Obstetrics & Gynecology Email Alerts
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Obstetrics & Gynecology 2007;110:113-120
© 2007 by The American College of Obstetricians and Gynecologists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Troisi, R.
Right arrow Articles by Hoover, R. N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Troisi, R.
Right arrow Articles by Hoover, R. N.
Related Collections
Right arrow Breast Disease
Right arrow Epidemiology/public health
Right arrow Hypertension and PIH
Right arrow Obstetric complications of pregnancy

ORIGINAL RESEARCH

Preeclampsia Risk in Women Exposed in Utero to Diethylstilbestrol

Rebecca Troisi, ScD1,2, Linda Titus-Ernstoff, PhD2, Marianne Hyer3, Elizabeth E. Hatch, PhD4, Stanley J. Robboy, MD5, William Strohsnitter, PhD6, Julie R. Palmer, PhD7, Bjørn Øglænd, MD8, Ervin Adam, MD9, Raymond Kaufman, MD9, Arthur L. Herbst, MD10 and Robert N. Hoover, MD1

From the 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland; 2Department of Community and Family Medicine, Dartmouth Medical School, Hanover, New Hampshire; 3Information Management Services Inc, Rockville, Maryland; 4Department of Epidemiology and Biostatistics, Boston University School of Public Health, Boston, Massachusetts; 5Pathology Department, Duke University Medical Center, Durham, North Carolina; 6Department of Obstetrics and Gynecology, New England Medical Center, Boston, Massachusetts; 7Slone Epidemiology Unit, Boston University, Boston, Massachusetts; 8Division of Gynaecology, Obstetrics and Paediatrics, Stavanger University Hospital, Stavanger, Norway; 9Obstetrics and Gynecology Physicians Organization, Methodist Hospital, Houston, Texas; and 10Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois.

OBJECTIVE: To assess whether preeclampsia risk is elevated in pregnancies of diethylstilbestrol (DES)-exposed daughters.

METHODS: This study used data from the National Cancer Institute DES Combined Cohorts Follow-up Study. A total of 285 preeclampsia cases (210 exposed and 75 unexposed) occurred in 7,313 live births (4,759 DES exposed and 2,554 unexposed). Poisson regression analysis estimated relative risks and 95% confidence intervals (CI) for preeclampsia adjusted for age at the index pregnancy, parity, education, smoking, body mass index, year of diagnosis, and cohort.

RESULTS: In utero DES exposure was associated with nearly a 50% elevation in preeclampsia risk. Adjustment for preeclampsia risk factors attenuated the relative risk slightly (1.42, 95% CI 1.04–1.94). The excess risk with DES was concentrated among women who developed preeclampsia in their first pregnancies (relative risk 1.81, 95% CI 1.17–2.79), who were exposed before 15 weeks of gestation (relative risk 1.57, 95% CI 1.11–2.23), and who were treated with magnesium sulfate (relative risk 2.10, 95% CI 0.82–5.42). Among DES-exposed women who had a prior hysterosalpingogram, preeclampsia prevalence was higher in those with uterine abnormalities (12.4%) than in those without (7.7%).

CONCLUSION: These data suggest that in utero exposure to DES is associated with a slightly elevated risk of preeclampsia, and that one possible biological mechanism involves uterine abnormalities.

LEVEL OF EVIDENCE: II






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the American College of Obstetricians and Gynecologists.