title: Epidemiological assessment of hypospadias by degree of severity.
abstract: OBJECTIVE
  Hypospadias is one of the most common congenital malformations, with reportedly increasing rates of prevalence but poorly defined etiological factors for the disease and the varying degrees of manifestation. We characterize the prevalence of hypospadias in Arkansas with consideration of the degree of hypospadias.
  
  
  METHODS
  Data from the Arkansas State Birth Defects Surveillance Program of the Arkansas Reproductive Health Monitoring System were used to identify hypospadias cases and all male births by women residing in Arkansas between 1998 and 2007. Categorization of hypospadias severity into first, second or third degree was determined by a common 6-digit birth defect coding system used by surveillance programs across the country. Prevalence rates were computed for maternal and infant characteristics, birth year and birth residence.
  
  
  RESULTS
  The prevalence of hypospadias in Arkansas for births between 1998 and 2007 was 74.2 cases per 10,000 live births. Degrees of hypospadias were graded as first (coronal/distal) in 60.7% of cases, second (mid penile/subcoronal) in 18.8%, third (perineal/proximal penile) in 4.6% and hypospadias not otherwise specified in 16%. The prevalence of hypospadias increased during the surveillance period, with 66.9 per 10,000 live births between 1998 and 2002, and 81.0 per 10,000 live births between 2003 and 2007 (p = 0.0003). While the prevalence rates for every degree of hypospadias also increased, the prevalence of hypospadias not otherwise specified decreased from 14.8 to 9.0 during these periods.
  
  
  CONCLUSIONS
  Hypospadias prevalence in Arkansas is increasing. Improvement in recognition and categorization of degrees of hypospadias may have an impact on the reported prevalence rates.
authors.affiliation: Department of Urology, Arkansas Children's Hospital, Little Rock, Arkansas 72202, USA. scanon@uams.edu
authors.forename: Stephen
authors.initials: S
authors.lastname: Canon
authors.forename: Bridget
authors.initials: B
authors.lastname: Mosley
authors.forename: Juan
authors.initials: J
authors.lastname: Chipollini
authors.forename: Jody Ann
authors.initials: JA
authors.lastname: Purifoy
authors.forename: Charlotte
authors.initials: C
authors.lastname: Hobbs
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D001131:Arkansas / Q000453:epidemiology; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007021:Hypospadias / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D016017:Odds Ratio; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D044465:White People / Q000706:statistics & numerical data