Altered infant feeding patterns in boys with acquired nonsyndromic cryptorchidism.
BACKGROUND
Genetic and environmental factors likely influence susceptibility to nonsyndromic cryptorchidism, a common disease presenting at birth or in later childhood. We compared cases and controls to define differential risk factors for congenital versus acquired cryptorchidism.


METHODS
We compared questionnaire and clinical data from cases of congenital cryptorchidism (n = 230), acquired cryptorchidism (n = 182) and hernia/hydrocele (n = 104) with a group of healthy male controls (n = 358). Potential predictor variables (p < 0.2 in univariable analysis) were included in stepwise multivariable logistic regression models.


RESULTS
Temporary (odds ratio [OR], 0.5; 95% confidence interval [CI], 0.4-0.8) or exclusive (OR, 0.6; 95% CI, 0.4-0.9) breastfeeding was reduced and soy formula feeding increased (OR, 1.8; 95% CI, 1.2-2.9) in acquired but not congenital or hernia/hydrocele groups. The highest risk estimates were observed for primary soy formula feeding with limited or no breastfeeding (OR 2.5; 95% CI, 1.4-4.3; adjusted OR, 2.7; 95% CI, 1.4-5.4) in the acquired group. Primary feeding risk estimates were equivalent or strengthened when multivariable models were limited to age greater than 2 years, full-term or not small for gestational age, or Caucasian subjects. Pregnancy complications and increased maternal exposure to cosmetic or household chemicals were not consistently associated with either form of cryptorchidism in these models.


CONCLUSIONS
Our data support reduced breastfeeding and soy formula feeding as potential risk factors for acquired cryptorchidism. Although additional studies are needed, hormonally active components of breast milk and soy formula could influence the establishment of normal testis position in the first months of life, leading to apparent ascent of testes in childhood. Birth Defects Research (Part A), 2012.
Division of Urology, Alfred I. duPont Hospital for Children, Wilmington, Delaware; Nemours Biomedical Research, Wilmington, Delaware, USA. jbarthol@nemours.org
Julia Spencer
JS
Barthold
Jobayer
J
Hossain
Alicia
A
Olivant-Fisher
Anita
A
Reilly
T Ernesto
TE
Figueroa
Ahmad
A
Banihani
Jennifer
J
Hagerty
Ricardo
R
González
Paul H
PH
Noh
Jeanne M
JM
Manson
D000293:Adolescent; D000328:Adult; D058070:Asymptomatic Diseases; D001942:Breast Feeding; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000145:classification / Q000453:epidemiology / Q000209:etiology*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007223:Infant; D041943:Infant Formula; D016015:Logistic Models; D008297:Male; D008895:Milk, Human / Q000737:chemistry; D011247:Pregnancy; D012307:Risk Factors; D045730:Soy Foods / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D006848:Testicular Hydrocele / Q000453:epidemiology / Q000209:etiology*; D013737:Testis / Q000473:pathology; D014481:United States / Q000453:epidemiology