Preterm birth, fetal growth, and age at menarche among women exposed prenatally to diethylstilbestrol (DES)

Diethylstilbestrol (DES), a synthetic estrogen used in pregnancy during the 1950s and 1960s, provides a model for potential health effects of endocrine disrupting compounds in the environment. We evaluated prenatal exposure to DES, based on medical record review, in relation to gestational length, fetal growth, and age at menarche in 4429 exposed and 1427 unexposed daughters. DES exposure was associated with an increase in preterm birth (odds ratio (OR) = 2.97; 95% CI = 2.27, 3.87), and a higher risk of small for gestational age (SGA) (OR = 1.61; 95% CI = 1.31, 1.98). The association between DES exposure and early menarche was borderline, with stronger effects when early menarche was defined as ≤10 years (OR = 1.41 95% CI = 0.97, 2.03) than defined as ≤11 years (OR = 1.16; 95% CI = 0.97, 1.39). This study provides evidence that prenatal DES exposure was associated with fetal growth and gestational length, which may mediate associations between DES and health outcomes in later life.