EPIDEMIOLOGY OF HYSTERECTOMY IN THE UNITED-STATES - DEMOGRAPHIC AND REPRODUCTIVE FACTORS IN A NATIONALLY REPRESENTATIVE SAMPLE

We describe the epidemiology of hysterectomy, overall as well as for s pecific indications. Data were obtained from the Epidemiologic Follow- up to the First National Health and Nutrition Examination Survey, a na tionally representative cohort followed prospectively from the mid-197 0s through 1992. Black and white women 25-49 years of age, interviewed during follow-up, were included in the analyses. The probability of u ndergoing a hysterectomy was estimated by demographic and reproductive factors. Hysterectomy as confirmed by hospital records was our main o utcome measure. We found that women who had completed 9-11 years of ed ucation were more likely to have undergone a hysterectomy than were wo men with either more or less education. Women who had completed 9-11 y ears of education were also more likely to have had a hysterectomy bec ause of menstrual problems. Three or more miscarriages, especially if caused by uterine prolapse, increased the probability of hysterectomy. Having had no live births decreased the probability of hysterectomy f or menstrual disorders and uterine prolapse, but women who had their f irst child before age 20 were at increased risk of hysterectomy becaus e of endometriosis. Hysterectomy appears to be associated with low edu cation, high parity, and a history of multiple miscarriages. The influ ence of these factors varies depending on the primary indication for t he hysterectomy.