Abstract
Objective: To systematically review disparities in surgical outcomes for uterine fibroids among Black women compared to non-Black women and identify contributing factors.
Data sources: Systematic searches of PubMed, Embase, and Scopus from January 2010 to May 2024 were conducted.
Study eligibility criteria: Included studies focused on surgical interventions for uterine fibroids in diverse populations, evaluating outcomes such as efficacy, safety, and complications. Excluded studies lacked racial stratification or reported non-surgical treatments.
Study appraisal and synthesis methods: Study quality was assessed using the Methodological Index for Nonrandomized Studies (MINORS). Data synthesis adhered to PRISMA guidelines.
Results: Of 1,063 studies screened, 14 met inclusion criteria. Black women faced higher rates of open hysterectomy (OR 1.65; 95% CI, 1.02–2.68), longer hospital stays (+0.6 days, p<0.001), and greater perioperative complications (OR 1.54; 95% CI, 1.31–1.80) compared to White women. Disparities persisted across socioeconomic strata.
Conclusions: Systemic inequities underlie significant disparities in surgical outcomes for uterine fibroids among Black women. Expanding access to minimally invasive techniques and addressing socioeconomic barriers are critical to reducing these disparities.
Keywords
Uterine fibroids, Racial disparities, Surgical outcomes, Black women, Hysterectomy, Myomectomy