Milken Institute School of Public Health Poster Presentations (Marvin Center & Video)

Title

Phytoestrogen Exposure During Infancy and Risk of Uterine Fibroid Development

Poster Number

32

Document Type

Poster

Status

Graduate Student - Masters

Abstract Category

Environmental and Occupational Health

Keywords

uterine fibroids; phytoestrogens; early-life

Publication Date

4-2017

Abstract

Background: Uterine leiomyomata (fibroids) are common, benign, smooth muscle tumors that primarily develop among reproductive-aged women. Fibroids are often associated with pelvic pain, heavy menstrual bleeding, and reproductive complications, thus accounting for a significant amount of hysterectomies each year. Although the pathogenesis of uterine fibroids is not well known, early-life exposures to hormonally active compounds, such as phytoestrogens, may affect uterine receptors to estrogen or progesterone that lead to fibroids.

Objectives: Here we report the results of four epidemiological studies which examined the association between early-life exposure to phytoestrogens contained in soy-based formula and increased risk of uterine fibroid development among premenopausal women.

Data sources: A comprehensive literature search was conducted using five peer-reviewed scientific journals, including: PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus. All four studies were prospective cohort studies.

Study eligibility criteria: For inclusion in this systematic review, studies included premenopausal women, aged 23-59 years old, exposed to soy-based protein formula within 6 months of birth, and clinically diagnosed with uterine fibroids by hysterectomy or ultrasound. Seventy-five percent of the studies evaluated were among African American women in the United States.

Study appraisal and synthesis method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was used to evaluate the studies within this systematic review.

Results: Based on the data across the four studies, there appears to be a low risk of association between phytoestrogen exposure during early-life and the risk of uterine fibroid development. One study, however, did observe an association between fibroid size and early-life phytoestrogen exposure.

Limitations: Two primary limitations across the epidemiological studies in this review are recall bias and exposure misclassification. Early-life exposures are difficult to obtain in the study population due to participants’ inability to self-report childhood feeding data and reliance on parents or caregivers.

Conclusions: Overall, the studies included in this review had many strengths to decrease disease misclassification by excluding menopausal women and by validating primary outcome of uterine fibroids through physician or clinical diagnosis. More studies that prospectively capture infant feeding data are necessary to determine if phytoestrogens in soy infant formula increases the risk for uterine fibroid development in premenopausal women.

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

1

Comments

Poster to be presented at GW Annual Research Days 2017.

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Phytoestrogen Exposure During Infancy and Risk of Uterine Fibroid Development

Background: Uterine leiomyomata (fibroids) are common, benign, smooth muscle tumors that primarily develop among reproductive-aged women. Fibroids are often associated with pelvic pain, heavy menstrual bleeding, and reproductive complications, thus accounting for a significant amount of hysterectomies each year. Although the pathogenesis of uterine fibroids is not well known, early-life exposures to hormonally active compounds, such as phytoestrogens, may affect uterine receptors to estrogen or progesterone that lead to fibroids.

Objectives: Here we report the results of four epidemiological studies which examined the association between early-life exposure to phytoestrogens contained in soy-based formula and increased risk of uterine fibroid development among premenopausal women.

Data sources: A comprehensive literature search was conducted using five peer-reviewed scientific journals, including: PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus. All four studies were prospective cohort studies.

Study eligibility criteria: For inclusion in this systematic review, studies included premenopausal women, aged 23-59 years old, exposed to soy-based protein formula within 6 months of birth, and clinically diagnosed with uterine fibroids by hysterectomy or ultrasound. Seventy-five percent of the studies evaluated were among African American women in the United States.

Study appraisal and synthesis method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was used to evaluate the studies within this systematic review.

Results: Based on the data across the four studies, there appears to be a low risk of association between phytoestrogen exposure during early-life and the risk of uterine fibroid development. One study, however, did observe an association between fibroid size and early-life phytoestrogen exposure.

Limitations: Two primary limitations across the epidemiological studies in this review are recall bias and exposure misclassification. Early-life exposures are difficult to obtain in the study population due to participants’ inability to self-report childhood feeding data and reliance on parents or caregivers.

Conclusions: Overall, the studies included in this review had many strengths to decrease disease misclassification by excluding menopausal women and by validating primary outcome of uterine fibroids through physician or clinical diagnosis. More studies that prospectively capture infant feeding data are necessary to determine if phytoestrogens in soy infant formula increases the risk for uterine fibroid development in premenopausal women.