title: ECLAMC Study: Prevalence patterns of hypospadias in South America: Multi-national analysis over a 24-year period.
abstract: OBJECTIVE
  To evaluate prevalence trends of hypospadias in South-America it is essential to perform multicenter and multinational studies with the same methodology. Herein we present systematic data as part of an international multicenter initiative evaluating congenital malformations in South America over a 24-year period.
  
  
  METHODS
  A nested case-control study was conducted using the Latin American Collaborative Study of Congenital Malformations (ECLAMC), between January 1989 and December 2012. Cases were stratified as isolated (IH) and non-isolated hypospadias (NIH). Global prevalence was calculated and discriminated by country. Associations between birth weight and gestational age, and NIH distribution by associated abnormality and severity of hypospadias, were analyzed.
  
  
  RESULTS
  A total of 159 hospitals from six countries participated, reporting surveillance on 4.020.384 newborns. A total of 4.537 hypospadias cases were detected, with a global prevalence of 11.3/10.000 newborns. Trend analyses showed in Chile, Brazil and Uruguay a statistically significant increase in prevalence. Analysis of severity and associated anomalies did not to find an association for distal cases, but did for proximal (RR=1.64 [95% CI=1.33-2.03]).
  
  
  CONCLUSIONS
  This is one of only a few Latin American multicenter studies reporting on the epidemiology of hypospadias in South America in the last two decades. Our data adds to evidence suggesting an increase in some countries in the region at different times. There were also variations in prevalence according to severity. This study adds to literature describing associated anomalies at a hospital-based level.
authors: Departamento de Urología, Pontificia Universidad Javeriana, Departamento de Urología, Hospital Universitario San Ignacio, Bogotá, Colombia.|Instituto de Genética Humana, Pontificia Universidad Javeriana, Bogotá, Colombia.
authors: Nicolás
authors: N
authors: Fernández
authors: Departamento de Urología, Pontificia Universidad Javeriana, Departamento de Urología, Hospital Universitario San Ignacio, Bogotá, Colombia.
authors: Jaime
authors: J
authors: Pérez
authors: Departamento de matemáticas, Rosario University, Bogotá, Colombia.
authors: Pedro
authors: P
authors: Monterrey
authors: ECLAMC (Estudio Colaborativo Latinoamericano de Malformaciones Congénitas) at Centro de Educación Médica e Investigaciones Clínicas (CEMIC-CONICET), Buenos Aires, Argentina e Instituto Nacional de Genética Médica Populacional (INaGeMP), Rio de Janeiro, Brasil.
authors: Fernando A
authors: FA
authors: Poletta
authors: Division of Urology, Department of Surgery, Hospital for Sick Children and University of Toronto, Toronto, Ontario.
authors: Darius J
authors: DJ
authors: Bägli
authors: Division of Urology, Department of Surgery, Hospital for Sick Children and University of Toronto, Toronto, Ontario.
authors: Armando J
authors: AJ
authors: Lorenzo
authors: Instituto de Genética Humana, Pontificia Universidad Javeriana, Bogotá, Colombia.
authors: Ignacio
authors: I
authors: Zarante
mesh_terms: D016022:Case-Control Studies; D005865:Gestational Age; D006801:Humans; D007021:Hypospadias / Q000453:epidemiology* / Q000503:physiopathology; D007231:Infant, Newborn; D008297:Male; D011159:Population Surveillance; D015995:Prevalence; D012044:Regression Analysis; D012720:Severity of Illness Index; D013020:South America / Q000453:epidemiology; D013997:Time Factors
keywords: Epidemiology; Hypospadias; Prevalence