Hypospadias: a transgenerational effect of diethylstilbestrol?
Hypospadias: a transgenerational effect of diethylstilbestrol?
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DOI：
10.1093/humrep/dei398
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发表时间：
2006-03-01
影响因子：
6.1
通讯作者：
Roeleveld, N
中科院分区：
文献类型：
--
作者：
Brouwers, MM;Feitz, WFJ;Roeleveld, N
背景技术背景：2002年，有报道称子宫内暴露于己烯雌酚（DES）的妇女的儿子患尿道下裂的风险增加，表明DES的跨代效应。本研究的目的是通过病例对照研究进一步评估父母DES暴露与尿道下裂之间的关联。方法：从医院信息系统中检索尿道下裂病例。通过病例的父母招募参考人。父母双方都完成了邮寄问卷。通过比值比（OR）和95%置信区间（CI）估计相关性。此外，对父母的匹配子集进行条件logistic回归分析。结果：最终数据库包括583例病例和251篇参考文献。在初步分析中，发现母亲在子宫内暴露于DES时尿道下裂风险增加：OR = 2.3（95% CI 0.7-7.9）。条件Logistic回归得出更强的风险估计：OR = 4.9（95%CI 1.1-22.3）。父亲暴露于DES不会增加风险。结论：研究结果证实，母亲在子宫内暴露于DES会增加尿道下裂的风险。然而，超额风险似乎比2002年的研究小得多。进一步研究第三代的潜在健康风险非常重要。
BACKGROUND: In 2002, an increased risk of hypospadias was reported for sons of women exposed to diethylstilbestrol (DES) in utero, suggesting transgenerational effects of DES. The aim of this study was to further assess the association between parental DES exposure and hypospadias in a case-referent study. METHODS: Cases with hypospadias were retrieved from the hospital information system. Referents were recruited via the parents of cases. Both parents completed postal questionnaires. Associations were estimated by odds ratios (OR) with 95% confidence intervals (CI). Additionally, conditional logistic regression analyses were performed for a matched subset of parents. RESULTS: The final database included 583 cases and 251 referents. In the initial analyses, an indication was found for an increased risk of hypospadias when mothers were exposed to DES in utero: OR = 2.3 (95% CI 0.7-7.9). Conditional logistic regression resulted in a stronger risk estimate: OR = 4.9 (95% CI 1.1-22.3). Paternal exposure to DES did not increase the risk. CONCLUSIONS: The results confirm an increased risk of hypospadias when mothers were exposed to DES in utero. However, the excess risk appears to be of much smaller magnitude than in the 2002 study. Further research on the potential health risks for the third generation is of great importance.