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Eur J Pediatr Surg 2022; 32(03): 274-279
DOI: 10.1055/s-0041-1723993
Original Article

Hypospadias and the Use of the Ages and Stages Questionnaire to Evaluate Neurodevelopmental Status of Boys with Hypospadias

Murat Cakmak
1   Department of Pediatric Surgery, Ankara University School of Medicine, Ankara, Turkey
,
Gulnur Gollu
1   Department of Pediatric Surgery, Ankara University School of Medicine, Ankara, Turkey
,
Ufuk Ates
1   Department of Pediatric Surgery, Ankara University School of Medicine, Ankara, Turkey
,
Ergun Ergun
1   Department of Pediatric Surgery, Ankara University School of Medicine, Ankara, Turkey
,
Ferid Khanmammadov
1   Department of Pediatric Surgery, Ankara University School of Medicine, Ankara, Turkey
,
Sumeyye Sozduyar
1   Department of Pediatric Surgery, Ankara University School of Medicine, Ankara, Turkey
,
Onur Telli
2   Department of Pediatric Urology, Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
,
Kenan Kose
3   Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkey
,
Habibe Dilsiz
1   Department of Pediatric Surgery, Ankara University School of Medicine, Ankara, Turkey
,
Aytul Cakmak
4   Department of Public Health, Ufuk Univercity School of Medicine, Ankara, Turkey
5   Department of Child and Adolescent Psychiatry, Ankara University School of Medicine, Ankara, Turkey
,
Emine G. Kapci
5   Department of Child and Adolescent Psychiatry, Ankara University School of Medicine, Ankara, Turkey
,
Sevgi Kucuker
5   Department of Child and Adolescent Psychiatry, Ankara University School of Medicine, Ankara, Turkey
,
Ozgur Oner
5   Department of Child and Adolescent Psychiatry, Ankara University School of Medicine, Ankara, Turkey
,
Meltem Bingol-Kologlu
1   Department of Pediatric Surgery, Ankara University School of Medicine, Ankara, Turkey
,
Aydin Yagmurlu
1   Department of Pediatric Surgery, Ankara University School of Medicine, Ankara, Turkey
5   Department of Child and Adolescent Psychiatry, Ankara University School of Medicine, Ankara, Turkey
,
Rana I. Uslu
5   Department of Child and Adolescent Psychiatry, Ankara University School of Medicine, Ankara, Turkey
› Author Affiliations Funding None.
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Abstract

Introduction Placental insufficiency is one of the reasons for the reduction of hormone production. Thus, if one of the suspected causes of hypospadias is placental insufficiency, then the neurodevelopmental status of boys with hypospadias may be impaired. The aim of this study was to evaluate the neurodevelopmental status of boys with hypospadias and guide the parents of those who need support to related departments for early intervention.

Materials and Methods Boys were divided into two groups, those with hypospadias (group H) and healthy children undergoing traditional circumcision (group C). The parents of the boys completed the Ages and Stages Questionnaire (ASQ) and ASQ–Social Emotional (SE), both of which are screening instruments for the early identification of developmental and social–emotional problems, respectively.

Results Seventy-eight boys had hypospadias and 59 were admitted for traditional circumcision. The group H had statistically significant more impaired scores than group C in communication, gross motor, and personal–social skill sections. The multivariate logistic regression analysis revealed that hypospadias was the independent predictive factor for communication and personal–social skills.

Conclusion Hypospadias and neurologic impairment may share common etiologic factors. Accordingly, physicians should keep in mind that if a boy presents with hypospadias, the possibility of having neurologic impairment is higher than normal population and early intervention has crucial importance. Every boy with hypospadias should be evaluated for neurodevelopmental status.

Keywords

child behavior - child development - etiology - hypospadias

Ethical Approval

Ethics committee approval was provided for the study. Written informed consent was obtained from the legal guardians of each child




