Association of Maternal First Trimester Serum Levels of Free Beta Human Chorionic Gonadotropin and Hypospadias: A Population Based Study

Association of Maternal First Trimester Serum Levels of Free Beta Human Chorionic Gonadotropin and Hypospadias: A Population Based Study

Human chorionic gonadotropin stimulates fetal testosterone production and contributes to normal development of male genitalia. Using population based data we hypothesized that differences in maternal free beta human chorionic gonadotropin may be associated with hypospadias. Data were obtained from t...

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Published in:The Journal of urology Vol. 203; no. 5; pp. 1017 - 1023
Main Authors: Peycelon, Matthieu, Lelong, Nathalie, Carlier, Léa, Monn, M Francesca, De Chalus, Aliénor, Bonnard, Adeline, Rachid, Myriam, Houang, Muriel, Paye-Jaouen, Annabel, Ali, Liza, Lecourbe, Alexandra, Grapin, Christine, Audry, Georges, Legendre, Marie, Muller, Françoise, Dreux, Sophie, El Ghoneimi, Alaa, Benachi, Alexandra, Khoshnood, Babak, Siffroi, Jean-Pierre
Format: Journal Article
Language:English
Published: United States Elsevier 01-05-2020
Subjects:
Adult
Biomarkers - blood
Chorionic Gonadotropin, beta Subunit, Human - blood
Female
Follow-Up Studies
France - epidemiology
Human health and pathology
Humans
Hypospadias - blood
Hypospadias - epidemiology
Incidence
Infant, Newborn
Life Sciences
Male
Pregnancy
Pregnancy Trimester, First - blood
Prognosis
Retrospective Studies
Urology and Nephrology
Young Adult
France
beta subunit
androgens
pregnancy
hypospadias
placenta
chorionic gonadotropin
human
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Summary:Human chorionic gonadotropin stimulates fetal testosterone production and contributes to normal development of male genitalia. Using population based data we hypothesized that differences in maternal free beta human chorionic gonadotropin may be associated with hypospadias. Data were obtained from the Paris Registry of Congenital Malformations (REMAPAR) (2011 to 2016). The initial study population included 3,172 pregnant women who gave birth to a singleton live born male infant with a congenital malformation. After exclusion of cases with unknown beta human chorionic gonadotropin and those with chromosomal or genetic abnormalities, the study population included 194 boys with isolated hypospadias and 1,075 controls. For cases with operative notes (125) we obtained data on type (proximal/distal) of hypospadias. Using quantile regression we compared median values of multiple of median beta human chorionic gonadotropin measured for first trimester Down syndrome screening (10th to 13th gestational weeks) for overall as well as by type of hypospadias vs controls. We also considered possible effects of placental dysfunction (maternal age, intrauterine growth retardation and preterm births) as potential confounding factors. Overall the median beta human chorionic gonadotropin multiple of median was comparable for women who had an infant with hypospadias vs controls (0.99 vs 0.95, p=0.3). However, proximal hypospadias was associated with a statistically significant higher median multiple of median than distal hypospadias or unspecified (1.49 vs 0.92 vs 1.05, p=0.02). The estimates were comparable after adjustment for placental dysfunction. Our findings support the hypothesis that an alteration in maternal beta human chorionic gonadotropin levels is associated with hypospadias. However, this association appears to be limited to proximal hypospadias.
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ISSN:0022-5347
1527-3792
DOI:10.1097/JU.0000000000000708