[To understand about hypospadias, please visit: hcd2.bupa.co.uk/fact_sheets/html/hypospadias.html]

Paul Appleby sent along the following article, along with this commentary:

A new study has provided more evidence linking a vegetarian diet during pregnancy with a higher risk of hypospadias in baby boys. However, it should be noted that only 22 mothers (14 mothers of boys with hypospadias and 8 mothers of boys without the condition), representing just 3% of the 719 mothers in the study, were not eating meat or fish, so the statistically significant result is based on a small number of vegetarian women. However, the fact that the result agrees with that of a previous study suggests that this might be a real finding. Whether the cause is a high intake of phytoestrogens from soy foods (which could affect the masculinisation of the male foetus) or some sort of nutrient deficiency during pregnancy is uncertain.

Although vegetarian mothers-to-be should be aware that they might be at greater risk of having a son born with hypospadias, it should be remembered that hypospadias is a rare condition (affecting approximately one in 400 newborn boys in the UK, for example) and one that is routinely corrected by surgery during infancy.

Environ Health Perspect. 2008 Aug; 116(8): 1071-6.

Maternal and gestational risk factors for hypospadias.

Akre O, Boyd HA, Ahlgren M, Wilbrand K, Westergaard T, Hjalgrim H, Nordenskjöld A, Ekbom A, Melbye M., Clinical Epidemiology Unit, Department of Medicine, Karolinska, University Hospital, Stockholm, Sweden. olof.akre@ki.se

Background: An increase in the prevalence of hypospadias has been reported, but the environmental causes remain virtually unknown.

Objectives: Our goal was to assess the association between risk of hypospadias and indicators of placental function and endogenous hormone levels, exposure to exogenous hormones, maternal diet during pregnancy, and other environmental factors.

Methods: We conducted a case-control study in Sweden and Denmark from 2000 through 2005 using self-administered questionnaires completed by mothers of hypospadias cases and matched controls. The response rate was 88% and 81% among mothers of cases and controls, respectively. The analyses included 292 cases and 427 controls.

Results: A diet during pregnancy lacking both fish and meat was associated with a more than 4-fold increased risk of hypospadias [odds ratio (OR) = 4.6; 95% confidence interval (CI), 1.6-13.3]. Boys born to obese [body mass index (BMI) > or = 30] women had a more than 2-fold increased risk of hypospadias (OR = 2.6; 95% CI, 1.2-5.7) compared with boys born to mothers with a normal weight (BMI = 20-24). Maternal hypertension during pregnancy and absence of maternal nausea increased a boy's risk of hypospadias 2.0-fold (95% CI, 1.1-3.7) and 1.8-fold (95% CI, 1.2-2.8), respectively. Nausea in late pregnancy also appeared to be positively associated with hypospadias risk (OR = 7.6; 95% CI, 1.1-53).

Conclusions: A pregnancy diet lacking meat and fish appears to increase the risk of hypospadias in the offspring. Other risk associations were compatible with a role for placental insufficiency in the etiology of hypospadias.

Another source of information on this topic is the Vegan Outreach website: www.veganhealth.org/articles/hypospadias

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