Association of health and lifestyle factors with uterine fibroids among Saudi women: A case–control study

Muawad, Reema; Dabbagh, Rufaidah; Sabr, Yasser

doi:10.1016/j.jtumed.2022.06.005

Cited by 8 publications

(11 citation statements)

References 29 publications

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“…Overall, the definition and ascertainment methods of family history in these prior studies were unclear. For example, some simply stated family history as the exposure and provided no further details about what relatives were included as evidence for a positive family history . Others stated that the participant self-reported whether their mother, sisters, or daughters had fibroids, but these measures are dependent on how many of these relatives the participant had, which was not taken into account.…”

Section: Discussionmentioning

confidence: 99%

“…Although these findings provide some evidence of an association between family history and fibroid outcomes, undergoing surgical treatment depends on many factors beside fibroid status, so results may be a biased estimate of an actual family history association. The remainder of prior epidemiologic research is composed of cross-sectional 11 , 13 and case-control 10 , 12 , 15 , 16 , 17 , 18 studies that consistently observed an association between family history and fibroid diagnosis, with estimates ranging from 20% increased risk (95% CI, 1.1-1.3) among 660 African American and/or Black participants of an urban health plan 13 to a greater than 4-fold increased odds (OR, 4.6; 95% CI, 1.6-13.6) in a study of 193 Haitian women. 11 In some of these studies, participant selection was predicated by hospital admission or outcome criteria that relied on surgical intervention, 15 , 16 , 17 which raises questions about bias due to access to care and about the extent of generalizability.…”

Section: Discussionmentioning

confidence: 99%

“…However, social and environmental factors are also associated with fibroid risk and can be shared within families; thus, it is difficult to disentangle the contribution of shared environment vs genetics among family members . Although few in number, prior epidemiologic studies have usually reported an increased risk if a family member has the condition . However, these studies were limited by cross-sectional methods, reliance on hospital-based participants, or surgical diagnosis of fibroids.…”

Section: Introductionmentioning

confidence: 99%

“… 6 , 9 Although few in number, prior epidemiologic studies have usually reported an increased risk if a family member has the condition. 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 However, these studies were limited by cross-sectional methods, reliance on hospital-based participants, or surgical diagnosis of fibroids. Moreover, interpretation is challenging because the measure of family history in most studies was poorly defined.…”

Section: Introductionmentioning

confidence: 99%

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Family History and Uterine Fibroid Development in Black and African American Women

Langton,

Harmon,

Baird

2024

JAMA Netw Open

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ImportanceUterine fibroids are an understudied condition, with earlier onset in Black than White women. Prior studies of the importance of family history on fibroid development are limited by reliance on hospital-based participant selection, poorly defined measures of family history, and nonsystematic fibroid assessment.ObjectiveTo examine whether family history is a risk factor for fibroid development using prospective ultrasonography data to identify incident fibroids and measure fibroid growth and standardized methods to ascertain family history.Design, Setting, and ParticipantsThis prospective community cohort of Black and African American women from the Detroit, Michigan, area was conducted from January 1, 2010, to December 31, 2018, using 4 standardized ultrasonographic examinations during 5 years to detect fibroids 0.5 cm or larger in diameter and measure fibroid growth. Data analysis was performed between May 2022 and January 2024.ExposuresMaternal fibroid history data were gathered directly from participants’ mothers when possible (1425/1628 [88%]), and 2 exposure variables were created: maternal history of fibroids (diagnosed vs not diagnosed) and age at maternal fibroid diagnosis (20-29, 30-39, or ≥40 years vs not diagnosed).Main Outcomes and MeasuresFibroid incidence was assessed using multivariable Cox proportional hazards regression models; fibroid growth was calculated as change in log-volume per 18 months for fibroids matched at successive ultrasonograms.ResultsA total of 1610 self-identified Black and/or African American women aged 23 to 35 years (mean [SD] age, 29.2 [3.4] years) with no prior clinical diagnosis of fibroids at enrollment were available for analysis. Of 1187 fibroid-free participants at enrollment, 442 (37%) had mothers who were diagnosed with fibroids. Compared with participants without a maternal history of fibroids, those reporting maternal history had an adjusted hazard ratio (AHR) of 1.21 (95% CI, 0.96-1.52). Risk was strongest in those whose mothers were diagnosed at a younger age (20-29 years: AHR, 1.56; 95% CI, 1.11-2.21; 30-39 years: AHR, 1.03; 95% CI, 0.71-1.49; ≥40 years: AHR, 1.11; 95% CI, 0.81-1.52; P = .053 for trend). Fibroid growth rates were higher when mothers were diagnosed with fibroids vs not diagnosed (8.0% increased growth; 95% CI, −1.2% to 18.0%).Conclusions and RelevanceIn this prospective cohort study, results supported maternal history of fibroids as a risk factor for incident fibroids, especially when mothers were diagnosed at a younger age. Maternal history was also associated with increased fibroid growth. Asking patients about their family history of fibroids could encourage patient self-advocacy and inform care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Family History and Uterine Fibroid Development in Black and African American Women

