The risk of incident fibroids is greater among patients with a maternal history of fibroids, according to a recent study published in JAMA Network Open.
Takeaways
- Uterine fibroids affect over 70% of reproductive-aged women, with Black women experiencing onset approximately 10 years earlier than White women, highlighting a significant health disparity.
- A maternal history of uterine fibroids is associated with an increased risk of fibroid development among Black women, as indicated by a recent study published in JAMA Network Open.
- The study, conducted using prospective ultrasonographic examinations, included Black women aged 23 to 35 years, providing valuable insights into the association between family history and fibroid development.
- Participants with a maternal history of fibroids exhibited a 26% increased risk of incident fibroids, emphasizing the importance of considering family medical history in patient care and advocacy efforts.
- These findings underscore the need for health care professionals to inquire about family history of fibroids, empowering patients with knowledge to advocate for their own health and inform personalized care strategies.
Over 70% of reproductive-aged women are impacted by uterine fibroids, which may lead to substantial morbidity and hysterectomy. In the United States, uterine fibroid onset occurs approximately 10 years earlier in Black women than White women. This population is also disproportionately impacted by uterine fibroids.
Experts have hypothesized a history of uterine fibroids in a first-degree relative is associated with an increased risk of uterine fibroid incidence. While data has indicated an impact of genetic factors on uterine fibroid risk, it can be difficult to separate shared social and environment factors from genetic factors.
Investigators conducted a study to evaluate the association between family history of uterine fibroids and fibroid development among Black women using prospective ultrasonographic examinations. Data was obtained from a prospective study of uterine fibroid incidence and growth among postmenopausal women.
Participants included Black women aged 23 to 35 years at baseline ultrasonography recruited between January 1, 2010, and December 31, 2012. Selected women received follow-up ultrasonographic examinations for uterine fibroid incidence approximately every 20 months for 5 years, concluding by December 31, 2018.
Maternal fibroid history was determined using 2 questionnaires. Participants were asked if their biological mother had been diagnosed with uterine fibroids, with responses including yes, no, and don’t know. The questionnaire was provided through an interview with the participant’s mother if they were available.
Exposure variables included maternal fibroid history and early-life questionnaires and age at maternal fibroid diagnosis. Fibroid detection was performed through a transvaginal ultrasonography conducted by experienced sonographers. Covariates included age at menarche, maternal or primary caregiver education level, maternal age at enrollment, and time-varying factors.
There were 1610 participants included in the analysis, aged a mean 29.2 years. Maternal fibroid history was reported in 37% of the incidence sample. Of these patients, 24% were diagnosed when aged 20 to 29 years. In comparison, 44% of the growth sample reported maternal fibroid history, with 27% of these mothers diagnosed when aged 20 to 29 years.
Increased educational attainment was observed among mothers and participants with a uterine fibroid diagnosis vs those without a diagnosis. Maternal fibroids were also associated with higher annual household income and decreased odds of smoking.
Of fibroid-free participants at enrollment, 24% developed fibroids during follow-up. The adjusted hazard ratio (AHR) for incident fibroid risk among patients with a maternal history of fibroids was 1.26, indicating increased risk.
The AHR was not impacted by additional maternal factors but was adjusted to 1.21 when accounting for participant factors. An increased risk was observed among participants with mothers diagnosed at an early age, with an AHR of 1.63 for 20 to 29 years vs 1.07 for 30 to 39 years and 1.15 for 40 or more years.
These results indicated an increased risk of incident fibroids among patients with a maternal fibroid history. Investigators recommended asking patients about their family history of fibroids to encourage patient self-advocacy and inform care.
Reference
Langton CR, Harmon QE, Baird DD. Family history and uterine fibroid development in Black and African American women. JAMA Netw Open. 2024;7(4):e244185. doi:10.1001/jamanetworkopen.2024.4185
