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Psychological consequences of DES exposure in utero.

机译：子宫内DES暴露的心理后果。

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Between the 1950s and the late 1970s, millions of women worldwide took diethylstilbestrol (DES) during pregnancy. It was claimed that DES prevented miscarriage, even though a clinical trial was interrupted in 1953 when an interim analysis showed no beneficial effect in the prevention of miscarriage. In 1971, it emerged that DES exposure in utero was associated with somatic effects in adulthood, including female genital abnormalities with obstetric consequences, vaginal cancer, and male urogenital disorders. This article examines the psychological effects of exposure to DES in utero, based on a review of the literature using the standard Prescrire methodology. In two experimental studies, mice exposed to DES during gestation were found to be more aggressive than unexposed mice. A randomised clinical trial and epidemiological studies have pointed to a risk of psychological disorders during adolescence and adulthood after DES exposure in utero. A placebo-controlled randomised trial of DES was conducted in London in the 1950s but was never published. In the 1980s, a research team recovered some of the original data and obtained information on the adult health status of the persons exposed in utero. Compared to the placebo group, psychological disorders were twice as frequent in the adults who were likely to have been exposed to DES in utero. Three large epidemiological studies were also conducted. One study showed that major depressive episodes were about 1.5 times more frequent in women exposed to DES in utero than in unexposed women; the second showed that exposed women had an episode of major weight loss more often than unexposed women; while the third showed no significant difference between the groups in terms of depressive episodes. Smaller studies also suggest that depressive episodes tend to be more frequent after DES exposure in utero. In practice, these data suggest that persons exposed to DES in utero have an increased risk of experiencing psychological disorders and should be monitored accordingly.
机译：在1950年代至1970年代后期，全球数以百万计的妇女在怀孕期间服用了己烯雌酚（DES）。据称，DES可以防止流产，即使1953年的一项临床试验中断了，当时的一项临时分析显示，预防流产没有任何有益效果。 1971年，人们发现子宫内DES暴露与成年后的躯体影响有关，包括女性生殖器异常，产科后果，阴道癌和男性泌尿生殖系统疾病。本文使用标准的Prescrire方法对文献进行回顾，以探讨子宫内DES暴露的心理影响。在两项实验研究中，发现在妊娠期间暴露于DES的小鼠比未暴露的小鼠更具攻击性。一项随机临床试验和流行病学研究指出，子宫内DES暴露后，青春期和成年期存在心理疾病的风险。 1950年代在伦敦进行了安慰剂对照的DES随机试验，但从未公开。在1980年代，一个研究小组恢复了一些原始数据，并获得了有关子宫内暴露者的成人健康状况的信息。与安慰剂组相比，在子宫内可能暴露于DES的成年人中，心理疾病的发病率是其两倍。还进行了三项大型流行病学研究。一项研究表明，子宫内暴露于DES的妇女的严重抑郁发作频率是未暴露妇女的1.5倍。第二个结果表明，暴露妇女比未暴露妇女更容易发生重大体重减轻。而第三组在抑郁发作方面两组之间无显着差异。较小的研究还表明，在子宫内暴露于DES后，抑郁发作往往更为频繁。在实践中，这些数据表明，在子宫内暴露于DES的人发生心理疾病的风险增加，应进行相应的监测。

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