County-Level Environmental Quality and Risk of Hypospadias in Arkansas

Area of Science:

• Environmental Health
• Pediatric Urology
• Reproductive Epidemiology

Background:

• Hypospadias, a common congenital defect in boys, affects approximately 1 in 125 live births.
• Previous research often focused on single environmental exposures, leaving a gap in understanding the impact of cumulative exposures.
• This study investigates the association between maternal prenatal environmental exposures and hypospadias in offspring.

Purpose of the Study:

• To examine the relationship between cumulative maternal prenatal environmental exposures and the occurrence of hypospadias.
• To assess the impact of overall environmental quality and specific domains on hypospadias prevalence.
• To provide insights into environmental risk factors for hypospadias.

Main Methods:

• A retrospective cohort study utilized Arkansas environmental quality index (EQI) data (2006-2010) and county-level estimates.
• Data on hypospadias diagnoses were obtained from the Arkansas Reproductive Health Monitoring System (2005-2012).
• Poisson regression with cluster-robust standard errors analyzed associations between EQI quartiles and hypospadias prevalence.

Main Results:

• No statistically significant association was found between overall fair environmental quality and hypospadias prevalence (adjusted PR=1.01).
• A higher prevalence of hypospadias was observed in boys born in areas with fair air quality compared to excellent air quality (adjusted PR=1.18).
• Specific environmental domains, apart from air quality, did not show significant associations with hypospadias.

Conclusions:

• Overall poor environmental quality index was not significantly associated with the prevalence of hypospadias.
• Poorer air quality during pregnancy was linked to an increased prevalence of hypospadias in male offspring.
• Findings highlight the potential role of air quality as an environmental risk factor for hypospadias.