Maternal Overweight and Obesity and Genital Anomalies in Male Offspring: A Population‐Based Swedish Cohort Study

Arendt, Linn Håkonsen; Ramlau‐Hansen, Cecilia Høst; Lindhard, Morten Søndergaard; Henriksen, Tine Brink; Olsen, Jørn; Yu, Yongfu; Cnattingius, Sven

doi:10.1111/ppe.12373

Cited by 16 publications

(11 citation statements)

References 33 publications

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“… 62 In case of cryptorchidism, results have been mixed with some showing an association, whereas others not. 6 , 9 , 10 , 12 , 14 , 16 , 18 , 23 – 26 , 31 , 33 , 34 , 63 A recent register-based Swedish study by Arendt et al, 63 including 1,055,705 boys, found results similar to ours regarding cryptorchidism and obesity.…”

Section: Discussionsupporting

confidence: 86%

Lifestyle in pregnancy and cryptorchidism in sons: a study within two large Danish birth cohorts

Kjersgaard¹,

Arendt²,

Ernst³

et al. 2018

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PurposeCryptorchidism is the most frequent congenital malformation in boys and is associated with low sperm count, infertility and testicular cancer. Unhealthy maternal lifestyle during pregnancy such as smoking, high prepregnancy body mass index (BMI) as well as alcohol and caffeine intake may constitute possible risk factors for cryptorchidism, but results from the few previous studies are conflicting. We aimed to explore the association between maternal lifestyle factors and occurrence of cryptorchidism in sons.Patients and methodsThe Danish National Birth Cohort and the Aarhus Birth Cohort provided information on maternal lifestyle from early pregnancy. Data were linked to several Danish health registers, multiple imputation was used to handle missing data and Cox proportional hazards models were used to adjust for potential confounders.ResultsIn total, 85,923 boys were included, and of them, 2.2% were diagnosed with cryptorchidism. We observed the strongest associations between maternal tobacco smoking and prepregnancy BMI and cryptorchidism. Sons of women who smoked 10–14 cigarettes/day had the highest hazard ratio (HR) for cryptorchidism (1.37; 95% CI: 1.06–1.76), and for maternal BMI ≥30 kg/m2, the HR was 1.32 (95% CI: 1.06–1.65). Binge drinking was associated with an HR <1, if the women had one or two episodes in pregnancy (HR: 0.81; 95% CI: 0.67–0.98). Average maternal alcohol intake and caffeine intake during pregnancy were not significantly associated with a higher occurrence of cryptorchidism detected at birth or later in life.ConclusionMaternal tobacco smoking, overweight and obesity in pregnancy were associated with higher occurrence of cryptorchidism in boys in this study.

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Section: Discussionsupporting

confidence: 86%

Lifestyle in pregnancy and cryptorchidism in sons: a study within two large Danish birth cohorts

Kjersgaard¹,

Arendt²,

Ernst³

et al. 2018

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“…1 Many cohort studies and trials have assessed pre-pregnancy body composition and GWG and related them to outcomes in women, such as gestational diabetes and weight retention, birth outcomes, and childhood health, body composition, temperament, mental health and educational attainment. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] Additionally, influences on GWG itself have been investigated, and interventions conducted to try to reduce it. [17][18][19][20] In 1990, the Institute of Medicine (IOM) produced guidelines for weight gain during pregnancy, 21 with the recommended amount of weight gain varying according to pre-pregnancy body mass index (BMI).…”

Section: Introductionmentioning

confidence: 99%

Measured weight in early pregnancy is a valid method for estimating pre-pregnancy weight

