Bräuner Elvira V, Hickey Martha, Hansen Åse Marie, Doherty Dorota A, Handelsman David J, Juul Anders, Hart Roger
Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Front Endocrinol (Lausanne). 2019 Aug 2;10:530. doi: 10.3389/fendo.2019.00530. eCollection 2019.
Cryptorchidism, registered at birth or later, is the most common birth defect in males in western countries, estimated to affect around 2-3% of newborn boys, declining to around 2% at 3 months. We have previously described a potential association between stressful life events (SLEs) in pregnancy and reduced semen quality and testosterone levels in adult offspring. Both outcomes are believed to share a common etiology with cryptorchidism thus increased risk of cryptorchidism in boys exposed to prenatal SLEs may be plausible. The risk of cryptorchidism associated with prenatal SLE amongst 1,273 male Generation 2 offspring was estimated using the Western Australian Pregnancy (Raine) Study. SLEs are discrete experiences that disrupt an individual's usual activities causing a life change and readjustment, such as death of a relative or friend, divorce, illness or job loss. Mothers prospectively reported SLEs, during pregnancy at gestational weeks (GW) 18 and 34 using a standardized 10-point questionnaire. A boy was diagnosed as cryptorchid if one or both testes was non-palpable in the scrotum and not able to be manipulated into the scrotum. Twenty-four (2%) cryptorchid boys were identified. Mean (standard deviation) of SLE exposures in GW34 was 1.1 (1.2) for non-cryptorchid boys and slightly higher 1.5 (1.8) for cryptorchid boys, similar differences were observed in GW18. Adjusted odds ratio [OR] and 95% confidence intervals (CI) for risk of cryptorchidism in early (18-weeks) and late gestation (34-weeks) according to prenatal SLE exposures were: 1.06 (95% CI: 0.77-1.45) and 1.18 (95% CI: 0.84-1.67), respectively. This is the first-time report on the possible relationships between exposure to early and late pregnancy SLEs and risk of cryptorchidism in a birth cohort. Prenatal SLE exposure was not associated with a statistically significant increase in the risk of cryptorchidism in male offspring. A small case population limits the statistical power of the study and future larger studies are required to evaluate this potential association.
隐睾症,在出生时或之后被记录,是西方国家男性中最常见的出生缺陷,估计影响约2%-3%的新生男婴,在3个月时降至约2%。我们之前描述过孕期应激性生活事件(SLEs)与成年后代精液质量下降和睾酮水平降低之间的潜在关联。这两种结果都被认为与隐睾症有共同的病因,因此,暴露于产前SLEs的男孩患隐睾症的风险增加可能是合理的。利用西澳大利亚孕期(雷恩)研究,对1273名第二代男性后代中与产前SLE相关的隐睾症风险进行了评估。SLEs是指那些破坏个体日常活动、导致生活改变和重新调整的离散经历,比如亲属或朋友死亡、离婚、患病或失业。母亲们在妊娠第18周和第34周时,使用标准化的10分问卷前瞻性地报告SLEs。如果一个或两个睾丸在阴囊内无法触及且不能被推至阴囊内,则该男孩被诊断为隐睾症。共识别出24名(2%)隐睾男孩。对于非隐睾男孩,妊娠第34周时SLE暴露的均值(标准差)为1.1(1.2),而隐睾男孩略高,为1.5(1.8),在妊娠第18周时也观察到了类似差异。根据产前SLE暴露情况,妊娠早期(18周)和晚期(34周)隐睾症风险的调整比值比[OR]及95%置信区间(CI)分别为:1.06(95%CI:0.77-1.45)和1.18(95%CI:0.84-1.67)。这是首次关于出生队列中妊娠早期和晚期暴露于SLEs与隐睾症风险之间可能关系的报告。产前暴露于SLEs与男性后代隐睾症风险的统计学显著增加无关。小样本病例限制了该研究的统计效力,未来需要更大规模的研究来评估这种潜在关联。