Modifiable prognostic factors in uterine fibroid development: a systematic review of literature

Abstract

Background

Many risk factors in uterine fibroid development have been identified, but women and their physicians are less aware of the influence of lifestyle on uterine fibroid development. The objective of this systematic review is to investigate and summarize modifiable prognostic factors associated with uterine fibroid development.

Methods

Pubmed and Embase were searched for relevant articles according to PRISMA guidelines. References from included articles were screened and when relevant also included. Human in vivo studies on modifiable factors in fibroid development were included. Studies on non-modifiable factors and treatment, in vitro studies and animal studies were excluded. 607 articles were screened and 33 articles were included. Two independent investigators collected data from the report.

Results

The strongest risk factor for fibroid development was a high BMI, while the strongest protective factors were a high fruit and vegetable intake and high vitamin D intake.

Conclusion

More high-quality studies are necessary to better understand the impact of the abovementioned factors as well as the role they play in the growth of already existing fibroids.

PLAIN LANGUAGE SUMMARY

Uterine fibroid development is multifactorial. Various non-modifiable and modifiable factors have been linked to uterine fibroid development. Modifiable factors are controllable by patients themselves. We performed a systematic review to investigate these modifiable factors. We screened 607 articles from 2 databases (PubMed and Embase) of which 33 were included in the review. We only included clinical studies on humans. A high body mass index (BMI) is found to be a modifiable risk factor for uterine fibroid development. Protective of uterine fibroid development are high fruit and vegetable intake and high vitamin D intake or sun exposure. More research is needed to investigate the applicability of these findings in clinical practice and to investigate the influence on the growth of already existing uterine fibroids.

Keywords:

• Uterine fibroid
• modifiable
• prognostic factor
• risk factor

Acknowledgements

None.

Authors’ contribution

A.L. Keizer contributed to conception and design, acquisition, analysis and interpretation of data, drafting the work, approving the final version and accepting accountability for all aspects of the work.

A. Semmler contributed to conception and design, acquisition, analysis and interpretation of data, drafting the work, approving the final version and accepting accountability for all aspects of the work.

H.S. Kok contributed to drafting and revising the work, approving the final version and accepting accountability for all aspects of the work.

P.J.M. van Kesteren contributed to drafting and revising the work, approving the final version and accepting accountability for all aspects of the work.

J.A.F. Huirne contributed to conception and design, drafting and revising the work, approving the final version and accepting accountability for all aspects of the work.

W.J.K. Hehenkamp contributed to conception and design, drafting and revising the work, approving the final version and accepting accountability for all aspects of the work.

Data availability statement

Data availability is not applicable to this article as no new data were created or analysed in this study.

Additional information

Funding

The authors have no relevant financial or non-financial interests to disclose.