Cited by 64Uterine Myomas and TreatmentsChild Abuse and TraumaIntimate Partner and Family Violence

Abuse in Childhood and Risk of Uterine Leiomyoma: The Role of Emotional Support in Biologic Resilience

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Boynton-Jarrett, Renée, Rich-Edwards, Janet W., Jun, Hee-Jin, Hibert, Eileen N., Wright, Rosalind J.·2011·Epidemiology

Abstract

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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  1. [31]Marshall LMSD Barbieri R Goldman M Manson J Colditz G Willett W Hunter D Variation in the indidence of uterine leiomyoma among premenopausal women by age and race Obstet Gynecol 1997 90 967 973 9397113
  2. [33]Straus M Hamby SL Boney-McCoy S Sugarman DB The revised conflict tactics scales (CTS2) Journal of Family Issues 1995 17 3 283 316

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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)
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
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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