Hypospadias Prevalence Up Slightly Since 1980

By Reuters Staff

July 31, 2019

NEW YORK (Reuters Health) - The prevalence of hypospadias increased slightly but significantly from 1980 to 2010, according to findings from international birth-defect surveillance systems.

Hypospadias, one of the most common congenital anomalies in male infants, is caused by incomplete development of the urethra. Several, but not all, countries have reported increases in the prevalence of hypospadias in recent decades.

Dr. A. J. Agopian of the University of Texas Health Science Center at Houston and colleagues from 27 birth-defect surveillance programs participating in the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR) evaluated the prevalence of hypospadias from 1980 to 2010.

The international total prevalence of hypospadias during this interval was 20.9 per 10,000 births, and during the most recent decade it was 23.8 per 10,000 births, a significant difference, the researchers report in European Urology, online July 9.

The highest total prevalence was in Arkansas (39.1 cases per 10,000 births), and the lowest total prevalence was in Argentina (2.1 cases per 10,000 births).

Since 1999, the international total prevalence increased significantly by 0.25 cases per year, and among the eight programs with at least 30 years of data, the total prevalence of hypospadias increased by 60% from 1980 to 2010, an average of 0.34 cases per year.

Significant increases in the total prevalence of hypospadias were observed for 45% of the years of observation, whereas significant decreases in the total prevalence were observed for only 10.4% of the years of observation, according to an analysis of the 21 programs with at least 11 years of data.

"It has been proposed that the observed prevalence increase might reflect increases in exposure to hypospadias risk factors over time," the researchers note. "However, given the broad range of potentially relevant environmental and occupational exposures that could be responsible for the observed increase, as well as issues related to exposure dosage, timing, and other factors, it has been challenging to identify the main culprits."

"It is also possible that changes over time in the distribution of other parental factors associated with hypospadias risk (e.g., parity, body mass index, maternal age, and fertility treatments) may have influenced the prevalence over time, but data were not available to assess this possibility in our analyses," they write. "Further study of potential hypospadias risk factors, including genetic factors, endocrine disruptors, and other maternal and paternal exposures and characteristics, may shed light on this possibility."

"Our results suggest that the international total prevalence of hypospadias increased during 1980–2010 and that these trends were probably not entirely artifactual," the authors conclude. "Considering these trends, it seems clear that further surveillance around hypospadias is critical."

Dr. Agopian did not respond to a request for comments.

SOURCE: https://bit.ly/2GrKsRH

Eur Urol 2019.