Prevalence of Uterine Leiomyomas in the First Trimester of Pregnancy

Abstract

Objective To estimate the proportion of pregnant women with one or more leiomyoma detected by research quality ultrasound screening in the first trimester; to describe the size and location of leiomyomas identified; and to report variation in prevalence by race/ethnicity. Methods Within an ongoing prospective cohort we conducted 4,271 first trimester, or post-miscarriage, ultrasounds. Sonographers measured each leiomyoma three separate times, recording the maximum diameter in three perpendicular planes each time. Sonographers and investigators classified type and location. Results Among 458 women with one or more leiomyomas (prevalence 10.7%), we identified a total of 687 leiomyomas. The mean size of the largest leiomyoma was 2.3cm (95% CI 1.8 to 2.8). Mean gestational age at ultrasound was 61 ± 13 days from last menstrual period. Prevalence varied by race/ethnicity: 18% in blacks (95%CI: 13, 25); 8% in whites (95%CI: 7, 11); and 10% in Hispanics (95% CI: 5, 19). The proportion of women with leiomyomas increased with age much more steeply for blacks than whites. Conclusions Leiomyomas are common in pregnancy and occur more often among black women. Given the limited research on effects of leiomyomas on reproductive outcomes, the degree to which race/ethnic disparities in prevalence of leiomyomas may contribute to disparities in events like miscarriage and preterm birth warrants investigation.

Prevalence of fibroids: a study in a semiurban area in Telangana, India

“…However, the incidence ws observed to be lesser in Caucasian women, where the incidence was 40% by age 35, and almost 70% by age 50. 7 The data was similar in Italy, while the incidence was lower among the Swedish women. 8,9 Risk factors for developing fibroids, such as: age, early age at menarche, reduced fertility, frequent alcohol and caffeine consumption, obesity, consumption of red meat, hypertension, diabetes mellitus, previous pelvic inflammatory disease and genetics have been observed.…”

A Prospective, Ultrasound-Based Study to Evaluate Risk Factors for Uterine Fibroid Incidence and Growth: Methods and Results of Recruitment

“…Five studies have used ultrasound to screen for fibroids. 1,11,[16][17][18] These studies identify prevalent fibroids that have not yet been clinically recognized, but the actual time of disease onset for these undiagnosed fibroids is also unknown. No previous study used ultrasound to follow fibroid-free women prospectively to detect new fibroid development and monitor tumor growth.…”

“…9,10 Ultrasound studies indicate that tumor onset begins 10 or more years earlier for African American than for white women. 11,12 Despite the morbidity and health care costs associated with uterine fibroids, there have been very few studies to identify risk factors and possible strategies for prevention. The only well-replicated risk factors are increased age (up to age of menopause), African American ethnicity, earlier age of menarche, and nulliparity.…”

The impact of fibroid characteristics on pregnancy outcome

“…Depending upon the trimester of assessment and the size threshold, the prevalence of fibroids in pregnancy varies between 1.2 and 10.7% [4][5][6][7] . Visualisation of fibroids in pregnancy can be problematic partly because of the difficulty of ultrasonography in differentiating fibroids from physiological thickening of the myometrium 4,8 .…”