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Maternal hypertension, medication use, and hypospadias in the National Birth Defects Prevention Study
Journal article   Open access   Peer reviewed

Maternal hypertension, medication use, and hypospadias in the National Birth Defects Prevention Study

Alissa R Van Zutphen, Martha M Werler, Marilyn M Browne, Paul A Romitti, Erin M Bell, Louise-Anne McNutt, Charlotte M Druschel, Allen A Mitchell and National Birth Defects Prevention Study
Obstetrics and gynecology (New York. 1953), Vol.123(2 Pt 1), pp.309-317
02/2014
DOI: 10.1097/AOG.0000000000000103
PMCID: PMC5893145
PMID: 24402588
url
http://doi.org/10.1097/AOG.0000000000000103View
Open Access

Abstract

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. Using telephone interviews from mothers of 2,131 children with severe hypospadias and 5,129 nonmalformed male control children for 1997-2009 births in a population-based case-control study, we estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) with multivariable logistic regression. We adjusted P values to account for multiple testing. Forty-eight (2.3%) case and 70 (1.4%) control mothers reported early pregnancy antihypertensive treatment, 45 (2.1%) case and 31 (0.6%) control mothers reported late treatment, and 315 (14.8%) case and 394 (7.7%) control mothers reported untreated hypertension. Selective β-blockers, centrally acting agents, renin-angiotensin system-acting agents, diuretics, and specific medications, methyldopa and atenolol, were not associated with hypospadias. Nonselective β-blockers (adjusted OR 3.22, 95% CI 1.47-7.05) were associated with hypospadias; however, P values adjusted for multiple testing were not statistically significant. We confirmed prior findings for associations between hypospadias and untreated hypertension (adjusted OR 2.09, 95% CI 1.76-2.48) and late initiation of treatment (adjusted OR 3.98, 95% CI 2.41-6.55). The increased risks would translate to severe hypospadias prevalences of 11.5, 17.7, and 21.9 per 10,000 births for women with untreated hypertension, nonselective β-blocker use, and late initiation of treatment, respectively. Our study suggests a relationship between hypospadias and the severity of hypertension. II.
 Pregnancy Congenital Abnormalities - prevention & control Humans Risk Factors Antihypertensive Agents - administration & dosage Hypertension - drug therapy Male Gestational Age Hypospadias - epidemiology Antihypertensive Agents - adverse effects Young Adult Pregnancy Complications, Cardiovascular - drug therapy Hypospadias - etiology Hypertension - complications Adrenergic beta-Antagonists - adverse effects Adult Female Odds Ratio

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