Arago Laboratory, CNRS, University Sorbonne, 75016 Paris, France.
Association HHORAGES-France, 95270 Asnières-sur-Oise, France.
Int J Environ Res Public Health. 2021 Sep 22;18(19):9965. doi: 10.3390/ijerph18199965.
Psychiatric disorders in children exposed in utero to diethylstilbestrol (DES) are still debated. We report here the impact of DES prescribed to suppress lactation on the children born after such treatment and their progeny, focusing particularly on psychiatric disorders.
We report here an informative family in which one or more psychiatric problems (e.g., bipolarity, suicide attempts and suicide, eating disorders) were detected in all children of second-generation (DES-exposed children; = 9), but for II-2 who died at the age of 26 years due to rupture of a congenital brain aneurysm, and were associated with non-psychiatric disorders (particularly, endometriosis and hypospadias). In the third generation, 10 out of 19 DES-exposed grandchildren had psychiatric disorders (autism spectrum disorder, bipolar disorder, dyspraxia and learning disabilities, mood and behavioral disorders, and eating disorders), often associated with comorbidities. In the fourth generation (7 DES-exposed great-grandchildren, aged between 0 and 18 years), one child had dyspraxia and autism spectrum disorder. The first daughter of the second generation (not exposed to DES) and her children and grandchildren did not have any psychiatric symptoms or comorbidities.
To our knowledge, the high prevalence of psychiatric disorders of various severities in two, and likely three generations, including DES-free pregnancies and DES-exposed pregnancies from the same family, has never been reported. This work strengthens the hypothesis that in utero exposure to DES contributes to the pathogenesis of psychiatric disorders. It also highlights a multigenerational, and possibly transgenerational, effect of DES in neurodevelopment and psychiatric disorders.
在子宫内暴露于己烯雌酚 (DES) 的儿童的精神障碍仍存在争议。我们在此报告 DES 用于抑制泌乳对接受此类治疗的儿童及其后代的影响，特别关注精神障碍。
我们在此报告一个信息丰富的家庭，其中第二代（DES 暴露儿童；n=9）的所有孩子都出现了一种或多种精神问题（例如，双相情感障碍、自杀企图和自杀、饮食障碍），但 II-2 除外，他在 26 岁时因先天性脑动脉瘤破裂而死亡，并且与非精神障碍相关（特别是子宫内膜异位症和尿道下裂）。在第三代中，19 名 DES 暴露的孙辈中有 10 人患有精神障碍（自闭症谱系障碍、双相情感障碍、运动障碍和学习障碍、情绪和行为障碍以及饮食障碍），通常伴有合并症。在第四代（7 名 DES 暴露的曾孙，年龄在 0 至 18 岁之间）中，一名儿童患有运动障碍和自闭症谱系障碍。第二代的长女（未接触 DES）及其子女和孙辈没有任何精神症状或合并症。
据我们所知，这种情况在两代人中，甚至可能在三代人中都从未有过报道，即各种严重程度的精神障碍在两个，而且可能是三个家族中都很普遍，包括来自同一家庭的 DES 无妊娠和 DES 暴露妊娠。这项工作加强了 DES 宫内暴露导致精神障碍发病机制的假设。它还突出了 DES 在神经发育和精神障碍方面的多代甚至跨代效应。
