The association between chronic psychological stress and uterine fibroids risk: A meta-analysis of observational studies.

The association between chronic psychological stress and uterine fibroids (UFs) risk remains unclear. In this study, a meta-analysis of observational studies was performed to explore the reported association between them. A literature search was performed in PubMed, EMBASE and Web of Science to identify relevant published articles. A random-effect model was used to examine pooled odds ratio (OR) and 95% confidence interval (CI). Additionally, subgroup analyses and two-stage random-effect dose-response meta-analysis were performed. A total of 6 articles with 7 studies were included in this meta-analysis. For the highest vs. lowest category of chronic psychological stress, the pooled OR was 1.24 (95% CI, 1.15-1.34; P=0.000). Through subgroup analyses, we found a positive association between chronic psychological stress and UFs risk especially in non-Hispanic blacks studies (OR, 1.24, 95% CI 1.14-1.34, P=0.000). When evaluating for a dose-response we found a weak correlation between chronic psychological stress and UFs risk, especially for the severe (OR, 1.17, 95% CI 1.07-1.29) and very severe (OR, 1.23, 95% CI 1.07-1.41) categories. Our meta-analysis shows a statistically significant association between chronic psychological stress and UFs risk particularly for non-Hispanic blacks. Interventions aiming to reduce chronic psychological stress may be useful to decrease the prevalence of UFs.