title: Intrauterine growth restriction and hypospadias: is there a connection?
abstract: Hypospadias is one of the most common congenital malformations of the genitourinary tract in males. It is an incomplete fusion of urethral folds early in fetal development and may be associated with other malformations of the genital tract. The etiology is poorly understood and may be hormonal, genetic, or environmental, but most often is idiopathic or multifactorial. Among many possible risk factors identified, of particular importance is low birth weight, which is defined in various ways in the literature. No mechanism has been identified for the association of low birth weight and hypospadias, but some authors propose placental insufficiency as a common inciting factor. Currently, there is no standardized approach for evaluating children with hypospadias in the setting of intrauterine growth restriction. We reviewed the available published literature on the association of hypospadias and growth restriction to determine whether it should be considered a separate entity within the category of disorders of sexual differentiation.
authors.affiliation: Section of Pediatric Diabetes and Endocrinology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.
authors.forename: Min-Jye
authors.initials: MJ
authors.lastname: Chen
authors.affiliation: Evidence-Based Outcomes Center and Center for Clinical Effectiveness, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.
authors.forename: Charles G
authors.initials: CG
authors.lastname: Macias
authors.affiliation: Section of Pediatric Diabetes and Endocrinology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.
authors.forename: Sheila K
authors.initials: SK
authors.lastname: Gunn
authors.affiliation: Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Dietrich
authors.affiliation: Division of Pediatric Urology, Department of Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Roth
authors.affiliation: Department of Urology, University of Texas Southwestern, Dallas, TX 75207, USA.
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Schlomer
authors.affiliation: Section of Pediatric Diabetes and Endocrinology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA.
authors.forename: Lefkothea P
authors.initials: LP
authors.lastname: Karaviti
keywords: Fetal growth restriction; Hypospadias; Intrauterine growth restriction; Low birth weight; Placental insufficiency; Small for gestational age