Retrospective Study On The Relative Risk Factors For Developing Hypospadias

Part Ⅰ A case-control study of risk factors associated with hypospadiasObjective:The aim of this study was to explore as many risk factors for hypospadias as possible and to assess known risk factors.At the same time,it also provides some Suggestions for future research on risk factors of hypospadias.Methods:We selected children with hypospadias who received treatment in Children’s Hospital of Soochow University from October 2017 to October 2019 as Cases group(n=194),Children with some simple diseases(phimosis,hernia,hydrocele)were selected as the control group(n=194).We communicated with the parents and completed the questionnaire to obtain the data.Crude and adjusted odds ratios(ORs)were estimated to control for confounding with their 95%confifidence interval(CI)by means of logistic regressions.The odds ratios were determined for the risk factors.Statistical significance was set at P<0.05.Result:Several risk factors for hypospadias were identified in this study,including adverse events during pregnancy(p=0,OR=9.606),maternal use of progestin during pregnancy(p=0,OR=3.69),maternal history of irregular menstruation(p=0.017,OR=2.042),maternal education background of college degree or above(p=0,OR=4.582),paternal smoking(p=0.03,OR=1.883),paternal occupational contact with metal grinding(p=0.04,OR=5.995),paternal habits of midnight working(p=0.022,OR=2.084),statistically significant,P values were all less than 0.05.conclusion:We identified adverse events during pregnancy,maternal intake of progestin during pregnancy,maternal history of irregular menstruation,maternal educational background of a college degree or above,paternal smoking,paternal occupation in metal grinding,paternal habits of midnight working,and preterm labor or low birth weight infant as independent risk factors for developing hypospadias in the offspring.Part Ⅱ Meta-analysis of Maternal Administration ofTocolytics and Risk for Developing Hypospadias inOffspringObjective:Progesterone is an essential hormone in human reproduction,which is involved in the menstrual cycle,implantation and pregnancy maintenance.It has been proposed and extensively used in the treatment of different gynecological pathologies as well as in assisted reproductive technologies and in the maintenance of pregnancy.However,the widespread use of tocolytic agents may potentially increase the chance of developing hypospadias in offspring.The purpose of this study was to conduct a meta-analysis of the published articles to determine whether fetal exposure to tocolytic agents may increase the risk of hypospadias.Methods:The keywords searched were "hypospadias","risk factor" and "progesterone".and Eight articles meeting the eligibility criteria were identified in our search and included in the analysis.A meta-analysis was conducted and pooled odds ratio(OR)estimates were calculated for tocolytic agent using meta-analysis.At the same time,we conducted a subgroup meta-analysis to compare the differences between the European region and the Chinese region.The software used in the meta-analysis is RevMan5.3Result:There was homogeneity between these studies(CHI2=7.42,I2=6%,p=0.39).Significant positive associations were observed between tocolytic agents and hypospadias(OR=1.84;95%CI 1.54-2.20),Moreover,the results of subgroup analysis were consistent with the overall results.Conclusions:There is a correlation between intrauterine fetal exposure to tocolytic agents and increased risk of hypospadias.