Hypospadias in a cohort of 1072 Danish newborn boys: Prevalence and relationship to placental weight, anthropometrical measurements at birth, and reproductive hormone levels at three months of age
Hypospadias in a cohort of 1072 Danish newborn boys: Prevalence and relationship to placental weight, anthropometrical measurements at birth, and reproductive hormone levels at three months of age
复制标题
DOI：
10.1210/jc.2005-0302
复制
发表时间：
2005-07-01
影响因子：
5.8
通讯作者：
Main, KM
中科院分区：
文献类型：
--
作者：
Boisen, KA;Chellakooty, M;Main, KM
背景：尿道下裂是最常见的男性先天性畸形之一，可能是睾丸发育不良综合征的一部分。目的：本研究的目的是调查丹麦尿道下裂的患病率，并评估其与出生时人体测量值和3个月大时生殖激素水平的关系。设计：前瞻性队列研究，随访3年（1997-2004）。背景：以人群为基础的研究在哥本哈根大学医院进行。参与者：共有1072名丹麦男孩在产前被连续招募，其中74.4%完成了研究。主要观察指标：该研究检查了尿道道位置、人体测量、胎盘重量和生殖激素水平。结果：丹麦出生时尿道下裂的患病率明显高于芬兰的同期研究（1.03 vs 0.27%; P = 0.012）。3年时的真实患病率为4.64%，因为生理包茎溶解时发现了额外的轻度病例。与健康男孩相比，尿道下裂男孩的胎龄体重（与预期平均值的百分比偏差）（- 5.00 vs - 0.59%, P = 0.030）和胎盘重量（567 vs 658 g, P = 0.023）显著降低，FSH显著升高（1.48 vs. 1.15 IU/l, P = 0.007）。结论：在这项大型前瞻性队列研究中，我们发现尿道下裂的总发生率惊人地高，达到4.6%。72%的病例只有在包皮能够收回后才明显。尿道下裂与3个月时血清FSH水平升高有关。我们还证实了胎儿生长障碍与尿道下裂之间的关联；然而，尚不清楚这是否表明一种因果关系或共同的致病因素。
Context: Hypospadias is one of the most frequent male congenital malformations and may be part of the testicular dysgenesis syndrome.Objective: The aim of the study was to investigate the prevalence of hypospadias in Denmark and evaluate the relationship to anthropometrical measurements at birth and reproductive hormone levels at 3 months of age.Design: A prospective cohort study was conducted with 3-yr follow-up ( 1997-2004). Setting: The population-based study was conducted at the University Hospital of Copenhagen.Participants: A total of 1072 Danish boys were consecutively recruited antenatally, with 74.4% completing the study.Main Outcome Measures: The study examined the position of the urethral meatus, anthropometrical measurements, placental weight, and reproductive hormone levels.Results: The Danish birth prevalence of hypospadias was significantly higher than in a concomitant Finnish study (1.03 vs. 0.27%; P = 0.012). At 3 yr, the true prevalence was found to be 4.64% because additional mild cases were detected when physiological phimosis dissolved. Weight for gestational age ( percentage deviation from expected mean) ( - 5.00 vs. - 0.59%; P = 0.030) and placental weight ( 567 vs. 658 g; P = 0.023) were significantly lower, and FSH was significantly higher (1.48 vs. 1.15 IU/liter; P = 0.007) in boys with hypospadias, compared with healthy boys.Conclusions: We found a surprisingly high total rate of hypospadias of 4.6% in this large prospective cohort study. Seventy-two percent of the cases were apparent only after the prepuce could be retracted. Hypospadias were associated with elevated serum FSH levels at 3 months. We also confirmed an association between fetal growth impairment and hypospadias; however, it is yet unknown whether this indicates a causal relationship or a shared pathogenic factor.