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Submitted on February 14, 2005
Accepted on April 22, 2005
University Department of Growth and Reproduction, GR-5064 Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; Departments of Physiology and Paediatrics, University of Turku, Kiinamyllynkatu 10, FIN-20520 Turku, Finland
* To whom correspondence should be addressed. E-mail: katharina.main{at}rh.hosp.dk.
Context: Hypospadias is one of the most frequent male congenital malformations and may be part of the testicular dysgenesis syndrome.
Objective: To investigate the prevalence of hypospadias in Denmark, and to evaluate the relationship to anthropometrical measurements at birth and reproductive hormone levels at 3 months of age.
Design: Prospective cohort study with 3 yr follow-up (1997-2004).
Setting: Population-based study at the University Hospital of Copenhagen.
Participants: 1072 Danish boys consecutively recruited antenatally, 74.4% completing the study.
Main outcome measures: Position of the urethral meatus. Anthropometrical measurements, placental weight, and reproductive hormone levels.
Results: The Danish birth prevalence of hypospadias was significantly higher than in a concomitant Finnish study (1.03% vs. 0.27%, P = 0.012). At 3 yr, the true prevalence was found to be 4.64% as additional mild cases were detected when physiological phimosis dissolved. Weight for gestational age (percentage deviation from expected mean) (-5.00% vs. -0.59%, P = 0.030) and placental weight (567 g vs. 658 g, P = 0.023) were significantly lower; and FSH was significantly higher (1.48 IU/L vs. 1.15 IU/L, P = 0.007) in boys with hypospadias compared with healthy boys.
Conclusions. We found a surprisingly high total rate of hypospadias of 4.6% in this large prospective cohort study. 72% of the cases were only apparent after the prepuce could be retracted. Hypospadias were associated with elevated serum FSH levels at 3 months. We also confirmed an association between fetal growth impairment and hypospadias, however, it is yet unknown whether this indicates a causal relationship or a shared pathogenic factor.
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