Health, growth and sexual development of teenagers exposed in utero to medroxyprogesterone acetate

Abstract

General health, growth and sexual development were evaluated in 74 teenage boys and 98 girls who had been exposed to medroxyprogesterone acetate (MPA) in utero, and 385 boys and 448 girls not exposed. In this 17-year prospective study, the ascertainment of the end points was 'double blind' in that neither the interviewer nor the subject was aware of our interest in MPA. On average, girls exposed to MPA reported reaching the menarche 4 months earlier than the comparison group. This difference disappeared, however, in a multiple regression analysis taking into account social class, the mother's age at menarche and height of the girl's mother and father. Boys exposed to MPA reported their growth spurt to have occurred an average of 6 months earlier and voices to have broken 5 months earlier than unexposed boys. Again, the differences between them and the comparison group disappeared after controlling for confounding variables. There were no significant differences between the MPA-exposed and comparison groups in a wide variety of indices of health reported by the teenagers' mothers. These findings are consistent with the hypothesis that intrauterine exposure to MPA, in the doses used for pregnancy maintenance or for contraception, poses no threat to the long-term health and development of the progeny.

The Jerusalem Perinatal Study cohort, 1964–2005: methods and a review of the main results

“…In recent studies, we found this scale to predict subsequent schizophrenia in offspring 19 and long‐term mortality in mothers 20 . Earlier work had suggested effects of social class on specific complications of pregnancy and labour, 21 and our scale was used as a covariate in studies of birthweight, 22–24 adolescent maturation 15 and cognitive ability 13 . Other studies used the municipal tax level of the census tract as an indicator of socio‐economic status 25 …”

“…A few minor differences were found comparing MPA‐exposed and non‐exposed offspring, most being due to the more favourable distribution of social variables in the exposed group. The study provided data on the prevalence of various health conditions in teenagers, on factors associated with puberty, and on gender‐dimorphic measures of cognitive ability, aggression and behaviour in school 13–15,76 …”

“…In the 1960s and 1970s, pregnant and parturient women gave verbal consent to being interviewed, and administrative approvals for the studies were obtained from the Ministry of Health, the Jerusalem District Health Office, the Jerusalem Municipality and the individual hospitals. In the 1980s, written informed consent was obtained from the mothers and 18‐year‐old teenagers for the studies of long‐term effects of medroxyprogesterone acetate 13–15 . Since the 1990s, all work on the cohort carried out at the Hebrew University of Jerusalem, and by our collaborators in New York, has been in compliance with the Helsinki Declaration and has been approved by Institutional Review Boards at Hadassah‐Hebrew University Hospital, the Hebrew University of Jerusalem, Columbia University and/or New York University.…”

The long‐acting progestogen‐only contraceptive injections: an update

“…One hundred and seventy two children, who were exposed in utero to oral MPA or DMPA (analysed together), were followed up for 17 years. These adolescents exhibited no evidence of adverse effects on their general health or on their physical, intellectual or sexual development 39 .…”

Exposure to female hormone drugs during pregnancy: effect on malformations and cancer

“…For other oestrogen and progestin drugs, some studies show a positive relation to genital malformations, others not (Heinonen et al, 1977;Goldstein et al, 1989;Briggs et al, 1994). In a follow-up study, sons exposed prenatally in utero to medroxyprogesterone had undescended testicles and inguinal hernia more frequently than control sons, but the difference was not statistically significant (Jaffe et al, 1990). Prenatal exposure to oestrogen has been reported to be a risk factor for testicular cancer, cryptorchidism and hypofunctional testes (Depue et al, 1983), and germ-cell tumours of testes and ovaries (Preston-Martin, 1989); there are no previous studies on other cancers of the daughter or any cancer of the mother.…”