Inskip

Crozier

Baird

et al. 2020

J Dev Orig Health Dis

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Estimation of pre-pregnancy weight is difficult because measurements taken before pregnancy are rarely available. No studies have compared various ‘proxy’ measures using recalled weight or based on early pregnancy weight with actual measurements of pre-pregnancy weight. The Southampton Women’s Survey recruited women during 1998–2002 who were not pregnant. Data on 198 women with an estimated date of conception within 3 months of recruitment were analysed. Three proxy measures were considered: (1) recalled pre-pregnancy weight obtained during early pregnancy, (2) measured weight in early pregnancy and (3) estimated pre-pregnancy weight using a published model. Mean (standard deviation) recalled weight was 1.65 (3.03) kg lighter than measured pre-pregnancy weight, while early pregnancy weight and weights from the published model were 0.88 (2.34) and 0.88 (2.33) kg heavier, respectively. The Bland–Altman limits of agreement for recalled weight were −7.59 to 4.29 kg, wider than those for the early pregnancy weight: −3.71 to 5.47 kg and the published model: −3.68 to 5.45 kg. For estimating pre-pregnancy weight, we recommend subtraction of 0.88 kg from early pregnancy weight or the published model, or addition of 1.65 kg to recalled weight. Estimates of pre-pregnancy body mass index and gestational weight gain categories were very similar when using early pregnancy and published model weights, but they differed from those using recalled weight. Our findings indicate that calculations of first trimester weight gain using recalled weight must be treated cautiously, and a measured weight in early pregnancy provides a more precise assessment of pre-pregnancy weight than recalled weight.

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“… 16 Recent studies have suggested that maternal smoking and obesity add to this risk, even if such studies have not considered the explanatory effect of prematurity-related risk factors on the common pathway to disease. 18 19 A few epidemiological studies have claimed that socioeconomic background, rurality and insurance status are associated with delayed treatment. 2 20 21 However, these studies were either based on population aggregates or averages for area of residence rather than individual-level data, or have not shown any clear association with the risk for delay.…”

Section: Introductionmentioning

confidence: 99%

How boys and testicles wander to surgery: a nationwide cohort study of surgical delay in Sweden

Omling

Bergbrant

Persson

et al. 2020

bmjpo

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BackgroundEarly orchidopexy is recommended for cryptorchidism and the surgery is increasingly centralised. The objectives were to determine the incidence, risk factors and if distance to treating hospital impacted on timely treatment of cryptorchidism.MethodsIn this observational study, all boys born in Sweden from 2001 to 2014 were followed in national registers to determine the incidence of cryptorchidism by levels of birth-related risk factors and social determinants. Travel time to hospital was used as the primary exposure in multivariable survival analysis, with age at surgery as main outcome.ResultsOf 748 678 boys at risk for cryptorchidism, 7351 were treated and evaluated for timing of surgery (cumulative childhood incidence 1.4%, 95% CI 1.3% to 1.5%). The incidence was clearly associated with prematurity and overdue pregnancy (HR for <32 weeks 2.77 (95% CI 2.39 to 3.21); 32–36 weeks HR 1.36 (95% CI 1.24 to 1.49); >41 weeks HR 1.19 (95% CI 1.10 to 1.29)), low birth weight (<1000 g HR 3.94 (95% CI 3.15 to 4.92); 1000–1499 g HR 3.70 (95% CI 3.07 to 4.46); 1500–2500 g HR 1.69 (95% CI 1.52 to 1.88)) and intrauterine growth restriction (small for gestational age HR 2.38 (95% CI 2.14 to 2.65); large for gestational age HR 1.26 (95% CI 1.13 to 1.42)), but not with smoking or maternal age. Each 30 min increase in travel time was associated with a reduced probability of timely treatment (HR for being treated by age 3 adjusted for risk factors and socioeconomic determinants: 0.91 (95% CI 0.88 to 0.95)). Lower income and financial support were also associated with treatment delays (adjusted HR for lowest income quintile 0.82 (95% CI 0.72 to 0.93) and for families with financial support 0.85 (95% CI 0.73 to 0.97)).ConclusionsTravel distance to treating hospital was associated with delayed treatment. ‘Not all those who wander are lost’, but these findings suggest a trade-off between centralisation benefits and barriers of geography also in elective paediatric surgery.

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Maternal Overweight and Obesity and Genital Anomalies in Male Offspring: A Population‐Based Swedish Cohort Study

Abstract: This large register-based study adds to the current literature and indicates that the occurrence of hypospadias and cryptorchidism increase with maternal overweight and obesity severity.

Cited by 16 publications

References 33 publications

Lifestyle in pregnancy and cryptorchidism in sons: a study within two large Danish birth cohorts

Lifestyle in pregnancy and cryptorchidism in sons: a study within two large Danish birth cohorts

Measured weight in early pregnancy is a valid method for estimating pre-pregnancy weight

How boys and testicles wander to surgery: a nationwide cohort study of surgical delay in Sweden

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