Long-term distress subsequent to pregnancy drug administration: Women with in utero diethylstilbestrol (DES) exposed daughters

Diethylstilbestrol (DES) is linked to cancer and reproductive loss in females exposed in utero. To examine levels of distress among mothers with in utero DES exposed daughters, we conducted interviews with 60 DES mothers. DES related distress was measured by a scale of 19 items and included such facets of emotional response as worry, fear, anger, and guilt. We also assessed levels of demoralization, a measure of generalized psychological symptomatology. In addition, information was gathered on age, education, psychological treatment history, DES health effects to daughter, certainty of drug exposure and knowledge regarding the efficacy and safety of DES. We found worry, concern, fear, and anxiety to be the strongest type of response at both discovery and the current time. Likewise, anger was a prominent emotion at both time periods while guilt was not as focal a response as had been suggested by a previous study. We collapsed our multiple DES distress items into two reliable scales and found a highly significant decline from distress levels at discovery to the current time. We compared the extent to which variables explaining levels of current DES distress also explain demoralization levels. As would be expected, DES distress at discovery was the strongest predictor of current DES distress. Significant effects were also found for age and DES knowledge, as well as a trend for DES health effects to daughter to exacerbate levels of DES distress. Psychological treatment history had no significant effect. In contrast, present demoralization was best explained by past psychological treatment, while all other factors, including DES situational factors, were not significant predictors. We conclude that there is no direct relationship between current DES distress and psychological problems but that the controversial record regarding the safety and efficacy of DES did contribute to greater distress.