Study design and population
A retrospective cohort study was conducted on pregnancies and the corresponding incidence of genital malformationsin male neonates atthe International Peace Maternal and Child Health Hospital (affiliated withthe Shanghai Jiao Tong University School of Medicine) from January 2015 to December 2019 to observe the effect of hypertensive disorder in pregnancy on the development of neonatal hypospadias. Every step was carried out in accordance with the relevant guidelines. Ethics approval and use of clinical data for research purposes was granted by the Ethics Committees of the International Peace Maternity and Child Health Hospital. Patients with pregnancies who registered and obtained routine prenatal examinationsat our hospital and their male infants were enrolled in this study, including male infants with hypospadias diagnosed by neonatologists using clinical observations documented at birth. The analysis excluded pregnancies whose newborns had malformations other than hypospadias;these non-malformation infants and their mothers were used as the normal controls. Basedon the timing of the occurrence of hypertension, the pregnancies were divided into three groups: chronic hypertension (CH, hypertension appeared before 20 weeks gestation), pregnancy-induced hypertension (PIH, including gestational hypertension, pre-eclampsia, and eclampsia) and normal control groups (women without hypertension, proteinuria, or evidence of edema). For the risk factor analysis, the pregnancies were divided into a hypospadias group and a non-malformation group. This clinical study has been registered at .