PREVALENCE AND RISK FACTORS OF UTERINE FIBROIDS IN WOMEN OF REPRODUCTIVE AGE: A FACILITY-BASED STUDY IN A MEGACITY.

Abstract

Introduction: Uterine fibroids (leiomyomas) are the most common benign tumors among women of reproductive age, significantly affecting reproductive function, quality of life, and work capacity. In Kazakhstan, there is a lack of systematic data on the population-level prevalence of uterine fibroids and associated risk factors. This study aimed to assess the prevalence of uterine fibroids among women in Almaty and to develop a predictive risk model.

Materials and methods: A prospective facility-based study was conducted involving 1,200 women aged 18-49 years who sought gynecological consultation. Diagnosis was established using transvaginal ultrasound and hormonal profile assessment. The questionnaire covered reproductive history, lifestyle, nutrition, and comorbid conditions. Binary logistic regression was employed to identify risk factors, and the predictive model was evaluated using the area under the ROC curve (AUC).

Results: The prevalence of uterine fibroids was 34.9% (crude prevalence), with clinically significant forms identified in 17.2% of cases. When recalculated using direct age standardization to the female population of Almaty, the overall prevalence was 11.3%, reflecting the influence of the sample's age composition. The incidence increased with age, peaking in the 45-49 age group (38.6%). The most common symptoms were menorrhagia (69.1%), pelvic pain (49.3%), and reproductive dysfunction (28%). Significant risk factors included advanced age, elevated BMI, high prolactin levels, and vitamin D deficiency. The predictive model demonstrated high accuracy (AUC=0.929), with sensitivity of 86.2% and specificity of 78.5%.

Conclusion: The prevalence of uterine fibroids in the urban population of Kazakhstan is comparable to international data. The developed model can be applied for individual risk stratification and for designing targeted screening programs. The identified associations underscore the importance of monitoring metabolic and hormonal factors in reproductive healthcare.