Department of Pediatrics, Emory University, Atlanta, Georgia, USA.
Morehouse School of Medicine, Atlanta, Georgia, USA.
Pediatr Blood Cancer. 2024 Jan;71(1):e30727. doi: 10.1002/pbc.30727. Epub 2023 Oct 16.
Sickle cell disease (SCD) is associated with hypercoagulability, but adults with SCD also have an increased incidence of bleeding including heavy menstrual bleeding (HMB). HMB is common among adolescent females, but the impact of HMB in pediatric SCD is unclear. The objectives of this study were to examine menstrual health status, knowledge, and quality of life (QOL).
We performed a single-institutional multi-clinic cross-sectional study comprised of a five-part survey in pediatric participants with SCD. The survey included the validated Menstrual Bleeding Questionnaire (MBQ) and Self-administered Bleeding Assessment Tool (Self-BAT).
Forty-eight participants with a median age of 16 years (range: 12-21 years) completed the study. The mean age at onset of menarche was 13 ± 1.3 years. On the MBQ, 29% reported heavy/very heavy menstrual flow, 61% reported moderate or severe dysmenorrhea, and 96% had menses lasting less than 1 week. The Self-BAT revealed that 42% of participants reported a history of HMB. Participants with severe dysmenorrhea or HMB had higher MBQ scores, corresponding to worse QOL. Despite this, less than 20% of participants had attempted any hormonal therapy for menstrual regulation. The odds of hormonal therapy utilization were comparable among participants on hydroxyurea versus not on hydroxyurea (odds ratio 1.58, 95% confidence interval [CI]: 0.33-7.56).
The prevalence of HMB and dysmenorrhea is high among adolescents and young women with SCD. Strategies that incorporate menstrual health assessment into routine medical care in this population would help address this important area of pediatric health.
镰状细胞病（SCD）与高凝状态有关，但 SCD 成人也有更高的出血发生率，包括月经过多（HMB）。HMB 在青少年女性中很常见，但 HMB 在儿科 SCD 中的影响尚不清楚。本研究的目的是检查月经健康状况、知识和生活质量（QOL）。
我们进行了一项单机构多诊所的横断面研究，包括儿科 SCD 患者的五部分调查。该调查包括经过验证的月经出血问卷（MBQ）和自我管理出血评估工具（Self-BAT）。
48 名参与者的中位年龄为 16 岁（范围：12-21 岁），完成了这项研究。月经初潮的平均年龄为 13 ± 1.3 岁。在 MBQ 上，29%的人报告月经量多/非常多，61%的人报告中度或重度痛经，96%的人经期持续不到 1 周。Self-BAT 显示，42%的参与者报告有 HMB 病史。有严重痛经或 HMB 的参与者的 MBQ 评分较高，对应的生活质量更差。尽管如此，不到 20%的参与者曾尝试过任何激素治疗来调节月经。接受羟基脲治疗的参与者与未接受羟基脲治疗的参与者（比值比 1.58，95%置信区间[CI]：0.33-7.56）相比，使用激素治疗的可能性相当。
在患有 SCD 的青少年和年轻女性中，HMB 和痛经的患病率很高。在该人群中，将月经健康评估纳入常规医疗的策略将有助于解决儿科健康的这一重要领域。
