Diethylstilbestrol (DES) Update: Recommendations for the Identification and Management of DES-Exposed Individuals

Barbara Hammes, CNM, MS, Cynthia J. Laitman, PhD

Disclosures

J Midwifery Womens Health. 2003;48(1) 

In This Article

Effects on Grandchildren of DES-Exposed Women

Reproductive tract tumors have been found in third-generation mice. (These mice were not directly exposed to DES but were grandchildren of females given DES during pregnancy.) These tumors include uterine adenocarcinoma and rete testis cancer in these DES-lineage mice, which were never exposed to DES themselves. The tumors found were in older mice, not young mice. These studies suggest that genetic changes are imprinted at the molecular level, thereby altering genetic expression, so the increased risks for reproductive cancers are transmitted genetically to future generations.[51,52,53,54]

Human studies are currently underway by the National Institutes of Health. A recent report in Lancet found increased prevalence of hypospadias in grandsons of women who took DES in pregnancy, supporting suspicions that there may be third-generation effects in humans.[8] To date, there has been one study of third-generation daughters.[10] Detailed pelvic examinations, colposcopy, Papanicolaou smears, and iodine staining of 28 third-generation daughters revealed no structural abnormalities associated with DES exposure.

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