Women Exposed to DES In Utero Face Ongoing Risks for Adverse Health Outcomes

In utero exposure to diethylstilbestrol (DES) is associated with higher lifetime risks for 12 adverse health outcomes in women, according to a New England Journal of Medicine study.

Researchers assessed reproductive outcomes (e.g., infertility, preeclampsia) through age 45 and other outcomes (cervical intraepithelial neoplasia grade 2 or higher, breast cancer at age 40 or older, and clear-cell adenocarcinoma) through age 55 among nearly 4700 women exposed to DES and 2000 unexposed controls. They found that risks for all 12 outcomes were significantly elevated in the exposed women: Hazard ratios ranged from 1.4 for preeclampsia to 8.1 for neonatal death.

Among exposed women, most adverse outcomes were more common among those with vaginal epithelial changes (a marker of high-dose DES) than among those without such changes.

In Journal Watch Women's Health, Dr. Andrew Kaunitz says the findings highlight "the importance of lifelong monitoring of DES daughters (including mammography and cervical cytology)" and "vigilance for possible unexpected health outcomes in this population (as well as their offspring)."