Exposure to female hormone drugs during pregnancy: effect on malformations and cancer.
This study aimed to investigate whether the use of female sex hormone drugs during pregnancy is a risk factor for subsequent breast and other oestrogen-dependent cancers among mothers and their children and for genital malformations in the children. A retrospective cohort of 2052 hormone-drug exposed mothers, 2038 control mothers and their 4130 infants was collected from maternity centres in Helsinki from 1954 to 1963. Cancer cases were searched for in national registers through record linkage. Exposures were examined by the type of the drug (oestrogen, progestin only) and by timing (early in pregnancy, only late in pregnancy). There were no statistically significant differences between the groups with regard to mothers' cancer, either in total or in specified hormone-dependent cancers. The total number of malformations recorded, as well as malformations of the genitals in male infants, were higher among exposed children. The number of cancers among the offspring was small and none of the differences between groups were statistically significant. The study supports the hypothesis that oestrogen or progestin drug therapy during pregnancy causes malformations among children who were exposed in utero but does not support the hypothesis that it causes cancer later in life in the mother; the power to study cancers in offspring, however, was very low. Non-existence of the risk, negative confounding, weak exposure or low study-power may explain the negative findings.
Hemminki
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E
National Research and Development Centre for Welfare and Health, Health Services Research Unit, Helsinki, Finland.
Gissler
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M
Toukomaa
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H
D000014:Abnormalities, Drug-Induced / Q000453:epidemiology*; D000328:Adult; D001943:Breast Neoplasms / Q000139:chemically induced / Q000453:epidemiology; D002675:Child, Preschool; D015331:Cohort Studies; D004967:Estrogens / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005835:Genitalia / Q000002:abnormalities / Q000187:drug effects; D006801:Humans; D015994:Incidence; D008297:Male; D009035:Mothers; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D016017:Odds Ratio; D011247:Pregnancy; D011372:Progestins / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment
D004967:Estrogens; D011372:Progestins