Publication History

Received: 31 October 2020

Accepted: 04 January 2021

Article published online:
04 March 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Springer A, van den Heijkant M, Baumann S. Worldwide prevalence of hypospadias. J Pediatr Urol 2016; 12 (03) 152.e1-152.e7
    CrossrefPubMedGoogle Scholar
  • 2 Fujimoto T, Suwa T, Kabe K, Adachi T, Nakabayashi M, Amamiya T. Placental insufficiency in early gestation is associated with hypospadias. J Pediatr Surg 2008; 43 (02) 358-361
    CrossrefPubMedGoogle Scholar
  • 3 Candel-Pau J, Perapoch López J, Castillo Salinas F, Sánchez Garcia O, Pérez Hoyos S, Llurba Olivé E. Neurodevelopment in preterm infants with and without placenta-related intrauterine growth restriction and its relation to perinatal and postnatal factors. J Matern Fetal Neonatal Med 2016; 29 (14) 2268-2274
    CrossrefPubMedGoogle Scholar
  • 4 Folger AT, Ding L, Ji H. et al. Neonatal NR3C1 methylation and social-emotional development at 6 and 18 months of age. Front Behav Neurosci 2019; 13: 14
    CrossrefPubMedGoogle Scholar
  • 5 Rana N, Kc A, Målqvist M, Subedi K, Andersson O. Effect of delayed cord clamping of term babies on neurodevelopment at 12 months: a randomized controlled trial. Neonatology 2019; 115 (01) 36-42
    CrossrefPubMedGoogle Scholar
  • 6 Squires J, Elizabeth T, Bricker D, LaWanda P. Ages & Stages Questionnaires, (ASQ-3): A Parent-Completed Child-Monitoring System. ASQ-3 User's Guide. 3rd ed.. Baltimore, MD: Brookes Publishing Company; 2009
    Google Scholar
  • 7 Bricker D, Squires J, Mounts L. et al. Ages and Stages Questionnaires: A Parent-Completed Child Monitoring System. 2nd ed.. Baltimore, MD: Brookes Publishing Company; 1999
    Google Scholar
  • 8 Kapci EG, Kucuker S, Uslu RI. How applicable are ages and stages questionnaires for use with Turkish children?. Top Early Child Spec Educ 2010; 30 (03) 176-188
    CrossrefPubMedGoogle Scholar
  • 9 Kucuker S, Kapci EG, Uslu RI. Evaluation of the Turkish version of the “ages and stages questionnaires: Social-emotional” in identifying children with social-emotional problems. Infants Young Child 2011; 24 (02) 207-220
    CrossrefPubMedGoogle Scholar
  • 10 Butwicka A, Lichtenstein P, Landén M. et al. Hypospadias and increased risk for neurodevelopmental disorders. J Child Psychol Psychiatry 2015; 56 (02) 155-161
    CrossrefPubMedGoogle Scholar
  • 11 Carmichael SL, Shaw GM, Lammer EJ. Environmental and genetic contributors to hypospadias: a review of the epidemiologic evidence. Birth Defects Res A Clin Mol Teratol 2012; 94 (07) 499-510
    CrossrefPubMedGoogle Scholar
  • 12 Carmichael SL, Witte JS, Ma C, Lammer EJ, Shaw GM. Hypospadias and variants in genes related to sex hormone biosynthesis and metabolism. Andrology 2014; 2 (01) 130-137
    CrossrefPubMedGoogle Scholar
  • 13 Kalfa N, Paris F, Soyer-Gobillard MO, Daures JP, Sultan C. Prevalence of hypospadias in grandsons of women exposed to diethylstilbestrol during pregnancy: a multigenerational national cohort study. Fertil Steril 2011; 95 (08) 2574-2577
    CrossrefPubMedGoogle Scholar
  • 14 Bauer SB, Retik AB, Colodny AH. Genetic aspects of hypospadias. Urol Clin North Am 1981; 8 (03) 559-564
    CrossrefPubMedGoogle Scholar
  • 15 Marrocco G, Grammatico P, Vallasciani S. et al. Environmental, parental and gestational factors that influence the occurrence of hypospadias in male patients. J Pediatr Urol 2015; 11 (01) 12-19
    CrossrefPubMedGoogle Scholar
  • 16 Yang Q, Qu WY, Yang L, Wang K, Tu HY, Wang J. Literature on the aetiology of hypospadias in the last 5 years: molecular mechanism and environmental factors. Andrologia 2014; 46 (06) 583-591
    CrossrefPubMedGoogle Scholar
