Urogenital abnormalities in men exposed to diethylstilbestrol in utero: a cohort study.
BACKGROUND
Diethylstilbestrol (DES), a synthetic estrogen widely prescribed to pregnant women during the 1940s70s, has been shown to cause reproductive problems in the daughters. Studies of prenatally-exposed males have yielded conflicting results.


METHODS
In data from a collaborative follow-up of three U.S. cohorts of DES-exposed sons, we examined the relation of prenatal DES exposure to occurrence of male urogenital abnormalities. Exposure status was determined through review of prenatal records. Mailed questionnaires (1994, 1997, 2001) asked about specified abnormalities of the urogenital tract. Risk ratios (RR) were estimated by Cox regression with constant time at risk and control for year of birth.


RESULTS
Prenatal DES exposure was not associated with varicocele, structural abnormalities of the penis, urethral stenosis, benign prostatic hypertrophy, or inflammation/infection of the prostate, urethra, or epididymus. However, RRs were 1.9 (95% confidence interval 1.13.4) for cryptorchidism, 2.5 (1.54.3) for epididymal cyst, and 2.4 (1.54.4) for testicular inflammation/infection. Stronger associations were observed for DES exposure that began before the 11th week of pregnancy: RRs were 2.9 (1.65.2) for cryptorchidism, 3.5 (2.06.0) for epididymal cyst, and 3.0 (1.75.4) for inflammation/infection of testes.


CONCLUSIONS
These results indicate that prenatal exposure to DES increases risk of male urogenital abnormalities and that the association is strongest for exposure that occurs early in gestation. The findings support the hypothesis that endocrine disrupting chemicals may be a cause of the increased prevalence of cryptorchidism that has been seen in recent years.
Palmer
Julie R
JR
Slone Epidemiology Center of Boston University, Boston, MA, USA. jpalmer@bu.edu
Herbst
Arthur L
AL
Noller
Kenneth L
KL
Boggs
Deborah A
DA
Troisi
Rebecca
R
Titus-Ernstoff
Linda
L
Hatch
Elizabeth E
EE
Wise
Lauren A
LA
Strohsnitter
William C
WC
Hoover
Robert N
RN
D000014:Abnormalities, Drug-Induced / Q000453:epidemiology; D000328:Adult; D015331:Cohort Studies; D003456:Cryptorchidism / Q000139:chemically induced / Q000453:epidemiology; D004054:Diethylstilbestrol / Q000009:adverse effects*; D004968:Estrogens, Non-Steroidal / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D008875:Middle Aged; D009679:Nuclear Family; D016017:Odds Ratio; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000453:epidemiology; D016016:Proportional Hazards Models; D012306:Risk; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014564:Urogenital Abnormalities / Q000139:chemically induced* / Q000453:epidemiology; D055815:Young Adult
D004968:Estrogens, Non-Steroidal; D004054:Diethylstilbestrol
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