Prenatal diethylstilbestrol exposure and risk of obesity in adult women

Journal of developmental origins of health and disease, 2015

Study Abstract

Diethylstilbestrol DES is a non-steroidal estrogen that was commonly prescribed during pregnancy from the late 1940s to 1971. A potent endocrine disruptor, prenatal DES exposure has been linked with reproductive tract malformations, adverse pregnancy outcomes, cancer, infertility and earlier menopause. DES was used for years as a growth promoter in animal production. Some animal studies suggest that prenatal DES exposure is associated with obesity and metabolic disturbances.

Using data from the National Cancer Institute DES Follow-Up Study, we evaluated the association between DES and adult obesity, weight gain from age 20 to mid-life, central adiposity and height among 2871 prenatally exposed and 1352 unexposed women between 23 and 52 years of age(median 41.5) at baseline in 1994. DES exposure status was confirmed by prenatal medical record review. We used multivariable log-binomial models to calculate risk ratios (RRs) for obesity in 2006, and linear regression to calculate mean differences in body mass index, weight gain, waist circumference and height.

The adjusted RR for DES and obesity was 1.09 [95% confidence interval (CI): 0.97, 1.22],

  • and RRs were 1.23 (CI: 1.07, 1.42)
  • and 1.05 (CI: 0.91, 1.20) for low and high estimated total DES dose, respectively, compared with no exposure.
  • DES-exposed women gained slightly more weight than unexposed women [mean difference, 0.70 kg (CI: -0.27, 1.66)].

This study suggests that prenatal DES exposure may be associated with a small increase in adult obesity.

From the “DES Follow-Up Study”

Some studies in animals suggest that prenatal DES exposure is linked to obesity and to abnormal metabolism of glucose. Using data from the National Cancer Institute DES Follow-Up Study, we evaluated the association between prenatal DES exposure and adult obesity. To do this, we looked at factors like weight gain, body mass index (BMI – a measure of body fatness) and waist circumference among 2,871 women exposed to DES before their birth and also among 1,352 who were not exposed to DES.

We conducted statistical analyses to see if exposed women had a higher risk of being obese, and whether there were differences between exposed and unexposed women in BMI, weight gain, waist circumference and height. Other factors possibly related to obesity such as age, educational level and whether the woman smoked, were accounted for in the analysis. We also considered whether the mother smoked during the pregnancy with the daughter, the daughter’s use of postmenopausal hormones, her menopausal status, and how many children she had.

DES-exposed women had a 9% greater overall risk of being obese compared with unexposed women, but these findings could have been due to chance. Compared with unexposed women, the risk of obesity was 23% greater for women who were exposed prenatally to a low DES dose and 5% greater for women exposed to a high dose. Overall, most women gained around 30 pounds between the ages of 20 and the mid-fifties, and DES-exposed women gained slightly more (about 1.5 pounds) than those not exposed, although this was not statistically significant. Height and waist circumference were very similar among DES- exposed and unexposed women. This study suggests that prenatal DES exposure may be associated with a small increase in adult obesity but not the larger differences that have been observed in some animal studies.

References

  • Prenatal diethylstilbestrol exposure and risk of obesity in adult women, Journal of developmental origins of health and disease, NCBI PobMed 25697972, 2015 Jun.
  • Image credit Sandra Cohen-Rose and Colin Rose..
DES DIETHYLSTILBESTROL RESOURCES

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