ESPE2014 Poster Presentations Sex Development (11 abstracts)
Isolated Hypospadias and Exposure to Endocrine Disrupting Chemicals During Pregnancy: a Multi-Institutional Controlled Study in a High Prevalence Area
Nicolas Kalfa a, , Pascal Philibert b , Sylvie Broussous a , Taieb Chouikh a , Mohamed Masmoudi a , Francoise Audran b , Françoise Paris b , Nadège Servant b , Charles Sultan b , Mattea Orsini c , Amel Zahhaf c , Jean Pierre Daures c , Hélène Lehors d , Jean Michel Guys d , Rachel Reynaud f , Pierre Alessandrini e , Florence Bastiani g , Jean Yves Kurzenne g , Kathy Wagner h & Gérard Morisson Lacombe i
aService de Chirurgie et Urologie Pédiatrique, Hôpital Lapeyronie, Montpellier, France; bService d’Hormonologie, Hôpital Lapeyronie, Montpellier, France; cInstitut Universitaire de Recherche Clinique, Montpellier, France; dService de Chirurgie et Urologie Pédiatrique, Hôpital la Timone, APHM, Marseille, France; eService de Chirurgie et Urologie Pédiatrique, Hôpital Nord, APHM, Marseille, France; fUnité d’Endocrinologie et Diabétologie Pédiatriques, Hôpital la Timone, APHM, Marseille, France; gService de Chirurgie et Urologie Pédiatrique, Hôpital Lenval, Nice, France; hService de Pédiatrie, Hôpital Lenval, Nice, France; iService de Chirurgie et Urologie Pédiatrique, Hôpital Saint-Jospeh, Marseille, France
Background: Numerous studies focused on the association between hypospadias and Endocrine Disrupting Chemicals (EDC) exposures. The wide variability of phenotypes included in these studies, the absence of comparison groups representative of the populations and the absence of concomitant genetic testing to rule out another cause make the results questionable.
Objective and hypotheses: We performed a prospective phenotype-specific analysis of patients with Isolated Hypospadias (IH) after exclusion of genetic defects to identify the role of EDC exposures.
Method: 700 boys were prospectively included in a multi-institutional study. After exclusion of genetic defects (androgen receptor and 5-αreductase genes) and familial forms (vertical transmission), 300 IH were included and 302 normal children were used as controls. The parents’ domestic and professional exposures to EDC were evaluated by a standardized detailed questionnaire and by a previously validated job-exposure matrix for EDC. The environmental exposition was estimated through the zip code of the pregnancy, type of surrounding hazards and straight distance from it.
Results: Maternal occupational exposition to EDC was more frequent during pregnancy in case of IH (35.11 vs 17.55%, P<0.001) mainly to paints/solvents/adhesive (16.05%), detergents (11.04%), pesticides (9.03%), cosmetics (5.69%). Exposed jobs (cleaners, hairdressers, beauticians, laboratory) were more frequently performed by hypospadiac boys’ mothers than controls’ one (19.73 vs 10.26%, P=0.0019). The paternal professional exposition around the time of fertilization was more frequent in IH (40.13 vs 27.48%, P=0.02). Regarding environmental exposure, industrial or intensive agriculture area were more frequently encountered in a 3 km radius around the place of pregnancy giving birth to a hypospadiac boy (13.31 vs 6.46%, P<0.0001) or (19.47 vs 14.64%, P=0.0137) respectively.
Conclusion: In an homogenous cohort of patients with IH and no genetic defect, the maternal exposure to EDC during pregnancy is more frequent compared to controls. Both occupational and environmental exposure may be considered as risk factors.
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