Maternal hypertension, antihypertensive medication use, and the risk of severe hypospadias.
نویسندگان
چکیده
BACKGROUND Hypertensive disorders occur in an estimated 5-10% of pregnancies, but few studies have examined birth defects in relation to high blood pressure and antihypertensive medication use. The objective of this study was to investigate the relationship between high blood pressure, antihypertensive medication use, and severe hypospadias. METHODS We used data from the National Birth Defects Prevention Study, a population-based, multicenter, case-control study of birth defects to assess risks for severe hypospadias in relation to self-reported high blood pressure and prenatal exposures to antihypertensive drugs in 758 male infants with severe hypospadias and 2,058 male controls born between 1997 and 2002. Logistic regression analyses estimated ORs and 95% CIs, adjusted for potential confounders. RESULTS We observed slight to moderate elevations in the risk of severe hypospadias for maternal untreated hypertension (adjusted OR 2.1; 95% CI: 1.6-2.9) and antihypertensive medication use during 1 month preconception through pregnancy month 4 (adjusted OR 1.4; 95% CI: 0.7-2.9). The association was strongest for subjects initiating medications after the fourth month (adjusted OR 5.0; 95% CI: 1.9-12.9). CONCLUSIONS We observed an association between hypertension, antihypertensive medication use, and the risk of severe hypospadias, particularly when medication use began late in pregnancy. Because hypospadias occurs in early pregnancy, the data suggest that hypertension and its morphologic/physiologic precursors play an etiologic role, perhaps via compromised uteroplacental perfusion. Birth Defects Research (Part A) 2008.
منابع مشابه
Maternal hypertension, medication use, and hypospadias in the National Birth Defects Prevention Study.
OBJECTIVE To investigate whether antihypertensive classes and specific medications in early pregnancy increase the risk of severe hypospadias and to assess prior associations detected for late-treated and untreated hypertension in the National Birth Defects Prevention Study. METHODS Using telephone interviews from mothers of 2,131 children with severe hypospadias and 5,129 nonmalformed male c...
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عنوان ژورنال:
- Birth defects research. Part A, Clinical and molecular teratology
دوره 82 1 شماره
صفحات -
تاریخ انتشار 2008