Epidemiologic Evidence for Adverse Effects of DES Exposure during Pregnancy
The American StatisticianPublished 1 August 1982
Theodore Colton, E. Robert Greenberg
Citations8
SJR quartileQ1
SJR score0.78
SNIP1.50
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The state of evidence regarding in utero DES exposure with other female genital tract abnormalities, with male genital tract irregularities, with subsequent adverse reproductive experiences, and, among the exposed mothers, with increased risk of breast and other gynecologic cancers is summarized.
Abstract
Abstract This report summarizes the evidence regarding adverse effects of diethylstilbestrol (DES) administration during pregnancy. From the association in 1969 of in utero DES exposure with subsequent increased risk of vaginal cancer in young women, the report includes the state of evidence regarding in utero DES exposure with other female genital tract abnormalities, with male genital tract abnormalities, with subsequent adverse reproductive experiences, and, among the exposed mothers, with increased risk of breast and other gynecologic cancers.
Keywords
Environmental Science
New England Journal of MedicineAdenocarcinoma of the Vagina
2,485 Citations1971Arthur L. Herbst, Howard Ulfelder +1 more
The association between treatment of the mothers with estrogen diethylstilbestrol during the pregnancies and the development of adenocarcinoma of the vagina in the girls is highly significant and non-significant factors include maternal age at time of birth smoking in parents intrauterine x-ray exposure and breast feeding.
NatureOEstrogenic Activity of Certain Synthetic Compounds
507 Citations1938E. C. Dodds, Leon I. Goldberg +2 more
Epidemiologic ReviewsA REVIEW OF THE EPIDEMIOLOGY OF HUMAN BREAST CANCER
454 Citations1979Jennifer L. Kelsey
This review covers the major aspects of the epidemiology of breast cancer included in the 1973 review and emphasizes recently reported work, as well as focusing on the magnitude of the problem in the U.S.
CancerAdenocarcinoma of the vagina in adolescence.A report of 7 cases including 6 clear-cell carcinomas (so-called mesonephromas)
454 Citations1970Arthur L. Herbst, Robert E. Scully
Seven cases of adenocarcinoma of the vagina occurring in young women 15 to 22 years of age are reported and radical surgery with vaginal replacement and ovarian conservation appears to have been a safe and effective method of therapy.
New England Journal of MedicineVaginal Cancer after Maternal Treatment with Synthetic Estrogens
335 Citations1971Peter Greenwald, Joseph J. Barlow +2 more
These findings confirm the association between stilbestrol therapy of the mother during pregnancy and adenocarcinoma in young women and provide additional information on dose and time relations.
Obstetrical & Gynecological SurveyFOLLOW-UP STUDY OF MALE AND FEMALE OFFSPRING OF DES-EXPOSED MOTHERS
313 Citations1977Marluce Bibbo, William B. Gill +8 more
The history of pregnancy revealed a lower incidence of pregnancy in the DES-exposed group (18%) than in the control group (33%) and the average values for sperm density and total motile spermatozoa per ejaculate, although in the normal range, were more than two times lower in theDES-exp exposed group as compared to the controls.
American Journal of Obstetrics and GynecologyDoes the administration of diethylstilbestrol during pregnancy have therapeutic value?
266 Citations1999W.J. Dieckmann, M.E. Davis +2 more
New England Journal of MedicinePrenatal Exposure to Stilbestrol
261 Citations1975Arthur L. Herbst, David C. Poskanzer +3 more
The incidence of vaginal adenosis was highest when diethylstilbestrol was begun in early pregnancy and was not detected when treatment was initiated in the 18th week or later.
American Journal of Obstetrics and GynecologyAge-incidence and risk of diethylstilbestrol-related clear cell adenocarcinoma of the vagina and cervix
208 Citations1977Arthur L. Herbst, Philip Cole +3 more
The low risk of disease and the narrow age range of the cases, relative to the long latency period, suggest that DES-related clear cell adenocarcinoma is an incomplete carcinogen.
