title: Self-Reported Reproductive Tract Infections and Ultrasound Diagnosed Uterine Fibroids in African-American Women.
abstract: BACKGROUND
  For decades, it has been hypothesized that reproductive tract infections (RTIs) are risk factors for uterine fibroids. However, only two recent studies have been conducted. We aimed to investigate the relationship between RTIs and fibroids in a large study using ultrasound screening for fibroids.
  
  
  METHODS
  We used cross-sectional enrollment data from African American women ages 23-34 years with no previous fibroid diagnosis. RTI history was measured by self-report and fibroid status by standardized ultrasound. Secondary fibroid outcomes were size, number, and total volume. Age- and multivariable-adjusted logistic regression were used to estimate odds ratios (ORs).
  
  
  RESULTS
  In total, 1,656 women were included; 22% had fibroids. Bacterial vaginosis (BV) was associated with a 21% increased odds of fibroids [aOR 1.21, 95% confidence interval (CI) 0.93-1.58]. Chlamydia infection and pelvic inflammatory disease were associated with a 38% (aOR 0.62, 95% CI 0.40-0.97) and a 46% (aOR 0.54, 95% CI 0.25-1.17) reduced odds of having two or more fibroids, respectively. Those with a previous BV diagnosis had a 47% increased odds of having 2 or more fibroids (aOR 1.47, 95% CI 0.98-2.21) and a 41% increased odds of having a larger total fibroid volume (aOR 1.41, 95% CI 0.98-2.04).
  
  
  CONCLUSIONS
  Our study was the first to explore the relationship between RTIs and fibroid size, number, and total volume. There appeared to be no strong associations between self-reported RTIs and fibroids. Studies using serology, a biochemical measure of past infection, are needed to better investigate associations between RTIs and fibroids.
authors.affiliation: 1 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.|2 Epidemiology Branch, National Institute of Environmental Health Sciences , National Institutes of Health, Research Triangle Park, North Carolina.
authors.forename: Kristen R
authors.initials: KR
authors.lastname: Moore
authors.affiliation: 1 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Cole
authors.affiliation: 3 Department of Microbiology and Immunology, Program in Global Oncology at the Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.
authors.forename: Dirk P
authors.initials: DP
authors.lastname: Dittmer
authors.affiliation: 1 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Schoenbach
authors.affiliation: 1 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Smith
authors.affiliation: 2 Epidemiology Branch, National Institute of Environmental Health Sciences , National Institutes of Health, Research Triangle Park, North Carolina.
authors.forename: Donna D
authors.initials: DD
authors.lastname: Baird
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000000981:diagnostic imaging* / Q000208:ethnology; D016015:Logistic Models; D016017:Odds Ratio; D060737:Reproductive Tract Infections / Q000208:ethnology*; D012307:Risk Factors; D057566:Self Report; D014463:Ultrasonography; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging* / Q000208:ethnology