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Pharmacologic sex hormones in pregnancy in relation to offspring obesity
Elizabeth T Jensen1, Matthew P Longnecker
1Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA.
Insights
In utero exposure to diethylstilbestrol (DES) or oral contraceptives during pregnancy was linked to childhood obesity. The risk was highest with early pregnancy exposure to oral contraceptives and mid-pregnancy exposure to DES.
Area of Science:
- Reproductive Health
- Pediatric Endocrinology
- Epidemiology
Background:
- Prenatal exposure to synthetic hormones has raised concerns regarding long-term health outcomes in offspring.
- Diethylstilbestrol (DES) and oral contraceptives (OCs) are examples of such exposures.
- Understanding the association between these exposures and offspring obesity is crucial for public health.
Purpose of the Study:
- To investigate the relationship between prenatal exposure to diethylstilbestrol (DES) or oral contraceptives (OCs) and the risk of obesity in offspring.
- To determine if the timing of exposure during pregnancy influences the association with childhood obesity.
Main Methods:
- Utilized data from the Collaborative Perinatal Project (1959-1974), a prospective multicenter study.
- Analyzed height and weight data at age 7 years for 34,419 children.
- Employed generalized linear models to calculate adjusted odds ratios (aOR) for overweight/obesity based on gestational exposure timing.
Main Results:
- Oral contraceptive (OC) use during pregnancy showed a positive association with offspring overweight/obesity and obesity.
- The strongest association for obesity with OC exposure occurred in the first two months of pregnancy (aOR 2.0).
- Diethylstilbestrol (DES) exposure was also linked to offspring overweight/obesity and obesity, with the highest risk observed for exposure starting between months 3-5 (aOR 2.8 for obesity).
Conclusions:
- Pharmacologic sex hormone use during pregnancy, including DES and OCs, may be associated with an increased risk of childhood obesity.
- The specific timing of exposure during gestation appears to influence the magnitude of this association.
- Further research is needed to ascertain if current, lower-dose oral contraceptive formulations carry similar risks for childhood obesity.
Objective:
To assess the association between in utero exposure to either diethylstilbestrol (DES) or an oral contraceptive in pregnancy and offspring obesity.
Methods:
Using data from the Collaborative Perinatal Project (1959-1974), a multicenter prospective study of pregnant women and their offspring, we examined overweight or obesity among 34,419 children with height and weight data at age 7 years. Generalized linear models to estimate the adjusted odds ratio (aOR) for overweight or obesity (≥85th percentile) or obesity (≥95th percentile) in the offspring according to exposure during different months of pregnancy were used.
Results:
Oral contraceptive use during pregnancy was positively associated with offspring overweight or obesity and obesity. The magnitude of association was strongest in the first 2 months of pregnancy for obesity (aOR 2.0, 95% CI: 1.1, 3.7). DES use was also associated with offspring overweight or obesity and obesity, with the association being strongest for exposure beginning between months 3 and 5 (e.g., for exposure beginning in months 3-4, the aOR for obesity was 2.8, 95% CI: 1.3, 6.3).
Conclusions:
Pharmacologic sex hormone use in pregnancy may be associated with childhood obesity. Whether contemporary, lower dose oral contraceptive formulations are similarly associated with increased risk of childhood obesity is unclear.
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