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Development of hypospadias is thought to occur during embryological development between 8 to 20 weeks gestation. There is a genetic component to the development of hypospadias but this doesn’t fully explain the presence of the condition.
Various other risk factors include early menarche in the mother, threatened miscarriage, low placental weight and exposure to progestins. There may be an increased incidence of hypospadias in pregnancies resulting from in vitro fertilization due to the hormonal manipulation that forms part of the IVF process.
However, environmental factors may also play a part. Exposure to chemicals from plastic bottles and pesticides on fruit and vegetables for example, may play a role in increasing the risk of hypospadias.
MATERNAL AGE AS A RISK FACTOR FOR HYPOSPADIAS
HARRY FISCH, ROBERT J. GOLDEN, GARY L. LIBERSEN, GRACE S. HYUN, PAMELA MADSEN,
MARIA I. NEW AND TERRY W. HENSLE
From the Male Reproductive Center, Department of Urology and Babies Hospital, Columbia-Presbyterian Medical Center, Columbia
University, American Infertility Association and Department of Pediatrics, New York Weill-Cornell Center, New York, New York, Toxlogic,
Potomac, Maryland, and Public Health Policy Advisory Board, Washington, D. C.
Purpose: Hypospadias incidence rates have been widely reported to be increasing. During the last 20 years there has been a significant increase in the number of women who delay childbearing until their mid 30s. Therefore, it was of interest to determine if increasing maternal age is an independent risk factor for hypospadias.
Materials and Methods: Data from the New York State Department of Health and California Birth Defects Monitoring Program were analyzed from 1983 to 1996 by maternal age groups of less than 20, 20 to 24, 25 to 29, 30 to 34, and 35 or greater years. A Poisson model was fitted to the data from each state using maternal age and year of birth from which relative rates were calculated.
Results: Our analysis revealed that advancing maternal age is significantly associated with hypospadias and is most evident for severe cases. For example, in California a 50% increase in severe cases was demonstrated for children of mothers older than 35 years compared to mothers younger than 20 years (p ,0.05).
Conclusions: Hypospadias is significantly associated with increasing maternal age. Women
who elect to delay childbearing until their mid 30s or later should be aware that their offspring are at increased risk of hypospadias.