The environmental risk factors related to uterine leiomyoma: An umbrella review

Abstract

Background: Uterine leiomyoma (UL) is the most common benign tumor of the reproductive period and become a major health problem. The present umbrella review assessed the environmental risk factors associated with UL based on meta-analyses studies.

Materials and methods: We searched three Major databases until February 2022. The meta-analyses that had focused on evaluating the environmental risk factors associated with the UL were included. The summary effect estimates, 95% CI, heterogeneity I², 95% prediction interval, small-study effects, excess significance biases, and sensitive analysis were applied. We used A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) for assessing the quality of the meta-analyses.

Result: The risk factor of chronic psychological stress (OR 1.24, 95% CI: 1.15, 1.34) and obesity (OR 1.19, 95% CI: 1.09, 1.29) was graded as suggestive evidence (class III). The current alcohol intake (OR 1.33, 95% CI: 1.01, 1.76) was graded as the risk factor with weak evidence (class IV). Current oral contraceptive (OCP) use (RR 0.43, 95% CI: 0.25, 0.73) (class IV), and former smokers (OR 0.93, 95% CI: 0.88, 0.99) (class IV) were as the protective factors.

Conclusion: The current alcohol intake, chronic psychological stress, and obesity were risk factors for the UL, but current OCP use and former smokers were the protective factors.

Keywords: Leiomyoma; Risk factor; Umbrella review; Uterine.