title: Adverse health effects in children of women exposed in utero to diethylstilbestrol (DES).
abstract: OBJECTIVE
  Exposure to diethylstilbestrol (DES) in utero is associated with adverse health effects, including genital anomalies in women and men, and cancers in women. Animal studies showed birth defects and tumors in the offspring of DES exposed mice, revealing transgenerational transmission of DES effects. In humans, birth defects, such as hypospadias were observed in children of prenatally exposed women. The aim of this research was to further assess the health effects in children of prenatally exposed women.
  
  
  METHODS
  In a retrospective cohort study, the reports of women exposed to DES in utero on their 4409 children were compared with those of unexposed women on their 6203 children. Comparisons used odd ratios (OR) between children of exposed and unexposed women and standardized incidence rate (SIR) with the general population. These cohorts were recruited on a voluntary basis to answer questionnaires.
  
  
  RESULTS
  There was a global increase of defects in children born to exposed women when compared with those born to unexposed (OR 2.29, 95% CI: 1.80-2.79, P<0.001) and with the general population (SIR 2.39, 95% CI: 2.11-2.68). Increased defects were observed in male genital tract, esophagus, lip or palate, musculoskeletal and circulatory systems. For female genital tract anomalies, there was no significant increase. However, this cohort being relatively young, further follow-up is needed. An increase of cerebral palsy was revealed. The incidence of cancers was not increased, in particular for breast, uterus and ovary.
  
  
  CONCLUSIONS
  Our results confirmed a transgenerational transmission of defects in male genital tract. With caution due to possible bias associated with this method, our data suggest an increase of defects for esophagus, lip or palate, musculoskeletal and circulatory system in children of exposed women.
authors.affiliation: Assistance publique-Hôpitaux de Paris, 75012 Paris, France; Descartes University, 75006 Paris, France; Association Réseau DES France, 40000 Mont-de-Marsan, France. Electronic address: mftournaire@gmail.com.
authors.forename: Michel
authors.initials: M
authors.lastname: Tournaire
authors.affiliation: Hôpital Bichat-Claude-Bernard, Assistance publique-Hôpitaux de Paris, 75018 Paris, France; Diderot University, 75013 Paris, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Epelboin
authors.affiliation: Descartes University, 75006 Paris, France; Laboratoire psychopathologie et processus de santé, Research Unit 4057, 92100 Boulogne, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Devouche
authors.affiliation: Descartes University, 75006 Paris, France; Hôpital Cochin, Assistance publique-Hôpitaux de Paris, 75014 Paris, France.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Viot
authors.affiliation: Descartes University, 75006 Paris, France; Pediatric Cardiology Unit, hôpital Necker, Assistance publique-Hôpitaux de Paris, 75015 Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Le Bidois
authors.affiliation: Assistance publique-Hôpitaux de Paris, 75012 Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Cabau
authors.affiliation: Mutualité française, 75015 Paris, France.
authors.forename: Annabel
authors.initials: A
authors.lastname: Dunbavand
authors.affiliation: Association Réseau DES France, 40000 Mont-de-Marsan, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Levadou
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D002273:Carcinogens; D002547:Cerebral Palsy / Q000139:chemically induced / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004054:Diethylstilbestrol / Q000009:adverse effects*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure; D008875:Middle Aged; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D002273:Carcinogens; D004054:Diethylstilbestrol
keywords: Birth defects; Cancer; Cerebral palsy; DES; Diethylstilbestrol; Diéthylstilbestrol; Epigenetic alterations; Estrogens; Estrogènes; Infirmes moteurs cérébraux; Malformations congénitales; Modifications épigénétiques