SUBMUCOSAL UTERINE FIBROIDS ARE ASSOCIATED WITH ANEMIA IN BLACK WOMEN

Document Type

Conference Proceeding

Publication Date

12-1-2025

Publication Title

Fertil Steril

Keywords

hemoglobin, adult, African American, anemia, cell counter, cohort analysis, conference abstract, cross-sectional study, diagnosis, female, fibroma, follow up, human, incidence, leiomyoma, major clinical study, risk factor, submucosa, therapy, transvaginal echography, uterus myoma

Abstract

OBJECTIVE: Understand the association between uterine fibroid type and hemoglobin (Hb) levels. MATERIALS AND METHODS: The Study of Environment, Lifestyle and Fibroids (SELF) is a cohort of women with intact uteri aged 23-35 years at entry who self-identified as Black/African American and did not have a known fibroid diagnosis at enrollment (2010-2012). SELF participants have had 4 follow-up visits with transvaginal ultrasounds to examine risk factors for fibroid incidence and growth. We performed a cross-sectional analysis of data from n=1266 participants attending the 4th follow-up (F4) ultrasound (2018-2023) to examine the association between fibroids and hemoglobin (Hb) concentrations. Hb (grams/dL) was measured in whole blood using an automated cell counter in the Henry Ford Health clinical laboratory; low Hb was defined as <11 grams/dL (moderate to severe anemia). We classified each participant into one of four mutually exclusive fibroid status groups: no fibroids, only non-submucosal fibroids, both non-submucosal and submucosal fibroids, and only submucosal fibroids. RESULTS: Participants were aged 29-45 years (mean (SD) = 37 (3.4)) and n=773 (61%) had no fibroids detected, n=404 (32%) had non-submucosal fibroids only, n=60 (4.7%) had both non-submucosal and submucosal fibroids, and n=29 (2.3%) had only submucosal fibroids. Hb values ranged from 6.3 to 17 grams/dL (mean (SD) = 12.3 (1.4)); with little difference in the median concentrations (12.2-12.6 g/dL) by fibroid presence or location. (Table 1) Overall, 13% had low Hb concentrations with a range from 11%, among those with no fibroids to 27% among those with both submucosal and non-submucosal fibroids. Results were unchanged after adjusting for age, BMI and pregnancy in the last 12 months. CONCLUSIONS: SELF participants with, versus without, submucosal fibroids tended to have lower Hb. These findings suggest that approximately 1 in 4 women with submucosal fibroids has anemia and highlights the importance of ultrasounds and labs in the evaluation of all fibroid patients. IMPACT STATEMENT: Compared with having no fibroids, having fibroids anywhere in the uterus is associated with somewhat higher rates of anemia. Submucosal fibroids, however, which were present in ∼18% of participants with fibroids, are associated with lower Hb levels and a higher risk of having Hb<11 g/dL. SUPPORT: R01ES028235 P50HD115356

Volume

124

Issue

6

First Page

e293

Last Page

e294

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