研究的目的是评估孕前母体肥胖与尿道下裂和隐睾症之间的关联。
我们利用1992年至2008年华盛顿州的出生记录与出生-住院出院记录相链接,对男性单胎新生儿的尿道下裂和隐睾症进行了病例对照研究。根据孕前体重和身高计算母体孕前体重指数(BMI)。通过拟合多变量逻辑回归模型,对尿道下裂或隐睾症的调整优势比(aORs)和95%置信区间(95% CIs)进行估计,该模型对出生年份、母体年龄、教育程度、产次、种族和孕期吸烟情况进行了调整。
完整病例分析包括2219例尿道下裂病例、2563例隐睾症病例和32734例对照。母体肥胖(BMI≥30 kg/m²)与男性后代尿道下裂或隐睾症的风险无关:尿道下裂(aOR,1.07;95% CI,0.95 - 1.21);隐睾症(aOR,0.99;95% CI,0.89 - 1.11),且未发现随着母体BMI增加风险有任何趋势。在任何被检查的母亲亚组中,包括患有糖尿病或高血压的女性、患先兆子痫的女性、非西班牙裔白人女性、初产妇或年龄≥30岁的母亲,几乎没有迹象表明BMI与风险相关。
本研究结果不支持孕前母体肥胖是男性婴儿尿道下裂或隐睾症病因的假设。