  • 17 Brouwers MM, van der Zanden LFM, de Gier RPE. et al. Hypospadias: risk factor patterns and different phenotypes. BJU Int 2010; 105 (02) 254-262
    CrossrefPubMedGoogle Scholar
  • 18 Buckley J, Willingham E, Agras K, Baskin LS. Embryonic exposure to the fungicide vinclozolin causes virilization of females and alteration of progesterone receptor expression in vivo: an experimental study in mice. Environ Health 2006;5(04):
    PubMedGoogle Scholar
  • 19 Huisma F, Thomas M, Armstrong L. Severe hypospadias and its association with maternal-placental factors. Am J Med Genet A 2013; 161A (09) 2183-2187
    CrossrefPubMedGoogle Scholar
  • 20 Miller SL, Huppi PS, Mallard C. The consequences of fetal growth restriction on brain structure and neurodevelopmental outcome. J Physiol 2016; 594 (04) 807-823
    CrossrefPubMedGoogle Scholar
  • 21 Chen YF, Huang WY, Huang KH, Hsieh JT, Lan CF, Chang HC. Factors related to the time to cryptorchidism surgery--a nationwide, population-based study in Taiwan. J Formos Med Assoc 2014; 113 (12) 915-920
    CrossrefPubMedGoogle Scholar
  • 22 Toufaily MH, Roberts DJ, Westgate MN, Hunt AT, Holmes LB. Hypospadias, intrauterine growth restriction, and abnormalities of the placenta. Birth Defects Res 2018; 110 (02) 122-127
    CrossrefPubMedGoogle Scholar
  • 23 Duby JC, Lipkin PH, Macias MM. et al; Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening. Pediatrics 2006; 118 (01) 405-420
    CrossrefPubMedGoogle Scholar
  • 24 Nordhov SM, Rønning JA, Ulvund SE, Dahl LB, Kaaresen PI. Early intervention improves behavioral outcomes for preterm infants: randomized controlled trial. Pediatrics 2012; 129 (01) e9-e16
    CrossrefPubMedGoogle Scholar
  • 25 Nordhov SM, Rønning JA, Dahl LB, Ulvund SE, Tunby J, Kaaresen PI. Early intervention improves cognitive outcomes for preterm infants: randomized controlled trial. Pediatrics 2010; 126 (05) e1088-e1094
    CrossrefPubMedGoogle Scholar
  • 26 Squires J, Bricker D, Potter L. Revision of a parent-completed development screening tool: Ages and Stages Questionnaires. J Pediatr Psychol 1997; 22 (03) 313-328
    CrossrefPubMedGoogle Scholar
  • 27 Skellern CY, Rogers Y, O'Callaghan MJ. A parent-completed developmental questionnaire: follow up of ex-premature infants. J Paediatr Child Health 2001; 37 (02) 125-129
    CrossrefPubMedGoogle Scholar
  • 28 Noeder MM, Logan BA, Struemph KL. et al. Developmental screening in children with CHD: Ages and Stages Questionnaires. Cardiol Young 2017; 27 (08) 1447-1454
    CrossrefPubMedGoogle Scholar
  • 29 Rogers EE, Hintz SR. Early neurodevelopmental outcomes of extremely preterm infants. Semin Perinatol 2016; 40 (08) 497-509
    CrossrefPubMedGoogle Scholar
  • 30 Volpe JJ. Brain injury in premature infants: a complex amalgam of destructive and developmental disturbances. Lancet Neurol 2009; 8 (01) 110-124
    CrossrefPubMedGoogle Scholar
  • 31 Volpe JJ. The encephalopathy of prematurity--brain injury and impaired brain development inextricably intertwined. Semin Pediatr Neurol 2009; 16 (04) 167-178
    CrossrefPubMedGoogle Scholar
  • 32 Costeloe KL, Hennessy EM, Haider S, Stacey F, Marlow N, Draper ES. Short term outcomes after extreme preterm birth in England: Comparison of two birth cohorts in 1995 and 2006 (the EPICure studies). BMJ 2012; 345: e7976
    CrossrefPubMedGoogle Scholar
  • 33 Sandberg DE, Meyer-Bahlburg HFL, Aranoff GS, Sconzo JM, Hensle TW. Boys with hypospadias: a survey of behavioral difficulties. J Pediatr Psychol 1989; 14 (04) 491-514
    CrossrefPubMedGoogle Scholar
  • 34 Berg R, Berg G, Svensson J. Penile malformation and mental health. A controlled psychiatric study of men operated for hypospadias in childhood. Acta Psychiatr Scand 1982; 66 (05) 398-416
    PubMedGoogle Scholar