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  • Title: Reproductive performance among DES exposed daughters compared with that of their mothers.
    Author: Kirkhope TG.
    Journal: Ohio State Med J; 1983 Nov; 79(11):867-9. PubMed ID: 6646562.
    Abstract:
    The study was undertaken to determine what the experience of 158 diethylstilbestrol (DES) exposed daughters in the Toledo area has been and whether the rate of pregnancy loss is related to a similar rate in their mothers, indicating a familial factor in the etiology. 45 patients could produce written, documented evidence through their mothers' prenatal records of having been exposed to DES. In these, not only the drug, but also the dose, stage of gestation, and duration were known. In 37 of these (82.2%), definite, benign DES related changes were found in the vagina and cervix. In another 49 patients documented evidence was not available, but all demonstrated the same gross and/or colposcopic changes, thereby giving presumptive evidence of DES exposure. These 94 patients make up Group A. In 64 patients, no documented evidence of DES exposure was obtainable, since their mothers' prenatal records had been lost or destroyed. The mothers themselves recalled using the drug with varying degrees of knowledge about the specifics of dose or duration. None of these daughters had objective findings, by gross or colposcopic examination, suggestive of DES effect. In 20 of them there was some evidence consistent with exposure. These were designated "equivocal findings" and included with the Group B patients. In the group of 94 women who satisfied the criteria of DES exposure by documented history and/or characteristic physical findings (Group A), there were 39 who were sexually active without contraception. The remaining either denied coitus or were regular contraceptive users. 10 patients attempted to conceive for more than 1 year without success, for a primary infertility rate of 25.6%. 29 achieved a total of 46 pregnancies; 22 were delivered at term, and 24 aborted spontaneously, for a pregnancy failure rate of 52.2%. Of the 64 patients with histories of DES exposure but no documented evidence (Group B), there were 24 sexually active without contraceptive use. In these 24 there were 3 who complained of primary infertility, which was defined as regular coitus without contraception for a period of at least 1 year, for a primary infertility rate of 12.5%. The remaining 21 patients had a total of 41 pregnancies. 31 of these resulted in full term live infants. 2 were electively aborted, and 8 were aborted spontaneously. Reproductive histories were available in 105 of the mothers of these daughters. The mothers of the women in both groups had poor reproductive histories. The reproductive performance of Group B daughters was better than that of their mothers and closely approximated that usually quoted for the general population. The performance of group A mothers was significantly worse than that of their mothers, in whom the pregnancy failure rate already was high. The data indicate that the DES exposed daughters have a higher reproductive failure rate than their mothers, while that of DES unexposed daughters is lower. The existence of a familial factor is not supported.
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