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Hypospadias risk is increased with maternal residential exposure to hormonally active hazardous air pollutants
Author(s) -
Sheth Kunj R.,
Kovar Erin,
White Jeffrey T.,
Chambers Tiffany M.,
PeckhamGregory Erin C.,
O'Neill Marisol,
Langlois Peter H.,
Seth Abhishek,
Scheurer Michael E.,
Lupo Philip J.,
Jorgez Carolina J.
Publication year - 2019
Publication title -
birth defects research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.845
H-Index - 17
ISSN - 2472-1727
DOI - 10.1002/bdr2.1461
Subject(s) - hypospadias , odds ratio , medicine , confidence interval , birth certificate , offspring , pregnancy , logistic regression , risk factor , toxicology , environmental health , obstetrics , surgery , population , biology , genetics
Background With the increasing birth prevalence of hypospadias, there is growing concern for pollutant exposure interfering with normal penile development. We assess the association between hypospadias and hormonally active hazardous air pollutants (HAHAPs) through a nationwide database of hazardous air pollutants and the Texas Birth Defects Registry (TBDR). Methods Using the TBDR, we identified 8,981 nonsyndromic isolated hypospadias cases from 1999 to 2008. Birth certificate controls were matched for birth year at a 10:1 ratio to cases. Estimated HAHAP concentrations from the 2005 U.S. EPA National‐Scale Air Toxics Assessment were used to assign exposure based on maternal residence at birth. Exposure levels were categorized as quintiles based on the distribution in controls. Logistic regression was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for each increasing exposure category of selected HAHAPs. Results Of the 10 HAHAPs studied, seven were significantly associated with hypospadias risk. The HAHAP that was most strongly associated with hypospadias was phenol, which was associated with risk in all groups except the high exposure group. Cumulative HAHAP exposure demonstrated a modest increase in hypospadias risk (OR 1.15, 95% CI: 1.07–1.24, p < 0.001) in the medium and medium–high quintiles. Conclusions While maternal exposure to some HAHAPs was significantly associated with the risk of hypospadias in male offspring, the effects were modest, and no dose–response effects were observed. Future work should employ biomarkers of exposure to better delineate the relationship.