Epidemiological risk factors of the bladder exstrophy-epispadias complex

• Applicants: Professorin Dr. Anne-Karoline Ebert; Professor Dr. Ekkehart Jenetzky
• Subject Area: Pediatric and Adolescent Medicine ; Epidemiology and Medical Biometry/Statistics ; Reproductive Medicine, Urology
• Term: from 2014 to 2019
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 251782188

The bladder exstrophy-epispadias complex (BEEC) is a major birth defect, nowadays understood as a spectrum from mild glandular epispadias to the multisystem defect of the cloacal exstrophy. Involving various organ systems at different levels the underlying course is assumed to be multifactorial with interplay of genetic and environmental factors. The BEEC prevalence varies according to the severity of the anomaly. However, the prevalence in Germany is unclear due to a lack of centralised data acquisition. Despite intense and dedicated clinical and experimental research during the last years clinical related outcome issues are unsolved. Patients suffer from lifelong physical and psychosocial problems due to genital or continence outcome. Current knowledge on the underlying causes and epidemiologic risk factors is still sparse. It is common knowledge that urogenital malformation might be caused by environmental factors, medication or noxes, paternal factors, morbidity and subfertility, as well as child related parameter like birth plurality. Aim of the present multicenter case-control study is to estimate the significance of potential empirically derived prenatal risk factors quantitatively with minimal selection bias. For patient recruitment, a well-arranged German-wide network is available. Using a standardized methodology including standardised questionnaires and medical documents, possible risk factors and confounders will be collected. The influence of potential risk factors, which is independent of confounders, is estimated using multivariable logistic regression. In addition to already analysed 40 newborns with BEEC, 60 newborns will be recruited as part of a nationwide register, established by the applicant. Terminations following pregnancy diagnosis of BEEC and still births of affected children will be recruited by birth clinics, if necessary by pathologies throughout Germany.

• DFG Programme: Research Grants
• Participating Persons: Professor Dr. Heiko Reutter; Dr. Nadine Zwink