TY - JOUR
T1 - The Relationship between Total Fibroid Burden and First Trimester Bleeding and Pain
AU - Michels, Kara A.
AU - Hartmann, Katherine E.
AU - Archer, Kristin R.
AU - Ye, Fei
AU - Velez Edwards, Digna R.
N1 - Funding Information:
None of the authors has any relevant financial, personal, political, intellectual, or religious interests to disclose. This research was supported by grants from the Eunice Kennedy Shriver National Institute of Child and Human Development (R01HD043883 and R01HD049675) and the American Water Works Association Research Foundation (2579). Additional funds were provided by the Building Interdisciplinary Research Careers in Women''s Health career development program (K12HD043483-12), NIH grant 1R01HD074711 and NIH grant 1R03HD078567. This research was supported in part by an a TL1 training grant (5TL1RR024978) through the Vanderbilt CTSA grant ULTR000445 from NCATS/NIH and in part by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (co-author KAM).
Publisher Copyright:
© 2015 John Wiley & Sons Ltd.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Background Few studies comment on the association between fibroids and symptoms among pregnant women. These studies generally are retrospective and do not to assess the influence of number of tumours or their volume on risk of symptoms. Methods Right from the Start is a prospective cohort that enrolled pregnant women from the southeastern USA between 2000 and 2012. In the first trimester, all participants had standardised ultrasounds to determine the presence or absence of fibroids. Symptoms were queried in a telephone survey. We used polytomous logistic regression to model odds of bleeding, pain, or both symptoms in relation to increasing total fibroid number and volume among white and black women. Results Among 4509 participants, the prevalence of fibroids was 11%. Among those reporting symptoms (70%), 11% reported only bleeding, 59% reported only pain, and 30% reported both symptoms. After adjusting for age, race, parity, hypertension, smoking, alcohol use, and study site, increasing number of fibroids was associated with pain [odds ratio (OR) 1.16, 95% confidence interval (CI) 1.00, 1.33] and both symptoms [OR 1.25, 95% CI 1.08, 1.45] but not with bleeding among all women. Fibroid volume was not associated with symptoms among black women, but white women with the smallest fibroid volumes were more likely to report both symptoms than those without fibroids [OR 1.79, 95% CI 1.17, 2.72]. Conclusions Very large tumours are not requisite for experiencing symptoms, as small fibroids and increasing number of tumours are associated with pain and both symptoms.
AB - Background Few studies comment on the association between fibroids and symptoms among pregnant women. These studies generally are retrospective and do not to assess the influence of number of tumours or their volume on risk of symptoms. Methods Right from the Start is a prospective cohort that enrolled pregnant women from the southeastern USA between 2000 and 2012. In the first trimester, all participants had standardised ultrasounds to determine the presence or absence of fibroids. Symptoms were queried in a telephone survey. We used polytomous logistic regression to model odds of bleeding, pain, or both symptoms in relation to increasing total fibroid number and volume among white and black women. Results Among 4509 participants, the prevalence of fibroids was 11%. Among those reporting symptoms (70%), 11% reported only bleeding, 59% reported only pain, and 30% reported both symptoms. After adjusting for age, race, parity, hypertension, smoking, alcohol use, and study site, increasing number of fibroids was associated with pain [odds ratio (OR) 1.16, 95% confidence interval (CI) 1.00, 1.33] and both symptoms [OR 1.25, 95% CI 1.08, 1.45] but not with bleeding among all women. Fibroid volume was not associated with symptoms among black women, but white women with the smallest fibroid volumes were more likely to report both symptoms than those without fibroids [OR 1.79, 95% CI 1.17, 2.72]. Conclusions Very large tumours are not requisite for experiencing symptoms, as small fibroids and increasing number of tumours are associated with pain and both symptoms.
KW - leiomyoma
KW - pain
KW - pregnancy
KW - prospective studies
KW - uterine haemorrhage
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U2 - 10.1111/ppe.12256
DO - 10.1111/ppe.12256
M3 - Article
C2 - 26525634
AN - SCOPUS:84960344054
VL - 30
SP - 115
EP - 123
JO - Paediatric and Perinatal Epidemiology
JF - Paediatric and Perinatal Epidemiology
SN - 0269-5022
IS - 2
ER -