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Maternal Gestational Smoking, Diabetes, Alcohol Drinking, Pre-Pregnancy Obesity and the Risk of Cryptorchidism: A Systematic Review and Meta-Analysis of Observational Studies

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  • Lin Zhang
  • Xing-Huan Wang
  • Xin-Min Zheng
  • Tong-Zu Liu
  • Wei-Bin Zhang
  • Hang Zheng
  • Mi-Feng Chen

Abstract

Background: Maternal gestational smoking, diabetes, alcohol drinking, and pre-pregnancy obesity are thought to increase the risk of cryptorchidism in newborn males, but the evidence is inconsistent. Method: We conducted a systematic review and meta-analysis of studies on the association between maternal gestational smoking, diabetes, alcohol drinking, and pre-pregnancy obesity and the risk of cryptorchidism. Articles were retrieved by searching PubMed and ScienceDirect, and the meta-analysis was conducted using Stata/SE 12.0 software. Sensitivity analysis was used to evaluate the influence of confounding variables. Results: We selected 32 articles, including 12 case—control, five nested case—control, and 15 cohort studies. The meta-analysis showed that maternal smoking (OR = 1.17, 95% CI: 1.11–1.23) or diabetes (OR = 1.21, 95%CI: 1.00–1.46) during pregnancy were associated with increased risk of cryptorchidism. Overall, the association between maternal alcohol drinking (OR = 0.97, 95% CI: 0.87–1.07), pre-pregnancy body mass index (OR = 1.02, 95% CI: 0.95–1.09) and risk of cryptorchidism were not statistically significant. Additional analysis showed reduced risk (OR = 0.89, 95% CI: 0.82–0.96) of cryptorchidism with moderate alcohol drinking during pregnancy. No dose—response relationship was observed for increments in body mass index in the risk of cryptorchidism. Sensitivity analysis revealed an unstable result for the association between maternal diabetes, alcohol drinking and cryptorchidism. Moderate heterogeneity was detected in studies of the effect of maternal alcohol drinking and diabetes. No publication bias was detected. Conclusion: Maternal gestational smoking, but not maternal pre-pregnancy overweight or obesity, was associated with increased cryptorchidism risk in the offspring. Moderate alcohol drinking may reduce the risk of cryptorchidism while gestational diabetes may be a risk factor, but further studies are needed to verify this.

Suggested Citation

  • Lin Zhang & Xing-Huan Wang & Xin-Min Zheng & Tong-Zu Liu & Wei-Bin Zhang & Hang Zheng & Mi-Feng Chen, 2015. "Maternal Gestational Smoking, Diabetes, Alcohol Drinking, Pre-Pregnancy Obesity and the Risk of Cryptorchidism: A Systematic Review and Meta-Analysis of Observational Studies," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-17, March.
  • Handle: RePEc:plo:pone00:0119006
    DOI: 10.1371/journal.pone.0119006
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    References listed on IDEAS

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    1. Nicola Orsini & Rino Bellocco & Sander Greenland, 2006. "Generalized least squares for trend estimation of summarized dose–response data," Stata Journal, StataCorp LP, vol. 6(1), pages 40-57, March.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    Cited by:

    1. Inês Francisco & Francisco Caramelo & Maria Helena Fernandes & Francisco Vale, 2021. "Parental Risk Factors and Child Birth Data in a Matched Year and Sex Group Cleft Population: A Case-Control Study," IJERPH, MDPI, vol. 18(9), pages 1-9, April.
    2. Gillian S. Gould & Alys Havard & Ling Li Lim & The PSANZ Smoking in Pregnancy Expert Group & Ratika Kumar, 2020. "Exposure to Tobacco, Environmental Tobacco Smoke and Nicotine in Pregnancy: A Pragmatic Overview of Reviews of Maternal and Child Outcomes, Effectiveness of Interventions and Barriers and Facilitators," IJERPH, MDPI, vol. 17(6), pages 1-34, March.
    3. Chihiro Miyashita & Yasuaki Saijo & Yoshiya Ito & Atsuko Ikeda-Araki & Sachiko Itoh & Keiko Yamazaki & Sumitaka Kobayashi & Yu Ait Bamai & Hideyuki Masuda & Naomi Tamura & Mariko Itoh & Takeshi Yamagu, 2021. "Association between the Concentrations of Metallic Elements in Maternal Blood during Pregnancy and Prevalence of Abdominal Congenital Malformations: The Japan Environment and Children’s Study," IJERPH, MDPI, vol. 18(19), pages 1-13, September.

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