Abuse in Childhood and Risk of Uterine Leiomyoma: The Role of Emotional Support in Biologic Resilience
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BACKGROUND: Childhood adversities are associated with adult health. We hypothesize that exposure to physical and sexual abuse in childhood and adolescence will be associated with incidence of clinically symptomatic uterine leiomyomas (fibroids) through influences on health behaviors and reproductive hormone regulation. METHODS: Participants included 68,505 women enrolled in the Nurses' Health Study II, an ongoing prospective cohort study of premenopausal women from 14 US states aged 25-42 years at enrollment (1989), who completed a retrospective questionnaire on childhood violence exposure (2001). A cumulative indicator of severity and chronicity of child/teen violence exposure was derived using factor analysis. We used a Cox proportional-hazards model to estimate the incidence rate ratios (IRRs) and 95% confidence intervals (CIs). RESULTS: During the 728,865 woman-years of follow-up (1989-2005), 9823 incident diagnoses of ultrasound- or hysterectomy-confirmed uterine leiomyomas were reported; 65% reported any physical or sexual abuse. A dose-response association between cumulative abuse and fibroid risk was found. Compared with those who reported no abuse, multivariable IRRs for ultrasound or hysterectomy-confirmed uterine leiomyomas were 1.08 (95% CI = 1.03-1.13), 1.17 (1.10-1.24), 1.23 (1.14-1.33), 1.24 (1.10-1.39), and 1.36 (1.18-1.54), for cumulative exposures ranging from mildest to most severe. Increased emotional support in childhood also attenuated associations. CONCLUSIONS: Severity and chronicity of child/teen sexual and physical abuse was associated with increasing risk of clinically detected fibroids among premenopausal women.
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Psychosocial stress may increase fibroid risk.
“Epidemiologic research suggests that psychosocial stress may increase fibroid risk, 1, 2”
From Adverse childhood experiences and health-related quality of life among women undergoing hysterectomy for uterine leiomyoma (2022) · cites this paper as [1]
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- Authors
- Boynton-Jarrett, R., Rich-Edwards, J. W., Jun, H.-J., Hibert, E. N., & Wright, R. J.
- Affiliations
- Brigham and Women's Hospital (US)
- Venue
- Epidemiology
- Published
- 2011-01
- Volume
- 22
- Issue
- 1
- Pages
- 6-14
- ISSN
- 1044-3983 (ISSN-L)
- PMC
- PMC4010091
- OpenAlex
- W2059829212
- Cited by
- 64
- References
- 66
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 5 · 2023: 4 · 2022: 7 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 6 · 2014: 4 · 2013: 4 · 2012: 6
- FWCI
- 4.82
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5k12hd043444-10)
- National Heart, Lung, and Blood Institute (R01HL064108, R01 HL64108)
- National Cancer Institute (R01CA050385)
- National Center for Research Resources (L40 RR033232)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12-HD043444, L40 HD057063, K12HD43444)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Social Sciences › Health › Intimate Partner and Family Violence
- Keywords
- childhood abuse, uterine fibroids, physical abuse, sexual abuse, childhood adversity, cumulative exposure, dose-response relationship, emotional support, premenopausal women, reproductive health, Nurses' Health Study II
- MeSH terms
- Adolescent, Adult, Child Abuse, Female, Humans, Leiomyoma, Prospective Studies, Surveys and Questionnaires, Risk, Gonadal Steroid Hormones, Sex Offenses, Social Support, United States, Uterine Neoplasms, Cohort Studies, Health Behavior, Confidence Intervals, Proportional Hazards Models, Young Adult
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