Menstrual and reproductive characteristics of women whose mothers were exposed in utero to diethylstilbestrol (DES).
Menstrual and reproductive characteristics of women whose mothers were exposed in utero to diethylstilbestrol (DES).
复制标题
母亲在子宫内暴露于己烯雌酚 (DES) 的妇女的月经和生殖特征。
DOI：
10.1093/ije/dyl106
复制
发表时间：
2006
影响因子：
7.7
通讯作者：
Hoover,Robert
中科院分区：
文献类型：
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作者：
Titus-Ernstoff,Linda;Troisi,Rebecca;Hatch,ElizabethE;Wise,LaurenA;Palmer,Julie;Hyer,Marianne;Kaufman,Raymond;Adam,Ervin;Strohsnitter,William;Noller,Kenneth;Herbst,ArthurL;Gibson-Chambers,Jennifer;Hartge,Patricia;Hoover,Robert
背景在妇女中，产前暴露于己烯雌酚（DES）与成年生殖功能障碍有关。复制了许多DES结果的小鼠模型表明DES会引起表观遗传改变，这些改变可传递给产前暴露动物的女儿。我们报告了一个独特的队列中的月经和生殖特征，该队列包括产前暴露于DES的女性的女儿，通过邮寄问卷对793名母亲记录了子宫DES暴露信息的女性的月经初潮和生殖结局以及基线特征进行了评估。但暴露妇女的女儿后来月经正常（平均年龄分别为16.2岁和15.8岁; P= 0.05），更可能报告月经不规律，比值比（OR）= 1.54 [95%可信区间（95%CI 1.02-2.32）]。母亲DES暴露与女儿不孕症之间的可能关联与机会、年龄和队列调整OR = 2.19（95%CI 0.95-5.07）一致。我们发现有限的证据表明，暴露的女儿有更多的不良生殖结果，但暴露的妇女的女儿有较少的活产（1.6）未曝光的（一、九）（P= 0.005）.结论在子宫内接触DES的妇女中观察到的生殖功能障碍的高风险在她们的女儿中没有观察到，但是我们队列中的大多数妇女还没有尝试建立她们的家庭，需要进一步的后续行动，以评估其生殖健康。我们在第三代女性中发现的月经不规律和可能的不孕症是初步的，但与关于DES相关的人类表观遗传改变的跨代传递的推测一致。
BackgroundIn women, prenatal exposure to diethylstilbestrol (DES) is associated with adult reproductive dysfunction. The mouse model, which replicates many DES outcomes, suggests DES causes epigenetic alterations, which are transmissable to daughters of prenatally exposed animals. We report menstrual and reproductive characteristics in a unique cohort comprising daughters of women exposed prenatally to DES.MethodsMenstrual and reproductive outcomes and baseline characteristics were assessed by mailed questionnaire in 793 women whose mothers had documented information regardingin uteroDES exposure.ResultsMean age at menarche was 12.6 years in both groups, but daughters of the exposed women attained menstrual regularization later (mean age of 16.2 years vs. 15.8 years;P= 0.05), and were more likely to report irregular menstrual periods, odds ratio (OR) = 1.54 [95% confidence interval (95% CI 1.02–2.32)]. A possible association between mothers' DES exposure and daughters' infertility was compatible with chance, age, and cohort adjusted OR = 2.19 (95% CI 0.95–5.07). We found limited evidence that daughters of the exposed had more adverse reproductive outcomes, but daughters of exposed women had fewer live births (1.6) than the unexposed (1.9) (P= 0.005).ConclusionsThe high risk of reproductive dysfunction seen in women exposed to DESin uterowas not observed in their daughters, but most women in our cohort have not yet attempted to start their families, and further follow-up is needed to assess their reproductive health. Our findings of menstrual irregularity and possible infertility in third-generation women are preliminary but compatible with speculation regarding transgenerational transmission of DES-related epigenetic alterations in humans.