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American Journal of Epidemiology Advance Access originally published online on June 21, 2006
American Journal of Epidemiology 2006 164(5):478-486; doi:10.1093/aje/kwj219
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

Original Contribution

Maternal Serum Alpha-Fetoprotein Level during Pregnancy and Isolated Cryptorchidism in Male Offspring

Heather A. Boyd1, Charlotte Myrup1, Jan Wohlfahrt1, Tine Westergaard1, Bent Nørgaard-Pedersen2 and Mads Melbye1

1 Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
2 Department of Clinical Biochemistry, Statens Serum Institut, Copenhagen, Denmark

Correspondence to Dr. Heather Boyd, Department of Epidemiology Research, Statens Serum Institut, Building 206, Room 208, Artillerivej 5, DK-2300 Copenhagen S, Denmark (e-mail: hoy{at}ssi.dk).

Cryptorchidism is thought to result from a disruption of the androgen-estrogen balance in utero. Alpha-fetoprotein (AFP) interacts with and may modulate fetal responses to estrogens. Using a cohort of boys born to women participating in a Danish maternal serum AFP screening program between 1980 and 1994, the authors explored whether AFP levels (as reflected by maternal serum AFP levels in gestational weeks 14–22) were associated with the risk of isolated cryptorchidism in male offspring. Cryptorchidism diagnoses and covariate information were obtained from Denmark's national health registries. Risk ratios for cryptorchidism by maternal serum AFP multiples of the median were estimated by use of log-linear binomial regression. Of 25,418 boys, 663 (2.6%) were diagnosed with cryptorchidism. After adjustment for confounders, boys with maternal serum AFP levels greater than or equal to 2.5 times the median had a 63% (95% confidence interval: –2, 172) greater risk of cryptorchidism than did boys with maternal serum AFP levels within 25% of the median. High fetal AFP levels may contribute directly to events producing cryptorchidism; alternatively, elevated maternal serum AFP levels may reflect placental dysfunction, some aspect of which contributes to cryptorchidism.

alpha-fetoproteins; cryptorchidism; estrogens; pregnancy; risk factors

Abbreviations: AFP, alpha-fetoprotein; CI, confidence interval; CRS, Civil Registration System; ICD, International Classification of Diseases; NCSP, Nordic Medico-Statistical Committee Classification of Surgical Procedures; RR, risk ratio


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[Abstract] [Full Text] [PDF]


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