ECLAMC Study: Prevalence patterns of hypospadias in South America: Multi-national analysis over a 24-year period

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Vol. 43 (2): 325-334, March – April, 2017

doi: 10.1590/S1677-5538.IBJU.2016.0002


Nicolás Fernández 1,2, Jaime Pérez 1, Pedro Monterrey 3, Fernando A. Poletta 4, Darius J. Bägli 5, Armando J. Lorenzo 5, Ignacio Zarante 2
1 Departamento de Urología, Pontificia Universidad Javeriana, Departamento de Urología, Hospital Universitario San Ignacio, Bogotá, Colombia; 2 Instituto de Genética Humana, Pontificia Universidad Javeriana, Bogotá, Colombia; 3 Departamento de matemáticas, Rosario University, Bogotá, Colombia; 4 ECLAMC (Estudio Colaborativo Latinoamericano de Malformaciones Congénitas) at Centro de Educación Médica e Investigaciones Clínicas (CEMIC-CONICET), Buenos Aires, Argentina and Instituto Nacional de Genética Médica Populacional (INaGeMP), Rio de Janeiro, Brasil; 5 Division of Urology, Department of Surgery, Hospital for Sick Children and University of Toronto, Toronto, Ontario


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.

Materials and 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]).

Conclusion: 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.

Keywords:  Hypospadias; Prevalence; Epidemiology

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