Abuse during Childhood Linked to Uterine Fibroids in African-American Women.

African-American women who reported sexual or physical abuse before age 11 had a greater risk of uterine fibroids in adulthood, compared with women who had no such abuse history, according to a new study by BU School of Public Health researchers at the Slone Epidemiology Center. 

The study, published online in the American Journal of Obstetrics and Gynecology, found that the fibroid association was strongest for women who experienced sexual abuse. The study was led by Lauren A. Wise, senior epidemiologist at the Slone Center and associate professor of epidemiology at BUSPH, and followed 9,910 premenopausal African-American women participating in the long-running Black Women’s Health Study. In 2005, participants provided information on lifetime experiences of physical and sexual abuse during childhood (up to age 11), adolescence (ages 12-18), and adulthood (19 and older). The incidence of fibroids was ascertained from 2005 through 2011.

Lauren WiseThe results indicate that the incidence of uterine fibroids was 16 percent higher among women who had been physically abused during childhood, and 34 percent higher among women who had been sexually abused. The risk of fibroids increased with the severity of abuse. The results were weaker among women who reported high levels of coping behaviors, which is consistent with previous research showing that emotional support may buffer the negative health effects of violence.

There was also little indication that abuse during adolescence and adulthood increased the risk of fibroids.

“This is the second prospective study to show an association between childhood abuse and uterine fibroids diagnosed during adulthood,” said Wise. She noted that the mechanisms involved may include the influence of psychosocial stress on the biosynthesis or metabolism of sex steroid hormones, which are thought to be involved in fibroid growth. In addition, child sexual abuse is associated with sexually transmitted infections, which also increase fibroid risk.

Fibroids are a major contributor to gynecologic problems, including heavy menstrual bleeding, pelvic pain and infertility. In the U.S., fibroids account for more than $9.4 billion in health care costs annually. The lifetime risk of clinically-relevant uterine fibroids is 30 percent, and black women are two to three times more likely to be affected by the condition.

“Given the high prevalence of fibroids in African-American women, the association is of public health importance,” Wise said.

The Black Women’s Health Study (BWHS) is the largest follow-up study of the health of African American women in the U.S. Led by researchers at Slone, the study has followed 59,000 African-American women through biennial questionnaires since 1995, and has led to a better understanding of numerous health conditions that disproportionately affect African-American women.

Co-authors of the study include Lynn Rosenberg and Julie Palmer, professors of epidemiology at BUSPH.

Funding for the study was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Cancer Institute.

Submitted by: Lisa Chedekel

chedekel@bu.edu