Consequences and Course of Uterine Fibroids in Pregnancy

妊娠期子宫肌瘤的后果和病程

基本信息

批准号：
7499559
负责人：
KATHERINE E HARTMANN
金额：
$ 60.13万
依托单位：
VANDERBILT UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2004
资助国家：
美国
起止时间：
2004-01-01 至 2009-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7499559
关键词：
Abruptio Placentae Address Admission activity Adverse effects Affect African American Age Birth Caring Characteristics Clinical Cohort Studies Communities Computer Assisted Contraceptive Agents Contraceptive History County Data Discipline of obstetrics Disinfection Documentation Enrollment Epidemiology Event Exposure to Fibroid Tumor Gestational Age Growth Health Hemorrhage High Prevalence Hispanics Hospitals Hypertension Infertility Interview Investigation Knowledge Laboratories Laboratory Research Lactation Link Literature Location Logistic Models Measures Medical Medical Records Methods Natural History North Carolina Outcome Participant Patient currently pregnant Patients Pattern Phase Physiology Placenta Planned Pregnancy Population Heterogeneity Postpartum Period Pregnancy Pregnancy Outcome Premature Birth Premature Labor Procedures Protocols documentation Public Health RQ2 Race Recruitment Activity Research Risk Spontaneous abortion Subjects Selections Survival Analysis System Techniques Telephone Interviews Test Result Training Ultrasonography Uterine Fibroids Visit Week Weight Weight Gain Woman abstracting base clinical epidemiology cohort data management drinking water experience follow-up glucose tolerance member prenatal preterm premature rupture of membranes prevent prospective reproductive size tertiary care tool

项目摘要

DESCRIPTION (provided by applicant): Tens of millions of reproductive age women in the U.S. have uterine leiomyomata, commonly called fibroids; yet, the influence of fibroids in pregnancy and vice versa is poorly understood. We propose to examine the association of fibroids with specific adverse pregnancy outcomes while investigating the natural history of fibroids during and after pregnancy. We will advance current knowledge by: recruiting an ethnically diverse population early in pregnancy; using a standardized research protocol to conduct ultrasound (US) for all participants to reduce fibroid misclassification; refining assessment of pregnancy events and outcomes; and investigating how size and location of fibroids affect risk. Based on procedures in place for "Right from the Start: A Study of Early Pregnancy Health", we propose to build a cohort of 3,300 women from 13 counties in North Carolina. We will include approximately 15% Hispanic, 35% African American, and 45% white women, obtaining an US in the 6-7th wk of gestation and a computer assisted telephone interview (CATI) before 10wks gestation. A second CATI, at 20-22 wks, and documentation of outcome, including medical record review, will be done for all medical participants. We will also randomly select a subcohort of 300 women from among those with fibroids and 100 from those without fibroids on 1st trimester US in return for US at 14-16 weeks, 26-28 wks, and 3 months post-pregnancy. In the subcohort, we will conduct a final CATI 3 months after pregnancy. By doing so, we will answer these primary research questions: 1. Are women with fibroids at higher risk of spontaneous abortion (SAB)? 2. Are women with fibroids at higher risk for a spontaneous preterm birth (PTB)? and these secondary questions: 3. Is fibroid size or submucosal location associated with increased risk of SAB or PTB? 4. Are fibroids beneath the placenta associated with increased risk of PTB? 5. Are fibroids likely to change size during and after pregnancy? Is growth pattern related to age, race, BMI, maternal weight gain, clinical glucose tolerance measures, hypertension, pregnancy outcome, lactation, or post-pregnancy contraceptive choice? If fibroids, or certain fibroids, have an adverse effect on pregnancy, the clinical and public health consequences would be substantial given the high prevalence of fibroids. By prospectively investigating fibroid characteristics and risk, this research has potential to inform care for many women with fibroids who are pregnant or planning pregnancy.

描述（由申请人提供）：在美国，数以百万计的生殖年龄女性具有子宫平滑肌瘤，通常称为肌瘤；然而，肌瘤在妊娠中的影响，反之亦然。我们建议检查肌瘤与特定不良妊娠结局的关联，同时研究妊娠期间肌瘤的自然历史。我们将通过以下方式提高当前知识：在怀孕初期招募种族多样化的人口；使用标准化的研究方案进行超声（US），以供所有参与者减少肌瘤错误分类；精炼对怀孕事件和结局的评估；并研究肌瘤的大小和位置如何影响风险。根据“从一开始：对早期妊娠健康的研究”的程序，我们建议建立来自北卡罗来纳州13个县的3300名妇女组成的队列。我们将在10WKS妊娠之前，将约15％的西班牙裔，35％的非裔美国人和45％的白人妇女在妊娠6-7周获得美国的美国妇女和计算机辅助电话采访（CATI）。第二次至22周的CATI将为所有医疗参与者完成结果的记录记录记录记录。我们还将在14-16周，26-28周和怀孕后3个月的我们回报我们的14-16周，从肌瘤中的患者中随机选择300名女性和100名女性和100名女性。在亚群中，我们将在怀孕3个月后进行最后的CATI。通过这样做，我们将回答以下主要研究问题：1。患有肌瘤风险较高（SAB）风险的妇女是吗？ 2。患有自发早产风险较高（PTB）风险较高的妇女吗？这些次要问题：3。肌瘤的大小或粘膜下位置是否与SAB或PTB风险增加有关？ 4。胎盘下方的肌瘤是否与PTB风险增加有关？ 5。肌瘤是否可能在怀孕期间和怀孕后改变大小？生长模式是否与年龄，种族，BMI，母体体重增加，临床葡萄糖耐量指标，高血压，妊娠结局，哺乳或怀孕后避孕药相关？如果肌瘤或某些肌瘤会对妊娠产生不利影响，那么鉴于肌瘤的高患病率很高，临床和公共卫生的后果将是很大的。通过前瞻性调查肌瘤特征和风险，这项研究有可能为许多怀孕或计划怀孕的肌瘤女性提供护理。

项目成果

期刊论文数量（19）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Association of uterine fibroids with birthweight and gestational age.

DOI：
10.1016/j.annepidem.2020.06.012
发表时间：
2020-10
期刊：
Annals of epidemiology
影响因子：
5.6
作者：
Zhao SK;Wu P;Jones SH;Torstenson ES;Hartmann KE;Velez Edwards DR
通讯作者：
Velez Edwards DR

Patterns and predictors of vaginal bleeding in the first trimester of pregnancy.

DOI：
10.1016/j.annepidem.2010.02.006
发表时间：
2010-07
期刊：
ANNALS OF EPIDEMIOLOGY
影响因子：
5.6
作者：
Hasan, Reem;Baird, Donna D.;Herring, Amy H.;Olshan, Andrew F.;Funk, Michele L. Jonsson;Hartmann, Katherine E.
通讯作者：
Hartmann, Katherine E.

Association between first-trimester vaginal bleeding and miscarriage.