Zhang Lin, Wang Xing-Huan, Zheng Xin-Min, Liu Tong-Zu, Zhang Wei-Bin, Zheng Hang, Chen Mi-Feng
Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China.
Department of Obstetrical, Jingmen No. 2 People's Hospital, Jingmen Hubei, People's Republic of China.
PLoS One. 2015 Mar 23;10(3):e0119006. doi: 10.1371/journal.pone.0119006. eCollection 2015.
Maternal gestational smoking, diabetes, alcohol drinking, and pre-pregnancy obesity are thought to increase the risk of cryptorchidism in newborn males, but the evidence is inconsistent.
We conducted a systematic review and meta-analysis of studies on the association between maternal gestational smoking, diabetes, alcohol drinking, and pre-pregnancy obesity and the risk of cryptorchidism. Articles were retrieved by searching PubMed and ScienceDirect, and the meta-analysis was conducted using Stata/SE 12.0 software. Sensitivity analysis was used to evaluate the influence of confounding variables.
We selected 32 articles, including 12 case-control, five nested case-control, and 15 cohort studies. The meta-analysis showed that maternal smoking (OR = 1.17, 95% CI: 1.11-1.23) or diabetes (OR = 1.21, 95%CI: 1.00-1.46) during pregnancy were associated with increased risk of cryptorchidism. Overall, the association between maternal alcohol drinking (OR = 0.97, 95% CI: 0.87-1.07), pre-pregnancy body mass index (OR = 1.02, 95% CI: 0.95-1.09) and risk of cryptorchidism were not statistically significant. Additional analysis showed reduced risk (OR = 0.89, 95% CI: 0.82-0.96) of cryptorchidism with moderate alcohol drinking during pregnancy. No dose-response relationship was observed for increments in body mass index in the risk of cryptorchidism. Sensitivity analysis revealed an unstable result for the association between maternal diabetes, alcohol drinking and cryptorchidism. Moderate heterogeneity was detected in studies of the effect of maternal alcohol drinking and diabetes. No publication bias was detected.
Maternal gestational smoking, but not maternal pre-pregnancy overweight or obesity, was associated with increased cryptorchidism risk in the offspring. Moderate alcohol drinking may reduce the risk of cryptorchidism while gestational diabetes may be a risk factor, but further studies are needed to verify this.
孕妇孕期吸烟、患糖尿病、饮酒以及孕前肥胖被认为会增加新生儿男性隐睾症的风险，但证据并不一致。
我们对关于孕妇孕期吸烟、患糖尿病、饮酒以及孕前肥胖与隐睾症风险之间关联的研究进行了系统综述和荟萃分析。通过检索PubMed和ScienceDirect获取文章，并使用Stata/SE 12.0软件进行荟萃分析。采用敏感性分析来评估混杂变量的影响。
我们选取了32篇文章，包括12项病例对照研究、5项巢式病例对照研究和15项队列研究。荟萃分析表明，孕妇孕期吸烟（比值比[OR]=1.17，95%置信区间[CI]：1.11 - 1.23）或患糖尿病（OR = 1.21，95%CI：1.00 - 1.46）与隐睾症风险增加相关。总体而言，孕妇饮酒（OR = 0.97，95%CI：0.87 - 1.07）、孕前体重指数（OR = 1.02，95%CI：0.95 - 1.09）与隐睾症风险之间的关联无统计学意义。进一步分析显示，孕期适度饮酒可降低隐睾症风险（OR = 0.89，95%CI：0.82 - 0.96）。未观察到体重指数增加与隐睾症风险之间存在剂量反应关系。敏感性分析显示，孕妇患糖尿病、饮酒与隐睾症之间关联的结果不稳定。在孕妇饮酒和糖尿病影响的研究中检测到中度异质性。未检测到发表偏倚。
孕妇孕期吸烟与后代隐睾症风险增加相关，而孕前超重或肥胖则不然。孕期适度饮酒可能降低隐睾症风险，而孕期糖尿病可能是一个风险因素，但需要进一步研究加以验证。
