RH, E Adam, EE Hatch, K Noller, A Herbst, JR Palmer and RN Hoover.
2000. Continued follow-up of pregnancy outcomes in diethylstilbestrol-exposed
offspring. Obstetrics & Gynecology 96(4):483-489.
study reveals that women who were exposed to DES in the womb "are
less likely to have had full-term live births and more likely to
have had premature births, spontaneous pregnancy losses, or ectopic
pregnancies" than unexposed women. It thus confirms that
pregnancy outcomes for DES-exposed women are significantly worse
than those of unexposed women. "Even if it is assumed that
DES was no longer used in pregnancy after 1971 in the United States
(which is not actually the case), there are still many DES-women
of reproductive age. Thus it is important for obstetrician-gynecologists
to be aware of the consequences of DES exposure in utero on pregnancy
study "is based on the largest number of women with documented
in utero exposure to DES to be observed systematically throughout
much of their reproductive life span."
these results, it raises important questions about the possible
contributions of other endocrine-disrupting chemicals to fertility
impairment in people. These questions cannot be resolved with
current public health data, but given the problems that many people
are experiencing with fertility, they warrant a focused and aggressive
did they do?
Kaufman et al. surveyed DES-exposed daughters for the history of
their pregnancies and compared their experience with non-exposed
counterparts. This work built on 3 decades of research with exposed
cohorts, one the National Collaborative Diethylestilbestrol Adenosis
cohort, the other the Chicago Lying-In Hospital cohort. Questionaires
were sent to all participants who could be traced, yielding responses
from 3373 exposed daughters (88%). These were compared with 1036
questionaires from unexposed women.
histories (numbers of pregnancies, pregnancy outcome) were obtained
from the questionaires. Pregnancy outcomes included preterm births,
first-trimester spontaneous abortions, ectopic pregnancies and stillbirths
or neonatal deaths.
initial analysis showed that findings were similar between the two
cohorts, so both cohorts were combined for comparison with unexposed
women. In the analysis, women who were recruited through review
of medical records were analyzed separately from those that were
physician-referred or self-referred.
What did they find?
Age at menarche, age at first intercourse, marital status, and race
did not differ between exposed and unexposed groups. Nonexposed
women began smoking at an earlier age and were more likely to have
Exposed women had
frequent unsuccessful pregnancy attempts for 12 or more months.
lower chance of becoming pregnant at least once
outcomes of first pregnancies... less likely to have full-term
live births and much more likely to have had preterm births, spontaneous
abortions and ectopic pregnancies
full-term infant was delivered in the first pregnancy of 84.5%
of unexposed women compared with 64.1% or 52.9% of exposed women
(the different percentages are for women from the medical record
group vs. the physican self-referred groups, respectively).
greater frequency of at least one second-trimester spontaneous
significantly greater proportion of first-trimester spontaneous