6533b854fe1ef96bd12adfe5
RESEARCH PRODUCT
Phenotype severity in the bladder exstrophy-epispadias complex: analysis of genetic and nongenetic contributing factors in 441 families from North America and Europe.
John P. GearhartAnnette SchröderRaimund SteinEkkehart JenetzkyAbdol-mohammad KajbafzadehEnrique JaureguizarSebastian RogenhoferEnrika BartelsYegappan LakshmananThomas M. BoemersLisa GambhirWolfgang RöschMarkus M. NöthenMarkus M. NöthenMichael LudwigNadine ZwinkMartin MüllerArend BökenkampBirte DetlefsenGoedele M.a. BeckersAnne Karoline EbertBoris UtschBoris UtschHeiko ReutterHannes VogtHannes VogtRita GobetMarkus DraakenMarkus DraakenSimeon A. BoyadjievSimeon A. Boyadjievsubject
MalePediatricsmedicine.medical_treatmentSeverity of Illness IndexIntracytoplasmic sperm injectionPregnancyRisk FactorsSurveys and QuestionnairesSmokingPrenatal CareMiddle AgedCleft PalateEuropePhenotypeVitamin B ComplexFemaleAntacidsMaternal AgeAdultmedicine.medical_specialtyEpispadiasCleft Lip610 Medicine & healthmacromolecular substancesEpispadiasPrenatal careFertilization in VitroGenetic determinismPaternal AgeArticleFolic AcidSeverity of illnessmedicineHumans10220 Clinic for Surgery2735 Pediatrics Perinatology and Child HealthSperm Injections IntracytoplasmicSex DistributionPregnancybusiness.industryBladder Exstrophymedicine.diseaseCloacal exstrophySurgeryBladder exstrophyRadiographyPregnancy Trimester FirstPediatrics Perinatology and Child HealthNorth Americabusinessdescription
Objective To identify genetic and nongenetic risk factors that contribute to the severity of the bladder exstrophy-epispadias complex (BEEC). Study design Patients with BEEC from North America (n = 167) and Europe (n = 274) were included. The following data were collected: associated anomalies, parental age at conception, mode of conception, periconceptional folic acid supplementation, maternal risk factors during pregnancy, and environmental risk factors. The patients were divided into 3 subgroups according to phenotype severity: (i) mild, epispadias (n = 43); (ii) intermediate, classic bladder exstrophy (n = 366); and (iii) severe, cloacal exstrophy (n = 31). These subgroups then were compared with identify factors that contribute to phenotype severity. Results Males were overrepresented in all subgroups. A relatively high prevalence of cleft lip, with or without cleft palate, was observed. Maternal smoking and medical radiation during the first trimester were associated with the severe cloacal exstrophy phenotype. Compliance with periconceptional folic acid supplementation was associated with the mildest phenotype (epispadias). Conclusions Periconceptional folic acid supplementation appears to prevent the development of the severe phenotype of BEEC.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2011-01-01 | The Journal of pediatrics |