American Journal of Obstetrics and GynecologyUpper genital tract changes associated with exposure in utero to diethylstilbestrol
198 Citations1977Raymond H. Kaufman, Gary L. Binder +2 more
In 40 women exposed to stilbestrol, changes in the uterus which differed significantly from those seen in the past in nonexposed individuals were noted, including a 'T-shaped appearance of the uterus,' constricting bands in the uterine cavity, a hypoplastic uterus, and less frequently, intrauterine polypoid defects, synechiae, and in one instance a unicornuate uterus.
American Journal of Obstetrics and GynecologyUpper genital tract changes and pregnancy outcome in offspring exposed in utero to diethylstilbestrol
187 Citations1980Raymond H. Kaufman, Ervin Adam +2 more
The women with abnormal x-ray films had more ectopic pregnancies, spontaneous abortions, and premature deliveries than women with normal x-rays although these differences were not statistically significant.
New England Journal of MedicineFertility and Outcome of Pregnancy in Women Exposed in Utero to Diethylstilbestrol
166 Citations1980Ann B. Barnes, Theodore Colton +7 more
An increased risk of unfavorable outcome of pregnancy was associated with DES exposure and among DES-exposed women who became pregnant, 81 per cent had at least one full-term live birth.
The Journal of UrologyPathological Seman and Anatomical Abnormalities of the Genital Tract in Human Male Subjects Exposed to Diethylstilbestrol in Utero
141 Citations1977W.R. Gill, G. Schumacher +1 more
Anatomical and functional abnormalities were significantly greater in male patients exposed to diethylstilbestrol compared to male controls whose mothers were all participants in a prospective, randomized double-blind study on the effects of diethymal cysts on pregnancy at the authors' hospital during the early 1950s.
Obstetrical & Gynecological SurveyUPPER GENITAL TRACT CHANGES ASSOCIATED WITH EXPOSURE IN UTERO TO DIETHYLSTILBESTROL
123 Citations1977Raymond H. Kaufman, Gary L. Binder +2 more
Changing changes in the uterus consisted of a “T-shaped appearance of the uterus,” constricting bands in the uterine cavity, a hypoplastic uterus, and, less frequently, intrauterine polypoid defects, synechiae, and in one instance a unicornuate uterus.
PEDIATRICSUrogenital Tract Abnormalities in Sons of Women Treated With Diethylstilbestrol
112 Citations1976Brian E. Henderson, Barbara Benton +6 more
Obstetrical & Gynecological SurveyVaginal Epithelial Changes in Young Women Enrolled in the National Cooperative Diethylstilbestrol Adenosis (Desad) Project
111 Citations1979Peter C. O’Brien, Kenneth L. Noller +5 more
Analysis of data on the 298 women who were identified by record review and whose prenatal records contained complete information about drug exposure indicated that VEC is most closely associated with the timing of the onset of inlrauterine exposure to diethylstilbestrol (DES), total dose, and length of exposure.
New England Journal of MedicineA Twenty-Five-Year Follow-up Study of Women Exposed to Diethylstilbestrol during Pregnancy
105 Citations1978Marluce Bibbo, William Haenszel +3 more
The LancetSTILBŒSTROL (DIETHYLSTILBESTROL) AND THE RISK OF OVARIAN CANCER
92 Citations1977Robert N. Hoover, LamanA. Gray +1 more
The results of this small trial are consistent with the increasing incidence of ovarian cancer in post-menopausal women in the U.S.A., and with the occurrence of stilboestrol-induced ovarian neoplasms in dogs.
Obstetrics and GynecologyDesign and Preliminary Observations of National Cooperative Diethylstilbestrol Adenosis (DESAD) Project
82 Citations1978Darwin R. Labarthe, Ervin Adam +12 more
The National Cooperative Diethylstilbestrol Adenosis (DESAD) Project has completed the major portion of its enrollment phase with the examination of more than 3000 daughters of women taking synthetic nonsteroidal estrogens during pregnancies occurring from the early 1940s to the mid-1960s.
