Secondary sex ratio among women exposed to diethylstilbestrol in utero.
Secondary sex ratio among women exposed to diethylstilbestrol in utero.
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DOI：
10.1289/ehp.10246
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发表时间：
2007-09
影响因子：
10.4
通讯作者：
Hoover, Robert N
中科院分区：
文献类型：
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作者：
Wise, Lauren A;Palmer, Julie R;Hatch, Elizabeth E;Troisi, Rebecca;Titus-Ernstoff, Linda;Herbst, Arthur L;Kaufman, Raymond;Noller, Kenneth L;Hoover, Robert N
己烯雌酚（DES）是一种合成雌激素，在20世纪中期被广泛用于孕妇，是一种有效的内分泌干扰物。以前的研究表明，内分泌干扰化合物和第二性比之间的关联。数据由参加国家癌症研究所（NCI）DES联合队列研究的女性提供。我们使用广义估计方程来估计子宫内DES暴露与性别比（男婴比例）关系的比值比（OR）和95%置信区间（CI）。模型根据母亲年龄、孩子出生年份、产次和队列进行了调整，并考虑了多胎妊娠妇女的聚集性。接触DES的女性与未接触DES的女性相比，产下男婴的OR为1.05（95% CI，0.95-1.17）。对于具有累积DES剂量和时间完整数据的暴露女性（33%），那些在妊娠早期首次暴露于DES且剂量较高的女性生男孩的几率最高。OR为0.91（95% C，0.65-1.27）妊娠≥ 13周时首次暴露于< 5 g DES; 0.95（95% CI，0.71-1.27）≥ 13周时首次暴露至≥ 5 g; 1.16（95% CI，0.96-1.41），首次暴露于< 13周至< 5 g;和1.24（95% CI，1.04-1.48），首次暴露于< 13周至≥ 5 g与无暴露相比。结果并没有明显不同的母亲年龄，胎次，队列，或不孕症史。总体而言，子宫内DES暴露与第二性比之间未观察到相关性，但在妊娠早期首次暴露于DES且累积剂量较高的女性中，发现男婴比例显著增加。
Diethylstilbestrol (DES), a synthetic estrogen widely prescribed to pregnant women during the mid-1900s, is a potent endocrine disruptor. Previous studies have suggested an association between endocrine-disrupting compounds and secondary sex ratio. Data were provided by women participating in the National Cancer Institute (NCI) DES Combined Cohort Study. We used generalized estimating equations to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the relation of in utero DES exposure to sex ratio (proportion of male births). Models were adjusted for maternal age, child’s birth year, parity, and cohort, and accounted for clustering among women with multiple pregnancies. The OR for having a male birth comparing DES-exposed to unexposed women was 1.05 (95% CI, 0.95–1.17). For exposed women with complete data on cumulative DES dose and timing (33%), those first exposed to DES earlier in gestation and to higher doses had the highest odds of having a male birth. The ORs were 0.91 (95% C, 0.65–1.27) for first exposure at ≥ 13 weeks gestation to < 5 g DES; 0.95 (95% CI, 0.71–1.27) for first exposure at ≥ 13 weeks to ≥ 5 g; 1.16 (95% CI, 0.96–1.41) for first exposure at < 13 weeks to < 5 g; and 1.24 (95% CI, 1.04–1.48) for first exposure at < 13 weeks to ≥ 5 g compared with no exposure. Results did not vary appreciably by maternal age, parity, cohort, or infertility history. Overall, no association was observed between in utero DES exposure and secondary sex ratio, but a significant increase in the proportion of male births was found among women first exposed to DES earlier in gestation and to a higher cumulative dose.