Association between fetal DES-exposure and psychiatric disorders in adolescence/adulthood: evidence from a French cohort of 1002 prenatally exposed children

Abstract

In utero diethylstilbestrol (DES) exposure has been demonstrated to be associated with somatic abnormalities in adult men and women. Conversely, the data are contradictory regarding the association with psychological or psychiatric disorders during adolescence and adulthood. This work was designed to determine whether prenatal exposure to DES affects brain development and whether it is associated with psychiatric disorders in male and female adolescents and young adults. HHORAGES Association, a national patient support group, has assembled a cohort of 1280 women who took DES during pregnancy. We obtained questionnaire responses from 529 families, corresponding to 1182 children divided into three groups: Group 1 (n = 180): firstborn children without DES treatment, Group 2 (n = 740): exposed children, and Group 3 (n = 262): children born after a previous pregnancy treated by DES. No psychiatric disorders were reported in Group 1. In Group 2, the incidence of disorders was drastically elevated (83.8%), and in Group 3, the incidence was still elevated (6.1%) compared with the general population. This work demonstrates that prenatal exposure to DES is associated with a high risk of psychiatric disorders in adolescence and adulthood.

Chinese abstract

宫内己烯雌酚（DES）暴露已被证实与成年后男性与女性的躯体异常有关。然而，青春期与成年期的心理或精神障碍相关性的数据是矛盾的。本研究的目的为确定产前宫内DES暴露是否影响大脑发育，以及是否与男性与女性的青春期与成年早期的精神障碍有关。国际性患者支持团队HHORAGES协会收集了1280名孕期服用DES的女性。我们获得了529个家庭的问卷，对应1182名儿童分为以下几组。第一组（n = 180）：一胎儿童无DES暴露，第二组（n = 740）：暴露组儿童，第三组（n = 262）：先前妊娠接受过DES再次妊娠生产的儿童。第一组未见精神障碍疾病报道。第二组中，疾病发病率大幅升高（83.8%），第三组的发病率（6.1%）仍高于正常人群。本研究显示，宫内DES暴露是青春期与成年期精神障碍疾病的高危因素。

• Adolescence
• adulthood
• prenatal DES exposure
• psychiatric disorders
• suicide

Acknowledgements

Mr. René Alexandre, Dr. Henri Pézerat and Prof. Jean Caston have worked tirelessly to demonstrate the harmful role of endocrine disruptors, particularly synthetic hormones, before passing away: we shall never forget their great help. This work could not continue without the daily ongoing support of the HHORAGES board, especially Geneviève Alchourroun, Mauricette Puillandre, Denise Hemmerdinger, Michel Datry, Yette Blanchet and Charles Zelwer. We are very grateful to Professor MO Krebs and Dr. O Kébir for believing in our hypothesis 9 years ago and for working so hard to scientifically demonstrate it.

Declaration of interest

The authors declare they have no competitive financial interest concerning this article; HHORAGES-France Association is financed exclusively by donations.