Diethylstilbestrol (DES): also harms the third generation

Area of Science:

• Endocrinology
• Reproductive Epidemiology
• Environmental Health

Background:

• Diethylstilbestrol (DES) is a synthetic estrogen endocrine disruptor used from the 1950s-1970s.
• Millions of women ingested DES during pregnancy, exposing their offspring (DES daughters and sons).
• DES daughters face increased risks of reproductive cancers and uterine abnormalities, impacting their own pregnancies.

Purpose of the Study:

• To investigate the health consequences for the third generation (grandchildren of women who took DES).
• To assess the transgenerational effects of in utero DES exposure.

Main Methods:

• Review of available data up to mid-2016 using the Prescrire methodology.
• Analysis of a retrospective study by Réseau DES France (2016) including 4409 DES grandchildren and controls.
• Inclusion of data from US studies on DES daughters and other international cohort studies.

Main Results:

• Approximately 25% of DES grandchildren experienced preterm birth, with higher rates of cerebral palsy, neonatal mortality, and stillbirth.
• Increased risk of malformations, including hypospadias in DES grandsons and esophageal atresia/tracheo-esophageal fistula in DES grandchildren.
• No significant increase in gynecological anomalies or cancers observed in DES granddaughters.

Conclusions:

• In utero DES exposure has detrimental transgenerational effects, impacting third-generation health.
• Epigenetic effects are a plausible mechanism for these observed harms in non-exposed descendants.
• Clinical management and monitoring are crucial for families affected by DES exposure.