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- Title
Impact of von Willebrand Disease on Women's Health Outcomes: A Matched Cohort Database Study.
- Authors
Hagberg, Katrina Wilcox; Jick, Susan; Du, Ping; Truong Berthoz, Françoise; Özen, Gülden; Tzivelekis, Spiros
- Abstract
Objective: To understand the impact of von Willebrand disease (VWD) on women's health, a retrospective cohort study was conducted using UK Clinical Practice Research Datalink (CPRD) GOLD database and Hospital Episode Statistics (HES) Admitted Patient Care data from 1988 to 2016. Materials and Methods: Hysterectomy and heavy menstrual bleeding (HMB) events were identified by recorded disease/clinical codes and compared in women with and without VWD (matched 1:10 by birth and CPRD record start years [±2 years], and general practice attended). Incidence rates and incidence rate ratios (IRR) were calculated; risks were estimated using the Kaplan–Meier method. Results: HMB was recorded after cohort entry in 388 of 1,335 women (29.1%) with VWD and 1,524 of 12,463 women (12.2%) without VWD. The cumulative incidence of HMB was higher in women with versus without VWD across all ages (p < 0.0001), and irrespective of prior HMB status (p < 0.001). Women with VWD were more likely to have HMB compared with women without VWD; IRR adjusted for age and prior HMB status was 2.74 (95% confidence interval [CI]: 2.44–3.07). Hysterectomy was recorded in 88 of 1,374 women (6.4%) with VWD and 320 of 12,791 women (2.5%) without VWD. The cumulative incidence of hysterectomy was higher for women with versus without VWD (p < 0.0001), and highest among women aged ≥30 years at cohort entry. Women with VWD aged 30 − 39 years were more likely to undergo hysterectomy than women without VWD; IRR adjusted for prior HMB was 3.58 (95% CI: 2.36 − 5.44). Conclusions: These findings highlight the substantial impact of VWD on women's health.
- Subjects
MENSTRUATION disorders; HYSTERECTOMY; CONFIDENCE intervals; RETROSPECTIVE studies; RISK assessment; TRANEXAMIC acid; KAPLAN-Meier estimator; DESCRIPTIVE statistics; RESEARCH funding; VON Willebrand disease; WOMEN'S health; DISEASE complications
- Publication
Journal of Women's Health (15409996), 2022, Vol 31, Issue 9, p1262
- ISSN
1540-9996
- Publication type
Article
- DOI
10.1089/jwh.2022.0082