title: Sex and congenital diaphragmatic hernia.
abstract: OBJECTIVE
  Human studies note sex reversal syndromes and sex difference(s) in the incidence of congenital diaphragmatic hernia (CDH). Epidemiology surveys record a higher incidence of CDH in females, whilst other reports cite a higher frequency in males. Nitrofen, a teratogen, produces experimental CDH. This agent is speculated to interfere with retinoid acid-steroid signalling pathways and may also be linked with sexual differentiation. This study was designed therefore to test the hypothesis that nitrofen may influence sexual phenotype and frequency of CDH.
  
  
  METHODS
  Time mated Sprague Dawley rats were dosed with nitrofen at day 9.5 to generate predominantly left sided CDH. Fetuses were delivered by caesarean section on days 20 or 21 of gestation (term=day 22). External genitalia were examined to define external genital phenotype. The abdominal cavity was opened and the genito-urinary system carefully examined. The internal genital organs were assigned a phenotype and findings correlated with external appearances. The diaphragm of each fetus was studied for the absence or presence of CDH and the laterality of defect recorded. Controls (non nitrofen fed) were used for all comparative analysis.
  
  
  RESULTS
  Control (n=600) and nitrofen exposed offspring (n=504) had equal frequencies of males and females. CDH occurred with similar incidence in male and female nitrofen treated pups. In all nitrofen exposed fetuses and normal controls, internal and external genitalia concorded without evidence of significant genital tract malformations or intersex states.
  
  
  CONCLUSIONS
  Prenatal nitrofen exposure is not associated with significant gender differences (or prenatal loss) in the risk of CDH. Genital tract malformations do not appear to accompany CDH in the nitrofen model.
authors.affiliation: Division of Child Health, Department of Paediatric Surgery, School of Reproductive and Developmental Medicine, The Royal Liverpool Children's Hospital (Alder Hey), University of Liverpool, Liverpool, UK. gwen@liv.ac.uk
authors.forename: M G
authors.initials: MG
authors.lastname: Connell
authors.forename: H J
authors.initials: HJ
authors.lastname: Corbett
authors.forename: A
authors.initials: A
authors.lastname: Purvis
authors.forename: P D
authors.initials: PD
authors.lastname: Losty
authors.forename: E C
authors.initials: EC
authors.lastname: Jesudason
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D012734:Disorders of Sex Development; D005260:Female; D006548:Hernia, Diaphragmatic / Q000196:embryology / Q000503:physiopathology*; D065630:Hernias, Diaphragmatic, Congenital; D008297:Male; D018811:Maternal Exposure; D010647:Phenyl Ethers / Q000494:pharmacology*; D011247:Pregnancy; D051381:Rats; D017207:Rats, Sprague-Dawley; D012733:Sex Differentiation / Q000187:drug effects*
chemical_list: D010647:Phenyl Ethers; C007350:nitrofen