Preeclampsia risk in women exposed in utero to diethylstilbestrol.

Published

Journal Article

OBJECTIVE: To assess whether preeclampsia risk is elevated in pregnancies of diethylstilbestrol (DES)-exposed daughters. METHODS: This study used data from the National Cancer Institute DES Combined Cohorts Follow-up Study. A total of 285 preeclampsia cases (210 exposed and 75 unexposed) occurred in 7,313 live births (4,759 DES exposed and 2,554 unexposed). Poisson regression analysis estimated relative risks and 95% confidence intervals (CI) for preeclampsia adjusted for age at the index pregnancy, parity, education, smoking, body mass index, year of diagnosis, and cohort. RESULTS: In utero DES exposure was associated with nearly a 50% elevation in preeclampsia risk. Adjustment for preeclampsia risk factors attenuated the relative risk slightly (1.42, 95% CI 1.04-1.94). The excess risk with DES was concentrated among women who developed preeclampsia in their first pregnancies (relative risk 1.81, 95% CI 1.17-2.79), who were exposed before 15 weeks of gestation (relative risk 1.57, 95% CI 1.11-2.23), and who were treated with magnesium sulfate (relative risk 2.10, 95% CI 0.82-5.42). Among DES-exposed women who had a prior hysterosalpingogram, preeclampsia prevalence was higher in those with uterine abnormalities (12.4%) than in those without (7.7%). CONCLUSION: These data suggest that in utero exposure to DES is associated with a slightly elevated risk of preeclampsia, and that one possible biological mechanism involves uterine abnormalities.

Full Text

Duke Authors

Cited Authors

  • Troisi, R; Titus-Ernstoff, L; Hyer, M; Hatch, EE; Robboy, SJ; Strohsnitter, W; Palmer, JR; Øglaend, B; Adam, E; Kaufman, R; Herbst, AL; Hoover, RN

Published Date

  • July 2007

Published In

Volume / Issue

  • 110 / 1

Start / End Page

  • 113 - 120

PubMed ID

  • 17601905

Pubmed Central ID

  • 17601905

Electronic International Standard Serial Number (EISSN)

  • 1873-233X

International Standard Serial Number (ISSN)

  • 0029-7844

Digital Object Identifier (DOI)

  • 10.1097/01.aog.0000268796.75591.02

Language

  • eng