Reproductive Factors, Hormonal Contraception, and Risk of Uterine Leiomyomata in African-American Women: A Prospective Study

The authors assessed the risk of uterine leiomyomata in relation to reproductive factors and hormonal contraception in a prospective cohort study of US Black women. From March 1997 through March 2001, the authors followed 22,895 premenopausal women with intact uteri and no prior self-reported diagno...

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Bibliographic Details
Published in:American journal of epidemiology 2004-01, Vol.159 (2), p.113-123
Main Authors: Wise, Lauren A., Palmer, Julie R., Harlow, Bernard L., Spiegelman, Donna, Stewart, Elizabeth A., Adams-Campbell, Lucile L., Rosenberg, Lynn
Format: Article
Language:English
Subjects:
Adult
African Americans
Age Factors
Aged
Birth control
Black People
Blacks
Cohort Studies
confidence interval
contraceptives
Contraceptives, Oral
depot medroxyprogesterone acetate
DMPA
Epidemiology
Female
Humans
leiomyoma
Leiomyoma - etiology
Leiomyoma - prevention & control
Menarche
Middle Aged
National Institute of Environmental Health Sciences
NIEHS
Obesity
oral
Parity
Premenopause
Progesterone Congeners - pharmacology
Prospective Studies
Regression Analysis
Reproduction
Risk Factors
uterine neoplasms
Uterine Neoplasms - etiology
Uterine Neoplasms - prevention & control
Women
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Summary:The authors assessed the risk of uterine leiomyomata in relation to reproductive factors and hormonal contraception in a prospective cohort study of US Black women. From March 1997 through March 2001, the authors followed 22,895 premenopausal women with intact uteri and no prior self-reported diagnosis of uterine leiomyomata. The authors used age- and time-stratified Cox regression models to estimate incidence rate ratios for self-reported uterine leiomyomata, confirmed by ultrasound or hysterectomy, in association with selected reproductive and hormonal factors. During 76,711 person-years of follow-up, 2,279 new cases of ultrasound- or hysterectomy-confirmed uterine leiomyomata were self-reported. After adjustment for age, body mass index, smoking, alcohol intake, and other reproductive covariates, the risk of ultrasound- or hysterectomy-confirmed leiomyomata was inversely associated with age at menarche, parity, and age at first birth and positively associated with years since last birth. Overweight or obesity appeared to attenuate the inverse association between parity and uterine leiomyomata. Current use of progestin-only injectables was inversely associated with risk. No consistent patterns were observed for other forms of hormonal contraception. Reproductive history is an important determinant of leiomyomata risk in premenopausal US Black women. Progestin-only injectables may reduce risk.
ISSN:0002-9262
1476-6256
0002-9262
DOI:10.1093/aje/kwh016