Srivaths LV, et al. - This study entailed a comparison/characterization of the bleeding phenotype and provider interventions in postmenarchal adolescents < 18 years and premenopausal adults ≥ 18 years with heavy menstrual bleeding (HMB) and bleeding disorders (BD). The bleeding phenotypes of adolescents and adults of the study cohort varied with more frequent bleeding complications, anaemia, gynaecologic procedures/surgeries, less desmopressin use and more delay in diagnosing BD in adults. In order to ascertain if improved patient/provider awareness and education translated to early diagnosis and timely management of BD/HMB in adolescents possibly preventing/reducing future haematologic/gynaecologic complications, longitudinal studies were warranted.

Methods

• A comparison was performed of the patient demographics, BD, and provider interventions/therapy details for HMB 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 were carried out, with the inclusion of frequency distributions, summary statistics, bivariate and logistic regression analyses.

Results

• Among the 269 females (79 adolescents; median age 16 years, interquartile range (IQR) = 2; 190 adults; median age 27 years, IQR = 13) evaluated, similar BD distribution was noted in both groups.
• In contrast to the adolescents, adults frequently reported 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).