Journal: Journal of Women’s Health
Authors: Katrina Wilcox Hagberg, Susan Jick, Ping Du, Françoise Truong Berthoz, Gülden Özen, Spiros Tzivelekis
NLM Citation: Hagberg KW, Jick S, Du P, Truong Berthoz F, Özen G, Tzivelekis S. Impact of von Willebrand Disease on Women’s Health Outcomes: A Matched Cohort Database Study. J Womens Health (Larchmt). 2022 Sep;31(9):1262-1270. doi: 10.1089/jwh.2022.0082. Epub 2022 Aug 12. PMID: 35960825; PMCID: PMC9527044.
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.
Keywords: heavy menstrual bleeding; hysterectomy; von Willebrand disease; women’s health.
