Hypospadias trends in two US surveillance systems
Hypospadias trends in two US surveillance systems
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DOI：
10.1542/peds.100.5.831
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发表时间：
1997-11-01
期刊：
影响因子：
8
通讯作者：
Jackson, RJ
中科院分区：
文献类型：
--
作者：
Paulozzi, LJ;Erickson, JD;Jackson, RJ
objective.尿道下裂是一种常见的先天性畸形，其原因尚不清楚。在1970年代和1980年代，尿道下裂的发病率在五个欧洲国家不明原因地增加。我们研究了来自美国两个出生缺陷监测系统的数据，以寻找类似趋势的证据。大都会亚特兰大先天缺陷计划（MACDP）提供了1968年至1993年的出生率。全国出生缺陷监测方案提供了1970年至1993年的出生缺陷率。MACDP数据是基于人群的，可以根据尿道下裂的严重程度进行分类。数据允许分析率趋势的四个人口普查地区的美国。来自两个监测系统的数据显示，在20世纪70年代和80年代，尿道下裂的发病率大约翻了一番。MACDP数据显示，重症病例比例增加，而轻、重症病例比例下降。研究数据显示，尿道下裂的发病率在美国的所有四个地区都有明显的增加。观察到的增加不太可能归因于监测系统的敏感性增加或医生随着时间的推移发现了更多的轻度病例，因为这两种趋势都会增加而不是减少轻度与重度病例的比例。如果是真实的，这些趋势代表了最大数量的病例，也是欧洲以外尿道下裂发病率增加的第一份报告。尿道下裂发生率可能增加的额外调查是必要的。
Objective. Hypospadias is a common congenital anomaly, the cause of which is unknown. Unexplained increases in the rates of hypospadias occurred in five European countries in the 1970s and 1980s. We examined data from two birth defects surveillance systems in the United States for evidence of similar trends.Methodology. The Metropolitan Atlanta Congenital Defects Program (MACDP) provided birth prevalence rates from 1968 to 1993. The nationwide Birth Defects Monitoring Program (BDMP) provided rates from 1970 to 1993. MACDP data are population-based and could be categorized by the severity of the hypospadias. BDMP data allowed analysis of rate trends for the four census regions of the United States.Results. Data from both surveillance systems showed an approximate doubling of hypospadias rates in the 1970s and 1980s. MACDP data showed that the rate of severe cases increased while the ratio of mild to severe cases decreased. BDMP data showed that hypospadias rates increased markedly in all four regions of the United States.Conclusions. The observed increases are unlikely to be attributable to increased sensitivity of the surveillance systems or the identification of more mild cases by physicians over time, because either trend would have increased rather than decreased the ratio of mild to severe cases. If real, these trends represent the largest number of cases and the first report of an increase in hypospadias rates outside of Europe. Additional investigation of a possible increase in hypospadias rates is warranted.