Risk factors, prevalence trend, and clustering of hypospadias cases in Puerto Rico

ObjectiveThe aim was to determine the distribution pattern of hypospadias cases across a well-defined geographic space.Materials and methodsThe dataset for this study was produced by the Birth Defects Prevention and Surveillance System of the Department of Health of Puerto Rico (BDSS-PR), which linked the information of male newborns of the Puerto Rico Birth Cohort dataset (PRBC; n = 92,285) from 2007 to 2010. A population-based case-control study was conducted to determine prevalence trend and to estimate the potential effects of maternal age, paternal age, birth-related variables, and health insurance status on hypospadias. Two types of geographic information systems (GIS) methods (Anselin Local Moran's I and Getis-Ord G) were used to determine the spatial distribution of hypospadias prevalence.ResultsBirthweight (<2500 g), age of mother (40 + years), and private health insurance were associated with hypospadias as confirmed with univariate and multivariate analyses at 95% CI. A cluster of hypospadias cases was detected in the north-central region of Puerto Rico with both GIS methods (p ≤ 0.05).ConclusionsThe clustering of hypospadias prevalence provides an opportunity to assess the underlying causes of the condition and their relationships with geographical space.