子宫内暴露于己烯雌酚(DES)的女性所生育子女的出生缺陷。
Birth defects in the sons and daughters of women who were exposed in utero to diethylstilbestrol (DES).
作者信息
Titus-Ernstoff L, Troisi R, Hatch E E, Palmer J R, Hyer M, Kaufman R, Adam E, Noller K, Hoover R N
机构信息
Departments of Community and Family Medicine and of Pediatrics, Dartmouth Medical School, and the Hood Center for Children and Families, Lebanon, NH 03756 USA.
出版信息
Int J Androl. 2010 Apr;33(2):377-84. doi: 10.1111/j.1365-2605.2009.01010.x. Epub 2009 Nov 30.
Prenatal exposure to diethylstilbestrol (DES) is associated with adverse health outcomes, including anatomic anomalies of the reproductive tract in women and of the genitourinary tract in men. The mouse model, which replicates many DES-related effects seen in humans, suggests that prenatal DES exposure causes alterations that may affect the next generation of offspring. We asked women participating in a large, multi-centre study of prenatal DES exposure to report birth defects occurring among 4029 sons and 3808 daughters (i.e., the third generation). A subcohort of 793 third generation daughters was also queried for birth defects. We used logistic regression models to generate odds ratio and 95% confidence intervals for the association between prenatal DES exposure in the mother and birth defects in the offspring. Based on the mothers' reports, overall birth defects were elevated in the sons (OR = 1.53; 95% CI = 1.04, 2.23) and in the daughters (OR = 2.35; 95% CI = 1.44, 3.82). Most estimates of association were imprecise, but daughters appeared to have an excess of heart conditions (OR = 4.56; 95% CI = 1.27, 16.34). Our data suggest a possible association between the mother's prenatal DES exposure and birth defects in their offspring, particularly in daughters. We cannot, however, rule-out the possible influence of reporting bias. In particular, the exposed daughters' elevated risk of cardiac defects may be as a result of the underreporting of these conditions by unexposed mothers.
产前接触己烯雌酚(DES)与不良健康后果相关,包括女性生殖道和男性泌尿生殖道的解剖学异常。小鼠模型复制了许多在人类中观察到的与DES相关的效应,表明产前接触DES会导致可能影响下一代后代的改变。我们询问参与一项关于产前DES暴露的大型多中心研究的女性,报告4029名儿子和3808名女儿(即第三代)中出现的出生缺陷。还对793名第三代女儿的一个亚队列询问了出生缺陷情况。我们使用逻辑回归模型来生成母亲产前接触DES与后代出生缺陷之间关联的比值比和95%置信区间。根据母亲的报告,儿子的总体出生缺陷有所增加(比值比=1.53;95%置信区间=1.04,2.23),女儿也是如此(比值比=2.35;95%置信区间=1.44,3.82)。大多数关联估计并不精确,但女儿似乎有过多的心脏疾病(比值比=4.56;95%置信区间=1.27,16.34)。我们的数据表明母亲产前接触DES与其后代出生缺陷之间可能存在关联,尤其是在女儿中。然而,我们不能排除报告偏倚的可能影响。特别是,暴露女儿心脏缺陷风险的升高可能是未暴露母亲对这些情况报告不足的结果。