Langton,

Harmon,

Baird

2024

JAMA Netw Open

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“…This decrease in the number of antral follicles can lead to anovulation infertility. These changes also lead to alterations in hormone receptors that can affect inflammatory responses, and respond to ischemic damage during the menstrual cycle, leading to the initiation of genetic changes (epi) and infertility [24].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the relationship between ovarian reserve with congenital anomalies and intramural uterine leiomyoma among infertile women: a cross-sectional study

et al. 2023

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Background Ovarian reserve is a crucial indicator of a woman’s fertility potential, which is determined by the quality and quantity of antral follicles and oocytes. However, certain factors such as endometriosis, pelvic inflammatory disease, myoma, and the natural process of aging can lead to a poor ovarian response to stimulation, reducing a woman’s chances of conceiving. Objective To evaluate the effect of uterus congenital anomalies and uterine leiomyoma are associated on ovarian reserve. Methods The present cross-sectional study was performed on 321 infertile women in three groups consisted of 97 infertile women with intramural uterine leiomyoma and 81 infertile women with uterine anomalies and 143 infertile women without uterine anomalies and uterine leiomyoma during 2017–2019 in Royan Center. Sampling method was continuous and available. Data collection tool in this study was a questionnaire which was in two parts of individual variables and the second part was related to ultrasound results (number of antral follicles and ovarian volume) and laboratory tests (Anti-Mullerian Hormone (AMH) and Follicle-stimulating Hormone (FSH)). Ovarian reserve parameters were measured in three groups on the third day of the cycle in both groups. Data analysis was performed using SPSS software version 21. Quantitative variables were analyzed using t-test, qualitative variables were analyzed using chi-square test. Results The results of in laboratory parameters showed that there was no statistically significant difference between the three groups in FSH (2.35 ± 1.55, 2.07 ± 1.81, 2.31 ± 1.93) and AMH (6.84 ± 2.75,7.52 ± 3.14,6.93 ± 3.04), respectively (P > 0.05). The results of sonographic variables also showed that the variables include number of antral follicles in right ovarian, number of antral follicles in left ovarian have statistically significant between the three groups (5.73 ± 2.69,4.84 ± 3.14,6.66 ± 3.13), respectively (P < 0.05). Conclusion The results of the present study showed that uterine abnormalities and uterine leiomyoma with different mechanisms such as reduce of antral follicle numbers and the effect on uterine and ovarian blood flow lead to a decrease in ovarian reserve and infertility. Therefore, treatment and surgery can reduce these effects and improve the fertility of the affected women.

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Psychological distress and uterine fibroids: a bidirectional two-sample mendelian randomization study

Han,

Wu,

Bian

et al. 2024

BMC Women's Health

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Background Observational data indicates a connection between emotional discomfort, such as anxiety and depression, and uterine fibroids (UFs). However, additional investigation is required to establish the causal relationship between them. Hence, we assessed the reciprocal causality between four psychological disorders and UFs utilizing two-sample Mendelian randomization (MR). Methods To evaluate the causal relationship between four types of psychological distress (depressive symptoms, severe depression, anxiety or panic attacks, mood swings) and UFs, bidirectional two-sample MR was employed, utilizing single nucleotide polymorphisms (SNPs) associated with these conditions. Both univariate MR (UVMR) and multivariate MR (MVMR) primarily applied inverse variance weighted (IVW) as the method for estimating potential causal effects. Complementary approaches such as MR Egger, weighted median, simple mode, and weighted mode were utilized to validate the findings. To assess the robustness of our MR results, we conducted sensitivity analyses using Cochran’s Q-test and the MR Egger intercept test. Results The results of our UVMR analysis suggest that genetic predispositions to depressive symptoms (Odds Ratio [OR] = 1.563, 95% Confidence Interval [CI] = 1.209–2.021, P = 0.001) and major depressive disorder (MDD) (OR = 1.176, 95% CI = 1.044–1.324, P = 0.007) are associated with an increased risk of UFs. Moreover, the IVW model showed a nominally significant positive correlation between mood swings (OR: 1.578; 95% CI: 1.062–2.345; P = 0.024) and UFs risk. However, our analysis did not establish a causal relationship between UFs and the four types of psychological distress. Even after adjusting for confounders like body mass index (BMI), smoking, alcohol consumption, and number of live births in the MVMR, the causal link between MDD and UFs remained significant (OR = 1.217, 95% CI = 1.039–1.425, P = 0.015). Conclusions Our study presents evidence supporting the causal relationship between genetic susceptibility to MDD and the incidence of UFs. These findings highlight the significance of addressing psychological health issues, particularly depression, in both the prevention and treatment of UFs.

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Association of health and lifestyle factors with uterine fibroids among Saudi women: A case–control study

Cited by 8 publications

References 29 publications

Family History and Uterine Fibroid Development in Black and African American Women

Family History and Uterine Fibroid Development in Black and African American Women

Evaluation of the relationship between ovarian reserve with congenital anomalies and intramural uterine leiomyoma among infertile women: a cross-sectional study

Psychological distress and uterine fibroids: a bidirectional two-sample mendelian randomization study

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