title: Early-life exposures and early-onset uterine leiomyomata in black women in the Sister Study.
abstract: BACKGROUND
  Uterine leiomyomata (fibroids) are hormonally responsive tumors, but little is known about risk factors. Early-life exposures may influence uterine development and subsequent response to hormones in adulthood. An earlier analysis of non-Hispanic white women who participated in the Sister Study found associations between several early-life factors and early-onset fibroids.
  
  
  OBJECTIVE
  We evaluated associations of early-life and childhood exposures with early-onset fibroids among black women and compared the results with those found among white women.
  
  
  METHODS
  We analyzed baseline data from 3,534 black women, 35-59 years of age, in the Sister Study (a nationwide cohort of women who had a sister diagnosed with breast cancer) who self-reported information on early-life and childhood exposures. Early-onset fibroids were assessed based on self-report of a physician diagnosis of fibroids by the age of 30 years (n = 561). We estimated risk ratios (RR) and 95% confidence intervals (CI) from log-binomial regression models.
  
  
  RESULTS
  Factors most strongly associated with early-onset fibroids were in utero diethylstilbestrol (DES; RR = 2.02; 95% CI: 1.28, 3.18), maternal prepregnancy diabetes or gestational diabetes (RR = 1.54; 95% CI: 0.95, 2.49), and monozygotic multiple birth (RR = 1.94; 95% CI: 1.26, 2.99). We also found positive associations with having been taller or thinner than peers at the age of 10 years and with early-life factors that included being the firstborn child of a teenage mother, maternal hypertensive disorder, preterm birth, and having been fed soy formula.
  
  
  CONCLUSIONS
  With the exception of monozygotic multiple birth and maternal hypertensive disorder, early-life risk factors for early-onset fibroids for black women were similar to those found for white women. However, in contrast to whites, childhood height and weight, but not low socioeconomic status indicators, were associated with early-onset fibroids in blacks. The general consistency of early-life findings for black and white women supports a possible role of early-life factors in fibroid development.
authors: Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina 27709, USA. daloisio@niehs.nih.gov
authors: Aimee A
authors: AA
authors: D'Aloisio
authors: Donna D
authors: DD
authors: Baird
authors: Lisa A
authors: LA
authors: DeRoo
authors: Dale P
authors: DP
authors: Sandler
mesh_terms: D000328:Adult; D001741:Black or African American; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology*; D018811:Maternal Exposure; D008875:Middle Aged; D016017:Odds Ratio; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology / Q000208:ethnology*; D011446:Prospective Studies; D011647:Puerto Rico / Q000453:epidemiology; D012307:Risk Factors; D035781:Siblings; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology*