Screening Yield of Inherited Bleeding Disorder Questionnaires in Women With Chronic Heavy Menstrual Bleeding (HMB): A Cross-Sectional Study

慢性月经过多女性遗传性出血性疾病问卷筛查的阳性率:一项横断面研究

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Abstract

Background Chronic disease, heavy menstrual bleeding (HMB), is among the common conditions that may negatively impact the overall health and quality of life of women. HMB is commonly associated with inherited bleeding disorders (IBDs); nonetheless, it remains underdiagnosed in Pakistan. Early detection may result in a more successful curative regimen and the prevention of unnecessary interventions, made possible by screening. This research aimed to investigate the diagnostic yield of an IBD questionnaire screening in women with persistent HMB. Methods The research study used a cross-sectional design at the Outpatient Gynecology Department of Shifa International Hospitals Limited, Islamabad, Pakistan, between October 2024 and June 2025. Convenience sampling was used to recruit 350 women with self-reported chronic HMB, confirmed by structured history, who were included. A structured questionnaire containing demographic information, as well as sections from the International Society on Thrombosis and Haemostasis Bleeding Assessment Tool (ISTH-BAT) and the Menstrual Bleeding Questionnaire (MBQ), was used to collect the data. Descriptive statistics, correlation, independent t-tests, ANOVA, chi-square tests, and multiple regression analyses were performed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, NY, USA). Results Of the total, 229 (65%) of the participants had a history of a diagnosis of an IBD, and 208 (59%) had a family history of a bleeding disorder. Women with a family history and women with IBDs had significantly higher mean ISTH-BAT and MBQ scores (p < 0.001). There were positive associations between ISTH-BAT scores and MBQ (r = 0.312, p < 0.001), indicating that higher ISTH-BAT scores were associated with a greater perception of menstrual burden. Among the IBDs, von Willebrand disease had the highest scores. Regression analysis showed that ISTH-BAT scores (B = 0.165, 95% CI: 0.076-0.254, p < 0.001), age (B = 0.328, 95% CI: 0.052-0.604, p = 0.020), family history (B = 0.842, 95% CI: 0.272-1.412, p = 0.004), previous diagnosis (B = 0.612, 95% CI: 0.109-1.115, p = 0.017), and the presence of bleeding symptoms (B = 0.533, 95% CI: 0.130-0.936, p = 0.010) were significant predictors of MBQ scores (R² = 0.362). Conclusions Screening via questionnaire was effective in detecting women at risk of IBDs among those with chronic HMB. Standardized bleeding assessment in gynecological practice may enable many women to be diagnosed earlier, undergo effective treatment, and avoid anemia and unnecessary surgical procedures.

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