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38
29
th
CONGRESS OF THE ESPU
15:44–15:47
S3-4 (PP)
MATERNAL FIRST TRIMESTER SERUM LEVELS
OF FREE BETA HUMAN CHORIONIC GONADOTROPHIN
AND HYPOSPADIAS
Matthieu PEYCELON
1
, Lea CARLIER
2
, Aliénor DE CHALUS
2
, Adeline BONNARD
2
,
Myriam RACHID
2
, Annabel PAYE-JAOUEN
1
, Muriel HOUANG
3
, Georges AUDRY
4
,
Serge AMSELEM
5
, Francoise MULLER
6
, Alexandra BENACHI
7
, Alaa EL GHONEIMI
1
,
Jean-Pierre SIFFROI
2
and Capucine HYON
2
1) Hôpital Robert-Debré, Paediatric Urology, Paris, FRANCE - 2) Hôpital Armand-Trousseau, Genetics, Paris, FRANCE
- 3) Hôpital Armand-Trousseau, Paediatric Endocrinology, Paris, FRANCE - 4) Hôpital Armand-Trousseau, Pediatric
Surgery, Paris, FRANCE - 5) Hôpital Armand-Trousseau, Inserm UMR_S933, Paris, FRANCE - 6) Hôpital Robert-Debré,
Biochemistry and Hormonology, Paris, FRANCE - 7) Hôpital Béclere, Gynaecology and Obstetrics, Clamart, FRANCE
PURPOSE
Hypospadias is the most common malformation affecting male genitalia and its incidence is increas-
ing. Although the causes remain often unknown, endocrine, vascular, genetic and environmental
factors have been implicated. Human chorionic gonadotrophin (hCG) peaks in the first trimester
of pregnancy stimulate foetal testosterone production and normal male genital development. One
potential etiological pathway could be an altered release of hCG leading to androgen deficiency.
The aim of this study was to identify an association between maternal first trimester levels of serum
free-beta hCG and occurrence of hypospadias.
MATERIAL AND METHODS
A cohort of 301 pregnant women who gave birth to a singleton live born male infant was established
in 2015 of whom 149 boys had surgery for hypospadias. Serum levels of free-beta hCG were ascer-
tained from laboratory databases and free-beta hCG multiple of the median (MoM) were compared
between affected and unaffected boys. Statistical analysis: Fisher test and logistic regression.
RESULTS
Median free-beta hCG values and MoM were 25.92 ng/mL (2.7–224) and 1.47 (0.3–7.6) respec-
tively amongst women with an infant with hypospadias and 1.0 in case of unaffected boy. No cor-
relation was found (p>0.05). Stratified by suspected placenta dysfunction (prematurity, intrauterine
growth retardation or low birth weight), median free-beta hCG MoM was 1.36 (0.7–7.6) (p>0.05).
However, there was interestingly a significant trend towards high levels of free-beta hCG for severe
types (1.87 (0.5–4.9) in proximal hypospadias (N=47) versus 1.14 (0.3–7.6) in distal hypospadias
(N=102), p<0.05).
CONCLUSIONS
Our findings do not support the hypothesis that alteration in maternal hCG levels is associated with
the development of hypospadias. However, higher free-beta hCG values were found in children with
proximal hypospadias. Because of the small number of patients, further studies are needed and
these preliminary results reported on should be interpreted with caution.