Lifetime abuse victimization and risk of uterine leiomyomata in black women

Abstract

Objective Uterine leiomyomata (UL) are a major contributor to gynecologic morbidity and medical costs, and black women are disproportionately affected by the condition. Previous studies have linked UL to psychosocial stress, including child abuse. We assessed the association between lifetime abuse victimization and UL among 9,910 premenopausal women. Study Design Data were derived from the Black Women’s Health Study, a prospective cohort study. In 2005, participants reported their experiences of physical and sexual abuse within each life stage (childhood, adolescence, adulthood). Biennial follow-up questionnaires from 2005 through 2011 ascertained new UL diagnoses. Rate ratios (RR) and 95% confidence intervals (CI) were estimated using Cox regression. Results There were 1,506 incident UL cases diagnosed by ultrasound or surgery. UL incidence was higher among women who reported child abuse, particularly sexual abuse. Relative to no abuse across the lifespan, RRs were 1.16 (CI, 1.02–1.33) for physical abuse only, 1.34 (CI, 1.09–1.66) for sexual abuse only, and 1.17 (CI, 0.99–1.39) for both physical and sexual abuse in childhood. RRs for 1–3 and ≥4 incidents of child sexual abuse were 1.29 (CI, 1.04–1.61) and 1.41 (CI, 1.07–1.85), respectively, while RRs for low, intermediate, and high frequencies of child physical abuse were 1.19, 1.04, and 1.23, respectively. The association was strongest for the highest category of child abuse severity (RR=1.57, CI, 1.19–2.07). No associations were found for teen or adult abuse. Conclusions In the present study, child sexual abuse was an independent risk factor for UL, supporting the hypothesis that childhood adversity increases UL risk.

Attendance at Religious Services, Prayer, Religious Coping, and Religious/Spiritual Identity as Predictors of All-Cause Mortality in the Black Women's Health Study

“…The 9-item abuse instrument was adapted from the Conflict Tactics Scale and the Pregnancy Abuse Assessment Screen (25,26) and included detailed information on both physical and sexual abuse in childhood (up to age 11 years), in adolescence, in adulthood, and in the past month. Further details on this assessment are provided elsewhere (27)(28)(29).…”

Childhood Abuse, Promoter Methylation of Leukocyte NR3C1 and the Potential Modifying Effect of Emotional Support

“…Finally, we created a 'severity' variable that defined 'mild' abuse as one type of physical abuse that occurred more than or equal to four-times or a more severe form of physical abuse (burn or choke or seriously harm someone I love) occurring one to threetimes; 'moderate' abuse as sexual abuse one to threetimes and/or two forms of physical abuse occurring more than or equal to four-times or a more severe form of physical abuse (burn or choke or seriously harm someone I love) occurring at any frequency; 'severe' abuse as three or more types of physical abuse occurring more than or equal to four-times and/or sexual abuse more than or equal to four-times; and 'very severe' abuse includes three or more types of physical abuse occurring more than or equal to four-times and sexual abuse more than or equal to four-times. These abuse definitions have been used in previous publications from the BWHS [24,[27][28][29][30] and other studies [31,32].…”

The Impact of a History of Sexual Abuse on Health: Data from a Self-Reported Questionnaire from a Sample of French Victims

“…There is a close link between sexual abuse and chronic pelvic pain [5,9]. In addition, organic disorders can be induced by violence to women; for example, it may promote in adulthood the more frequent occurrence of uterine fibroma, as shown by two prospective cohort studies in female victims during childhood [26,27].…”

“…For example, the studies collected for the meta-analyses evaluating the effects of sexual abuse on physical health are almost all cross-sectional studies [11,12]. Longitudinal cohort studies have been more recently published, highlighting a higher risk of obesity, diabetes, hypertension and uterine fibroids in adult women who have been sexually abused in childhood or adolescence [26][27][28][29]. But these studies were all conducted in the United States on particular populations: female nurses and black women.…”

“…A lot of published data on the consequences of sexual violence on health come from meta-analyses, which have the advantage of gathering a large number of victims but brings together studies whose methodology and populations are different [1,6,11,12]. This survey focused on sexual abuse only unlike others which have taken into account other forms of violence: physical, psychological [3,8,12,[26][27][28][29].…”