The search for the causes of hypospadias continues at a pace. These authors from Turkey extrapolated other findings about the higher incidence of congenital anomalies in babies during summer months’ gestation to studying the risks of high ambient temperature during weeks 8-14 gestation (the time of hypospadias formation). A retrospective analysis of data from 1709 children who had hypospadias repair and 4946 children with other urological treatment between 2000 and 2015 was carried out. Ambient temperature at gestational age of 8-14 weeks was obtained from the General Directorate of Meteorology in Turkey. The study population was from Istanbul or Ankara. Exclusions included low birth weight (<2500g), prematurity (>38/40), young maternal age (<18 years), old maternal age (>35 years), multiple pregnancy, consanguinity, and other congenital diseases. As expected, the maximum temperature was between July and August. The study showed that the risk for hypospadias increased during the summer (OR 1.32, 95% CI, 1.08-1.52, and OR 1.22, 95% CI, 0.99-1.54, respectively). The authors discuss the possible reasons for this in terms of environmental and heat stress (metabolic fat deposition increases, core temperature increases, metabolic rate changes within the mother and the fetus). Other epidemiological data suggests that the incidence of hypospadias is higher in hotter countries such as Spain, South Italy, Australia and Puerto Rico. The authors also discuss the confounding variables that were not allowed for, such as: time spent outdoors, use of air conditioners and use or exposure to other potential hypospadiac stimulae such as chemical factors. They conclude that, in the current discussions on climate change, this data is important when looking at human health as a whole.

Does maternal exposure during pregnancy to higher ambient temperature increase the risk of hypospadias?
Kilinc M, Cakmak S, Demir D, et al.
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Henrik Steinbrecher

Southampton University Hospital NHS Trust

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