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Higher Incidence of Hypospadias in Monochorionic Twins

  • Remco Visser (a1), Nienke C. M. Burger (a1), Erik W. van Zwet (a2), Yvonne Hilhorst-Hofstee (a3), Monique C. Haak (a4), Joop van den Hoek (a5), Dick Oepkes (a4) and Enrico Lopriore (a1)...

Abstract

Background: Hypospadias is associated with twinning. The incidence of hypospadias in monochorionic and dichorionic male twins is, however, yet to be determined. Methods: All medical records of monochorionic and dichorionic twins admitted to our neonatal nursery between January 2004 and August 2013 were reviewed for the presence of hypospadias. Results: A total of 350 monochorionic and 303 dichorionic male twins were included in the study. The incidence of hypospadias in monochorionic and dichorionic groups was 4% (14/350) and 1% (3/303) (p = .016) respectively. In 11 of the 15 twin couples, hypospadias occurred in the twin with the lowest birth weight. The rate of hypospadias in twin infants small-for-gestational-age group was 10% (6/60) compared with 2% (11/593) in the appropriate-for-gestational-age group (p = .002). In a multivariate analysis, both monochorionicity and small-for-gestational-age were independently associated with hypospadias, odds ratio 4.1 (95% confidence interval (CI): 1.1–14.7) and 6.1 (95% CI: 2.2–17.2) respectively. Conclusions: The incidence of hypospadias is four-fold higher in monochorionic twins compared with dichorionic twins. Hypospadias is also independently associated with small-for-gestational-age.

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Copyright

Corresponding author

address for correspondence: Dr E. Lopriore, MD, PhD, Division of Neonatology, Department of Pediatrics, J6-S, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands. E-mail: e.lopriore@lumc.nl

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