Department of Child Health, University of Ghana Medical School, Accra, Ghana.
Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana.
J Womens Health (Larchmt). 2023 Dec;32(12):1284-1291. doi: 10.1089/jwh.2023.0023. Epub 2023 Nov 23.
Pain crises in sickle cell disease (SCD) lead to high rates of health care utilization. Historically, women have reported higher pain burdens than men, with recent studies showing a temporal association between pain crisis and menstruation. However, health care utilization patterns of SCD women with menstruation-associated pain crises have not been reported. We studied the frequency, severity, and health care utilization of menstruation-associated pain crises in SCD women. A multinational, cross-sectional cohort study of the SCD phenotype was executed using a validated questionnaire and medical chart review from the Consortium for the Advancement of Sickle Cell Research (CASiRe) cohort. Total number of pain crises, emergency room/day hospital visits, and hospitalizations were collected from a subcohort of 178 SCD women within the past 6 months and previous year. Thirty-nine percent of women reported menstruation-associated pain crises in their lifetime. These women were significantly more likely to be hospitalized compared with those who did not (mean 1.70 vs. 0.67, = 0.0005). Women reporting menstruation-associated pain crises in the past 6 months also experienced increased hospitalizations compared with those who did not (mean 1.71 vs. 0.75, = 0.0016). Forty percent of women reported at least four menstruation-associated pain crises in the past 6 months. Nearly 40% of SCD women have menstruation-associated pain crises. Menstruation-associated pain crises are associated with high pain burden and increased rates of hospitalization. Strategies are needed to address health care disparities within gynecologic care in SCD.
镰状细胞病（SCD）的疼痛危象导致高利用率的医疗保健。历史上，女性报告的疼痛负担高于男性，最近的研究表明疼痛危象与月经之间存在时间关联。然而，与月经相关的疼痛危象的 SCD 女性的医疗保健利用模式尚未报道。我们研究了与月经相关的疼痛危象在 SCD 女性中的频率、严重程度和医疗保健利用情况。
一项使用经过验证的问卷和来自镰状细胞研究推进联盟（CASiRe）队列的医疗记录回顾的多国、横断面队列研究，对 SCD 表型进行了研究。从过去 6 个月和前一年的 178 名 SCD 女性的子队列中收集了与月经相关的疼痛危象的总疼痛危象次数、急诊室/日间医院就诊次数和住院次数。
39%的女性报告在其一生中经历过与月经相关的疼痛危象。与未经历过的女性相比，这些女性更有可能住院（平均 1.70 比 0.67，=0.0005）。在过去 6 个月报告与月经相关的疼痛危象的女性与未经历过的女性相比，住院率也有所增加（平均 1.71 比 0.75，=0.0016）。40%的女性报告在过去 6 个月至少经历了四次与月经相关的疼痛危象。
近 40%的 SCD 女性有与月经相关的疼痛危象。与月经相关的疼痛危象与高疼痛负担和住院率增加有关。需要制定策略来解决 SCD 中妇科护理中的医疗保健差异。
