Obstetrics and gynecology, Volume 56 – Issue 1, July 1980.
Diethylstilbestrol DES exposure in utero produces histologic and gross anatomic abnormalities in the lower and upper female genital tract. The authors investigated the reproductive history of 71 DES-exposed women by comparing their questionnaire data with those of 69 demographically matched non-DES-exposed control subjects.
- The study group’s menstrual indices were comparable with those of the control group except in menstrual flow, which was significantly shorter in duration (P < .001), and in dysmenorrhea, which was reported more often (P<.05).
- Fertility, as indicated by incidence of pregnancy, mean gravidity, and frequency of infertility problems, did not differ between groups.
- The incidence of early (less than 20 weeks) pregnancy complications, ectopic pregnancy, and spontaneous abortion was comparable between groups. However, the incidence of late (after 20 weeks) pregnancy complications, premature delivery (40%, P<.001), and perinatal death (25%, P<.05) was significantly increased in the study group. Among DES-exposed subjects with gross cervicovaginal changes, premature delivery was even more frequent (71.4%, P<.0005), and consequently it was associated with a higher perinatal mortality (43%, P<.001).
The authors conclude that DES exposure in utero in this study group was not associated with increased difficulty in conceiving or early pregnancy complications. However, among pregnancies that progressed beyond 20 weeks’ gestation, the incidence of premature delivery was significantly increased and associated with an increased perinatal mortality. The mechanism(s) for these premature deliveries remains to be elucidated.
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