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  • Title: The effects of exogenous female hormones on the fetus.
    Author: Shapiro S, Slone D.
    Journal: Epidemiol Rev; 1979; 1():110-23. PubMed ID: 398263.
    Abstract:
    The many side effects and sequelae of maternal ingestion of diethylstilbestrol (DES) during pregnancy are reviewed and the review focuses on the effects of female hormones on the fetus in terms of public health consequences. DES affects female offspring in many ways: clear cell adenocarcinoma of the vagina and cervix; possible risks of uterine, ovarian, and breast cancers; infertility; and pregnancy complications. In DES-exposed males analogous problems are surfacing: testicular cancer, congenital anomalies of the urogenital tract, and infertility. Other effects of female hormones for which strong documentation exists are major malformations in general, cardiovascular malformations, and perhaps, limb reduction deformities. The public health consequences of intrauterine exposure to DES are considerable. Congenital malformations in urogenital tracts of offspring will require long-term follow-ups and careful watching to avoid development of cancers and other malformations in the affected regions. The social cost of long-term follow-up might be computed monetarily or on another scale, such as the psychological impact. Either way, the cost is high. Since DES has been proven a culprit in offspring malformations, the burden of proof that oral contraceptives in general do not provoke similar offspring changes is on the health community.
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