Investigating risk factors for hypospadias: insights from a study in Eastern Algeria

Abstract

Background: Hypospadias is among the most common congenital anomalies of the male genitalia, with a multifactorial cause involving genetic, environmental, and maternal factors. In Algeria, the condition remains under-studied, with limited data on its epidemiology and risk factors.

Objective: To analyze the clinical characteristics, associated anomalies and key risk factors for hypospadias in Eastern Algeria over a 16-year period.

Methods: This retrospective case-control study included 483 hypospadias cases and 503 healthy controls. Cases were identified through medical records from the Pediatric Surgery Department, while controls were recruited via online questionnaires. Statistical analyses, including logistic regression, were performed to identify independent risk factors.

Results: Significant risk factors for hypospadias included low birth weight (<2500 g; OR = 11.86, p < 0.001), intrauterine growth restriction (IUGR) (OR = 2.36, p = 0.027), maternal gestational hypertension (OR = 2.65, p = 0.008), and rural residence (OR = 3.78, p < 0.001). Severe forms of hypospadias were associated with a higher prevalence of anomalies, particularly genitourinary anomalies (81.82 %).

Conclusion: Hypospadias in Eastern Algeria is strongly influenced by perinatal, maternal, and environmental factors. Enhancing prenatal care, enforcing stricter environmental regulations, and improving healthcare access in rural areas are crucial steps in reducing the burden of this condition and its complications.

Keywords: Congenital anomaly; Hypospadias; Low birth weight; Maternal hypertension; Risk factors; Rural residence.