title: Epidemiology of hypospadias in Europe: a registry-based study.
abstract: BACKGROUND
  Hypospadias is a common congenital malformation. The prevalence of hypospadias has a large geographical variation, and recent studies have reported both increasing and decreasing temporal trends. It is unclear whether hypospadias prevalence is associated with maternal age.
  
  
  OBJECTIVE
  To analyze the prevalence and trends of total hypospadias, isolated hypospadias, hypospadias with multiple congenital anomalies, hypospadias with a known cause, and hypospadias severity subtypes in Europe over a 10-year period and to investigate whether maternal age is associated with hypospadias.
  
  
  METHODS
  We included all children with hypospadias born from 2001 to 2010 who were registered in 23 EUROCAT registries. Information on the total number of births and maternal age distribution for the registry population was also provided. We analyzed the total prevalence of hypospadias and relative risks by maternal age.
  
  
  RESULTS
  From 2001 to 2010, 10,929 hypospadias cases were registered in 5,871,855 births, yielding a total prevalence of 18.61 per 10,000 births. Prevalence varied considerably between different registries, probably due to differences in ascertainment of hypospadias cases. No significant temporal trends were observed with the exceptions of an increasing trend for anterior and posterior hypospadias and a decreasing trend for unspecified hypospadias. After adjusting for registry effects, maternal age was not significantly associated with hypospadias.
  
  
  CONCLUSIONS
  Total hypospadias prevalence was stable in 23 EUROCAT registries from 2001 to 2010 and was not significantly influenced by maternal age.
authors.affiliation: Department of Genetics, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands. j.e.h.van.kammen@umcg.nl.
authors.forename: Jorieke E H
authors.initials: JE
authors.lastname: Bergman
authors.affiliation: EUROCAT Central Registry, Centre for Maternal, Fetal, and Infant Research, Institute of Nursing Research, University of Ulster, Northern Ireland, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Loane
authors.affiliation: CREAL - Centre for Research in Environmental Epidemiology, Barcelona, Spain.|Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain.
authors.forename: Martine
authors.initials: M
authors.lastname: Vrijheid
authors.affiliation: CNR Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Pierini
authors.affiliation: Department of Urology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Rien J M
authors.initials: RJ
authors.lastname: Nijman
authors.affiliation: Division of Medical Genetics, Lausanne, Switzerland.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Addor
authors.affiliation: Children's Hospital Zagreb, Medical School University of Zagreb, Zagreb, Croatia.
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Barisic
authors.affiliation: Department of Hungarian Congenital Abnormality Registry and Surveillance, National Institute for Health Development, Budapest, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Béres
authors.affiliation: Department of Epidemiology, National Institute of Health, Lisbon, Portugal.
authors.forename: Paula
authors.initials: P
authors.lastname: Braz
authors.affiliation: Department of Health Sciences, University of Leicester, Leicester, UK.
authors.forename: Judith
authors.initials: J
authors.lastname: Budd
authors.affiliation: Health Information Unit, Dr Steevens Hospital, Dublin, Ireland.
authors.forename: Virginia
authors.initials: V
authors.lastname: Delaney
authors.affiliation: Department of Health Information and Research, Gardamangia, Malta.
authors.forename: Miriam
authors.initials: M
authors.lastname: Gatt
authors.affiliation: INSERM U953, Paris, France.
authors.forename: Babak
authors.initials: B
authors.lastname: Khoshnood
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.|Medical Birth Registry of Norway, Norwegian Institute of Public Health, Bergen, Norway.
authors.forename: Kari
authors.initials: K
authors.lastname: Klungsøyr
authors.affiliation: Centro Superior de Investigación en Salud Publica, Valencia, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Martos
authors.affiliation: South East Ireland Congenital Anomaly Registry, Public Health Department, HSE South (South East), Kilkenny, Ireland.
authors.forename: Carmel
authors.initials: C
authors.lastname: Mullaney
authors.affiliation: Department of Environment, Province of Antwerp, Antwerp, Belgium.
authors.forename: Vera
authors.initials: V
authors.lastname: Nelen
authors.affiliation: IMER Registry (Emilia Romagna Registry of Birth Defects), Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Neville
authors.affiliation: Department of Public Health, Health Service Executive South, Cork and Kerry, Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: O'Mahony
authors.affiliation: Universitatskinderklinik Mainz, Mainz, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Queisser-Luft
authors.affiliation: Unit of Congenital Malformations and Medical Genetics, CHU Reunion, St Pierre, France.
authors.forename: Hanitra
authors.initials: H
authors.lastname: Randrianaivo
authors.affiliation: Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.
authors.forename: Anke
authors.initials: A
authors.lastname: Rissmann
authors.affiliation: National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Rounding
authors.affiliation: Congenital Anomaly Register and Information Service Public Health, Singleton Hospital, Wales, UK.
authors.forename: David
authors.initials: D
authors.lastname: Tucker
authors.affiliation: University Hospitals Southampton Faculty of Medicine and Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK.
authors.forename: Diana
authors.initials: D
authors.lastname: Wellesley
authors.affiliation: OMNI-Net Ukraine and Khmelnytsky Perinatal Center, Khmelnytsky, Ukraine.
authors.forename: Natalya
authors.initials: N
authors.lastname: Zymak-Zakutnia
authors.affiliation: Department of Genetics, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
authors.forename: Marian K
authors.initials: MK
authors.lastname: Bakker
authors.affiliation: Department of Genetics, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
authors.forename: Hermien E K
authors.initials: HE
authors.lastname: de Walle
mesh_terms: D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007021:Hypospadias / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D015995:Prevalence; D012042:Registries; D012307:Risk Factors
keywords: Ascertainment; Congenital anomaly registers; Epidemiology; Hypospadias; Maternal age; Prevalence