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Maternal hypertension affects up to 10% of pregnancies, and management guidelines have recently been updated (NEJM JW Womens Health Nov 21 2013). To investigate whether use of antihypertensive medications during early pregnancy raises fetal risk for hypospadias (hypothesized to result from abnormal placentation associated with hypertension), researchers used data from the National Birth Defects Prevention Study. This analysis involved information from 2131 children with severe hypospadias and 5129 nonmalformed males born from 1997 through 2009.
Compared with mothers without hypertension, those who used antihypertensive medication during the month before pregnancy or the first 4 months of pregnancy (i.e., during fetal urethral formation) were…