A Prospective Cohort Study of Prenatal Diethylstilbestrol Exposure and Cardiovascular Disease Risk.
Previous studies suggest that exposure to endocrine disruptors, such as prenatal exposure to DES, is linked to cardiovascular disease (CVD). We examined data from the National Cancer Institute DES Follow-Up Study, to explore the association between prenatal DES exposure and CVD. We updated our earlier suggestion of a possible CVD excess in the DES exposed by looking at physician-verified diagnoses.
We included 3,941 exposed and 1,705 unexposed women in our statistical analyses to learn whether exposed women had a higher risk of CVD and whether there were differences between exposed and unexposed women in coronary artery disease (CAD), myocardial infarction (MI), and stroke in addition to adult-onset diabetes, high cholesterol, and hypertension. To rule out other factors possibly related to CVD, we also accounted for differences between the exposed and unexposed women in body size, age, educational level, age at menarche, menopausal status, and use of post-menopausal hormones, and smoking and alcohol use.
DES-exposed women had about twice the risk of self-reported CAD and MI compared with unexposed women. This study demonstrates that prenatal DES exposure contributes to risk of CAD and MI and these risks appear to be independent of established risk factors. We did not find an association of prenatal exposure and stroke.