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- Akre, Olof, et al.
(författare)
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Maternal and gestational risk factors for hypospadias
- 2008
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Ingår i: Journal of Environmental Health Perspectives. - : Environmental Health Perspectives. - 0091-6765 .- 1552-9924. ; 116:8, s. 1071-1076
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: An increase in the prevalence of hypospadias has been reported, but the environmental causes remain virtually unknown. OBJECTIVES: Our goal was to assess the association between risk of hypospadias and indicators of placental function and endogenous hormone levels, exposure to exogenous hormones, maternal diet during pregnancy, and other environmental factors. METHODS: We conducted a case-control study in Sweden and Denmark from 2000 through 2005 using self-administered questionnaires completed by mothers of hypospadias cases and matched controls. The response rate was 88% and 81% among mothers of cases and controls, respectively. The analyses included 292 cases and 427 controls. RESULTS: A diet during pregnancy lacking both fish and meat was associated with a more than 4-fold increased risk of hypospadias [odds ratio (OR) 4.6, 95% confidence interval (CI), 1.6-13.3]. Boys born to obese [body mass index (BMI) > ;= 30] women had a more than 2-fold increased risk of hypospadias (OR = 2.6, 95% CI, 1.2-5.7) compared with boys born to mothers with a normal weight (BMI = 20-24). Maternal hypertension during pregnancy and absence of maternal nausea increased a boy's risk of hypospadias 2.0-fold (95% CI, 1.1-3.7) and 1.8-fold (95% CI, 1.2-2.8), respectively. Nausea in late pregnancy also appeared to be positively associated with hypospadias risk (OR = 7.6, 95% CI, 1.1-53). CONCLUSIONS: A pregnancy diet lacking meat and fish appears to increase the risk of hypospadias in the offspring. Other risk associations were compatible with a role for placental insufficiency in the etiology of hypospadias.
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| 4. |
- Scheike, Thomas, et al.
(författare)
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Time Trends in Human Fecundability in Sweden.
- 2008
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Ingår i: Epidemiology. - 1531-5487. ; 19:2, s. 191-196
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:: Trends in biologic fertility are elusive. Possible negative trends in male reproductive health are still debated, and their effect on human fertility might be negligible. Time-to-pregnancy (TTP) is a functional measure of couple fecundability. METHODS:: We analyzed data on TTP among 832,000 primiparous women 20 years of age and older in the nationwide Swedish Medical Birth Registry from 1983 through 2002. This age restriction led to an exclusion of 10% of primiparous pregnancies. Subfertility (TTP >/=1 year) was analyzed as a function of maternal age, calendar time at initiation of attempt, and birth cohort-taking into account the truncation problems that are inherent in birth-based retrospective sampling. RESULTS:: Subfertility generally decreased over successive birth cohorts. When studied as a period effect, a transient increase in subfertility was seen in the early 1990s. Subfertility increased with age, except that for women in their late 1930s, an apparent decrease was observed, particularly among the early cohorts. CONCLUSION:: We found decreasing subfertility over time. We speculate that these patterns might be related to a Sweden-specific decrease over time in sexually transmitted diseases, to changes in sexual behavior induced by socioeconomic conditions, or to broader biologic or educational trends.
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