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Advisory Committee on Health Effects of Endocrine Disruptors
The Supplement II to the Intermediary Report
1.4.2.2_8 |
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[Results]
1. Diethylstilbestrol (DES)
A cohort study from Holland reports 4 cases of hypospadias out
of 205 cases of prenatal exposure to DES as reported by mothers
compared with 8 out of 8729 in an unexpected group. The
prevalence rate of 21.3 (95% CI = 6.5-70.1) suggests that
prenatal DES exposure of the male fetus increases the risk of
hypospadias (Klip 2002).
2. Estrogen preparations
Since Aarskog (1970) pointed out that administration of
progesteron preparations during pregnancy increases hypospadias
risk, several studies has addressed association of progesteron
preparation use during pregnancy and risk of hypospadias
appearing in the fetus. No significant correlation, however, had
been found until 1980s.
Allylestrenol, a progesteron preparation used for avoiding
miscarriage, has increased hypospadias risk, according to
Czeizel et al. (1988). A case-control study based on Hungarian
congenital malformation registry (207 cases of hypospadias, 162
as the control) found the ratio of mothers who took
Allylestrenol during gestation of the child with hypospadias was
significantly higher than control (p < 0.05).
In a cohort study on pregnancy and delivery in Australia, the
only abnormality found significantly correlated with oral
contraceptives was concave foot. Hypospadias was not mentioned
as a correlated malformation (Correy 1991).
A case-control study conducted in seven systems of ICBDMS member
organizations reports administration of hormone preparations
between the 8th and 16th week of pregnancy increases hypospadias
risk (OR = 2.3, 95% CI = 1.2-4.4) (Källén 1992).
3. 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (p,pf-DDE)
Longnecker et al. (2002) conducted a nested case-control study
in the Collaborative Perinatal Project in 1959-66 in which a
case group consisting of 219 cases of cryptorchidism, 199 of
hypospadias and 167 of polythelia was compared with a control
group of 552 subjects. Mothers' serum DDE concentrations were
quartered after correction for the recovery ratio of the gas
chromatograph, and the lowest quartile (< 21.4 Ęg/l) was used as
a reference. The odds ratios for cryptorchidism, hypospadias and
polythelia in the highest quartile ( 85.6 Ęg/l) were 1.3 (95%
CI = 0.7-2.4), 1.2 (95% CI = 0.6-2.4) and 1.9 (95% CI = 0.9-4.0)
after correction for race, triglyceride level and cholesterol
level. No significant difference was observed.
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