Details:

Alternative Title:
Haemophilia
Personal Author:
Srivaths, L. V. ; Zhang, Q. C. ; Byams, V. R. ; Dietrich, J. E. ; James, A. H. ; ... More +
Srivaths, L. V. ; Zhang, Q. C. ; Byams, V. R. ; Dietrich, J. E. ; James, A. H. ; Kouides, P. A. ; Kulkarni, R. Less -
Description:
Introduction

Due to lack of patient/health care provider awareness causing delayed diagnosis, the bleeding phenotype and provider interventions in adolescents with heavy menstrual bleeding (HMB) and bleeding disorders (BD) may be different when compared to adults.

Aim

The aim of this study was to compare/characterize bleeding phenotype and provider interventions in postmenarchal adolescents < 18 years and premenopausal adults ≥ 18 years with HMB and BD.

Methods

Patient demographics, BD, and provider interventions/therapy details for HMB were compared between both age groups enrolled in the Centers for Disease Control and Prevention (CDC) Female Universal Data Collection (UDC) surveillance project in United States hemophilia treatment centres. Cross-sectional descriptive analyses including frequency distributions, summary statistics, bivariate and logistic regression analyses were performed.

Results

Of 269 females (79 adolescents; median age 16 years, interquartile range (IQR) = 2; 190 adults; median age 27 years, IQR = 13) evaluated, BD distribution was similar in both groups. Compared to adolescents, adults more often had family history of bleeding (Adjusted odds ratios [AOR] = 2.6, 1.3–5.6), delay in diagnosis (AOR = 2.5, 1.2–4.9), bleeding with dental procedures (AOR = 2.0, 1.0–4.0), gastrointestinal bleeding (AOR = 4.6, 1.0–21.9), anaemia (AOR = 2.7, 1.4–5.2), utilized desmopressin less often (AOR = 0.4, 0.2–0.8) and underwent gynaecologic procedure/surgery more frequently (AOR = 5.9, 1.3–27.3).

Conclusion

Bleeding phenotypes of adolescents and adults with HMB and BD were different with more frequent bleeding complications, anaemia, gynaecologic procedures/surgeries, less desmopressin use and more delay in diagnosing BD in adults. Longitudinal studies are needed to determine whether improved patient/provider awareness and education will translate to early diagnosis and timely management of BD/HMB in adolescents that may prevent/reduce future haematologic/gynaecologic complications.


Subjects:
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Adolescents Article Bleeding Disorder Bleeding Phenotype Females Heavy Menstrual Bleeding Provider Intervention
Source:
Haemophilia. 24(1):63-69.
Pubmed ID:
28873279
Pubmed Central ID:
PMC5937715
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:5b6fdcd61f492de560a0d08463f99acc44a7ee7b291f5fa09cc342dcc709e1bf
Download URL:
https://stacks.cdc.gov/view/cdc/53826/cdc_53826_DS1.pdf
File Type:

Supporting Files

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