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Published on: September 22, 2023
Altered infant feeding patterns in boys with acquired nonsyndromic cryptorchidism
Julia Spencer Barthold1, Jobayer Hossain, Alicia Olivant-Fisher
1Division of Urology, Alfred I. duPont Hospital for Children, Wilmington, Delaware; Nemours Biomedical Research, Wilmington, Delaware, USA. jbarthol@nemours.org
Insights
Reduced breastfeeding and soy formula feeding are potential risk factors for acquired cryptorchidism, a condition affecting male testis position. Further research is needed to understand the hormonal influences on normal testis development.
Area of Science:
- Pediatric Endocrinology
- Environmental Health
- Reproductive Medicine
Background:
- Nonsyndromic cryptorchidism is a common congenital condition influenced by genetic and environmental factors.
- Distinguishing risk factors for congenital versus acquired cryptorchidism is crucial for understanding disease etiology.
Purpose of the Study:
- To identify differential risk factors for congenital and acquired forms of cryptorchidism.
- To investigate the association between infant feeding practices and cryptorchidism development.
Main Methods:
- Case-control study comparing congenital cryptorchidism, acquired cryptorchidism, hernia/hydrocele, and healthy male controls.
- Utilized questionnaire and clinical data, including infant feeding history.
- Employed stepwise multivariable logistic regression to identify significant predictors.
Main Results:
- Reduced breastfeeding and increased soy formula feeding were associated with acquired cryptorchidism, but not congenital cryptorchidism or hernia/hydrocele.
- Primary soy formula feeding with limited breastfeeding showed the highest risk for acquired cryptorchidism (adjusted OR, 2.7).
- Pregnancy complications and maternal chemical exposures were not consistently linked to either form of cryptorchidism.
Conclusions:
- Reduced breastfeeding and soy formula feeding are identified as potential risk factors for acquired cryptorchidism.
- Hormonally active components in breast milk and soy formula may influence normal testis position during early development.
- Findings suggest a potential mechanism for acquired cryptorchidism related to infant nutrition and hormonal signaling.
Background:
Genetic and environmental factors likely influence susceptibility to nonsyndromic cryptorchidism, a common disease presenting at birth or in later childhood. We compared cases and controls to define differential risk factors for congenital versus acquired cryptorchidism.
Methods:
We compared questionnaire and clinical data from cases of congenital cryptorchidism (n = 230), acquired cryptorchidism (n = 182) and hernia/hydrocele (n = 104) with a group of healthy male controls (n = 358). Potential predictor variables (p < 0.2 in univariable analysis) were included in stepwise multivariable logistic regression models.
Results:
Temporary (odds ratio [OR], 0.5; 95% confidence interval [CI], 0.4-0.8) or exclusive (OR, 0.6; 95% CI, 0.4-0.9) breastfeeding was reduced and soy formula feeding increased (OR, 1.8; 95% CI, 1.2-2.9) in acquired but not congenital or hernia/hydrocele groups. The highest risk estimates were observed for primary soy formula feeding with limited or no breastfeeding (OR 2.5; 95% CI, 1.4-4.3; adjusted OR, 2.7; 95% CI, 1.4-5.4) in the acquired group. Primary feeding risk estimates were equivalent or strengthened when multivariable models were limited to age greater than 2 years, full-term or not small for gestational age, or Caucasian subjects. Pregnancy complications and increased maternal exposure to cosmetic or household chemicals were not consistently associated with either form of cryptorchidism in these models.
Conclusions:
Our data support reduced breastfeeding and soy formula feeding as potential risk factors for acquired cryptorchidism. Although additional studies are needed, hormonally active components of breast milk and soy formula could influence the establishment of normal testis position in the first months of life, leading to apparent ascent of testes in childhood. Birth Defects Research (Part A), 2012.
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