McCormick Meghan, Hu Jianzhong, Chandler Martin, Manuel Matthew, Chrisentery-Singleton Tammuella, Ragni Margaret V
University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Hemophilia Center of Western Pennsylvania, Pittsburgh, Pennsylvania, USA.
Haemophilia. 2025 May;31(3):502-508. doi: 10.1111/hae.70004. Epub 2025 Mar 18.
Iron deficiency (ID) impairs cognitive and physical function. Females with bleeding disorders (FBD) are at risk of ID as a result of bleeding symptoms.
This study aimed to report the overall incidence and prevalence of ID in FBD, identify factors associated with ID and describe the screening practices for and management of ID within haemophilia treatment centres (HTC).
Electronic surveys were distributed to medical providers caring for FBD within HTCs participating in the American Thrombosis Haemostasis (ATHN) affiliate network to gather data on practices for screening of ID and the use of iron supplementation. We next used the ATHNdataset to identify females 13-40 years of age receiving care at an ATHN-affiliated HTC between 2015 and 2019. Prevalence and incidence of ID were estimated based on the presence of one of the following lab results: transferrin >360 mg/dL, total iron binding capacity (TIBC) >460mcg/dL, % saturation <20% or ferritin <50 ng/mL, and clinical and demographic characteristics associated with ID were identified using logistic regression.
Although all providers reported screening for ID, only 70% did so as part of their routine practice and significant variation existed in the form of iron supplementation used. Only 3.6% of participants in the ATHNdataset were tested for ID, and 71.9% of tested participants were ID. Black or African American race, platelet disorder and heavy menstrual bleeding were associated with increased risk of ID.
ID is highly prevalent among FBD and is underrecognised and undertreated. Practitioners should standardise practices to identify and manage ID.
缺铁（ID）会损害认知和身体功能。患有出血性疾病的女性（FBD）因出血症状而有缺铁风险。
本研究旨在报告FBD中铁缺乏症的总体发病率和患病率，确定与缺铁相关的因素，并描述血友病治疗中心（HTC）内缺铁的筛查方法及管理情况。
向参与美国血栓形成止血（ATHN）附属网络的HTC中负责治疗FBD的医疗服务提供者进行电子调查，以收集缺铁筛查方法和铁补充剂使用情况的数据。接下来，我们使用ATHN数据集来识别2015年至2019年期间在ATHN附属HTC接受治疗的13至40岁女性。根据以下实验室检查结果之一估计缺铁的患病率和发病率：转铁蛋白>360mg/dL、总铁结合力（TIBC）>460mcg/dL、饱和度百分比<20%或铁蛋白<50ng/mL，并使用逻辑回归确定与缺铁相关的临床和人口统计学特征。
尽管所有医疗服务提供者都报告对缺铁进行了筛查，但只有70%将其作为常规操作的一部分，且所使用的铁补充剂形式存在显著差异。ATHN数据集中只有3.6%的参与者进行了缺铁检测，71.9%的检测参与者缺铁。黑人或非裔美国人种族、血小板疾病和月经过多与缺铁风险增加有关。
缺铁在FBD中非常普遍，但未得到充分认识和治疗。从业者应规范识别和管理缺铁的操作。