Obstetrical & Gynecological SurveyPathologic Findings in Young Women Enrolled in the National Cooperative Diethylstilbestrol Adenosis (DESAD) Project
76 Citations1979Stanley J. Robboy, Raymond H. Kaufman +8 more
The pathologic findings in 3246 biopsy specimens obtained during the initial examination of 3339 young women, 88% of whom had documented prenatal exposure to diethylstilbestrol, are presented, suggesting that there may be differences other than those based on location alone between vaginal adenosis and cervical ectropion.
American Journal of Obstetrics and GynecologyEffect of stilbestrol on pregnancy compared to the effect of a placebo
65 Citations1953James Henry Ferguson
The stilbestrol had no effect on pre-eclampsia, prematurity, fetal weight and survival, or the size of the placenta.
BMJRandomised trial of high doses of stilboestrol and ethisterone in pregnancy: long-term follow-up of mothers.
52 Citations1980Valerie Beral, Linda Colwell
Findings support other evidence linking oestrogen treatment and breast cancer and suggest that the latent period before the tumour becomes clinically apparent may be 15 years or longer.
PubMedClear-cell adenocarcinoma of the cervix after maternal treatment with synthetic estrogens.
50 Citations1972Noller Kl, Decker Dg +2 more
The results of the study suggest that the same maternal drug association may exist for mesonephric carcinoma of the cervix as for vaginal lesions following maternal use of stilbestrol.
PubMedCancer and stilbestrol. A follow-up of 1,719 persons exposed to estrogens in utero and born 1943-1959.
39 Citations1973Lanier Ap, Noller Kl +3 more
American Journal of Obstetrics and GynecologyNatural history of diethylstilbestrol-associated genital tract lesions: Cervical ectopy and cervicovaginal hood
38 Citations1980Donald A. Antonioli, Louis Burke +1 more
The investigation documents that DES-associated ectopy and CVH are labile lesions which tend to decrease in extent with time and may eventually disappear.
Epidemiologic ReviewsTHE EFFECTS OF EXOGENOUS FEMALE HORMONES ON THE FETUS1
37 Citations1979Samuel Shapiro, Dennis Slone
The many side effects and sequelae of maternal ingestion of diethylstilbestrol during pregnancy are reviewed and the review focuses on the effects of female hormones on the fetus in terms of public health consequences.
PubMedBreast cancer in DES-exposed mothers: absence of association.
22 Citations1980Duncan Brian, Barbara C. Tilley +4 more
Among 408 women given DES, there were 8 confirmed instances of breast cancer, in comparison with an expected number of 8.1, based on breast cancer incidence rates among parous women in the local population.
Obstetrical & Gynecological SurveyADENOCARCINOMA OF THE VAGINA IN ADOLESCENCE. A REPORT OF 7 CASES INCLUDING 6 CLEAR-CELL CARCINOMAS
18 Citations1970Arthur L. Herbst, Robert E. Scully
CancerThe stilbestrol disorders in historical perspective
18 Citations1980Howard Ulfelder
In the late 1960's when a series of adolescent girls with adenocarcinoma of the vagina presented themselves to the authors' hospital, a clue to etiology from one mother's observation regarding DES as a pregnancy supportive medication was quickly and conclusively converted into fact by an investigation with case controls.
PubMedEvolution of diethylstilbestrol-associated genital tract lesions.
17 Citations1981Louis Burke, Donald A. Antonioli +1 more
The evolution of the colposcopic manifestations of adenosis involving the cervicovaginal hood and vagina was determined by the long-term follow-up of 173 diethylstilbestrol-exposed women, showing that adenotes is a dynamic lesion that undergoes progressive squamous metaplasia over time.
New England Journal of MedicineDiethylstilbestrol and the Risk of Cancer
7 Citations1979L. Clark, Kenneth M. Portier
There is striking evidence that there is an increased risk of early cancer mortality in women treated with diethylstilbestrol during pregnancy and there is a difference in the magnitude of the relative risk between premenopausal and postmenopausal breast cancer, the mortality cases being primarily in pre menopausal women.