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14:09 - 14:12

S1-14

(PP)

A NATIONWIDE REGISTER STUDY OM MATERNAL AND FOETAL FACTORS IN

BLADDER EXSTROPHY IN SWEDEN

Gisela REINFELDT ENGBERG, Magdalena FOSSUM, Agneta NORDENSKJÖLD and ängla MANTEL

Karolinska Institute, Womens and childrens health, Stockholm, SWEDEN

PURPOSE

Bladder exstrophy is a rare congenital complex malformation where the underlying cause is largely unknown with both

environmental and genetic mechanisms involved.

The aim of this study was to conduct a nationwide epidemiological study related to maternal and foetal risk factors of

bladder exstrophy in Sweden 1973-2011.

MATERIAL AND METHODS

120 patients were identified in the Medical Birth Register with ICD codes; 753.50, 753F and Q64.1, 1973-2011. The

cases were matched with 5 controls per patient for calendar year of delivery and sex, and a case-control study was

performed by linkage between several national registers.

RESULTS

The study showed a total live-birth prevalence of 2.98:100 000 with a male-to-female ratio of 1.14:1. We found a

higher risk among mothers with Nordic origin of birth, higher age, extremes of BMI and smoking. Neither maternal

disease, parity nor assisted conception were identified as risk factors for bladder exstrophy. Delivery mode, birth weight,

gestational week at birth, Apgar score and survival rate did not differ from controls. Associated malformations were

present in 7.5% of the cases, including anal atresia, esophageal atresia, CDH, cardiac malformations, cleft palate and

malformations of extremities. 41% had surgery for congenital inguinal hernia and 11% of the boys had surgery for

retentio testis.

CONCLUSIONS

This national register study on bladder exstrophy demonstrated a prevalence of 2.98:100 000 live-births with an almost

equal sex ratio. The majority of the cases were isolated without major associated malformations. Nordic maternal origin

of birth, higher age, extremes of BMI and smoking were associated with higher risk.