EBT Annotated Bibliography
Cooke, A. G., Mccavit, T. L., Buchanan, G. R., & Powers, J. M. (2017). Iron Deficiency Anemia
in Adolescents Who Present with Heavy Menstrual Bleeding. Journal of Pediatric and
Adolescent Gynecology, 30(2), 247-250. doi:10.1016/j.jpag.2016.10.010
The purpose of this study was to assess the clinical severity and treatment of iron deficiency anemia in female adolescents with heavy menstrual bleeding at the Children’s Medical Center in Dallas, Texas. This was a reflective cohort study of electronic medical records that looked at 107 female adolescent patients with heavy menstrual bleeding and iron deficiency anemia. The average age of the participants was 14.4 years old. Treatment options for iron deficiency anemia for these patients are blood transfusions, oral iron therapy, intravenous iron therapy. Abnormal uterine bleeding was treated with combined oral contraceptives. The study found that the most common treatment was blood transfusions. Furthermore, the study recommends that early prevention and diagnosis should be highly encouraged to improve management of adolescents who have heavy menstrual bleeding and iron deficiency anemia. This resource is relevant because it explores how individuals with heavy menstruation and iron deficiency anemia are treated, which brings to light the importance of early detection and prevention.
Gunasekaran, D., Venkatesh, C., Soundararajan, P., & Swapna, K. (2012). Iron stores and
menstruation in healthy adolescent girls – pilot study. Department of Pediatrics Mahatma
Gandhi Medical College and Research Institute, 16(2), 153-155. doi:ISSN 0971-9032
The purpose of this study was to compare iron stores in healthy adolescent girls who are menstruating with healthy adolescent girls who have not started menstruating. This was a pilot study, a small-scale preliminary analysis of two groups of adolescent females. The study design was observational. The study participants consisted of 18 healthy adolescent females that ranged from ages 10-12; 9 of those females attained menarche and 9 did not. Data was collected by measuring hemoglobin, serum Iron and Ferritin levels in both groups and were compared. Serum ferritin levels in girls who had attained menarche compared to girls who have not attained menarche were significantly higher. In regards to the hemoglobin and serum iron levels, there was no significant difference between the two groups. The study recommended that serum ferritin should not be the only data analyzed when trying to figure out if an individual has depleted iron stores. Other biomarkers should be taken into consideration. This is a relevant study because it recommends medical professionals to be more vigilant when diagnosing iron deficiency in adolescent females.
Lang, A. T., Johnson, S., Sturm, M., & O’Brien, S. H. (2014). Iron Deficiency without Anemia: A
Common Yet Under-Recognized Diagnosis in Young Women with Heavy Menstrual
Bleeding. Blood, 124(21), 3510. Accessed December 07, 2018. Retrieved from http://
www.bloodjournal.org/content/124/21/3510.
The purpose of this study was to determine the percentage of iron deficiency in a population of young adolescents with heavy menstrual bleeding, that would have been missed by screening with hemoglobin or CBC testing, as compared to screening ferritin levels. This was a reflective cohort study of medical records for 114 adolescent females ages 9-19 years at Nationwide Children’s Hospital in Columbus, Ohio. The study concluded that testing for hemoglobin or CBC on its own may miss over half of patients with iron deficiency. The researchers recommend to test for serum ferritin in addition to hemoglobin as a screening tool for iron deficiency in adolescent females with heavy menstrual bleeding. This study is relevant because it informs and makes medical professionals more aware to be more vigilant when screening adolescent females who could be iron deficient.
Moschonis, G., Papandreou, D., Mavrogianni, C., Giannopoulou, A., Damianidi, L., Malindretos,
P., . . . Manios, Y. (2013). Association of Iron Depletion with Menstruation and Dietary
Intake Indices in Pubertal Girls: The Healthy Growth Study. BioMed Research
International, 2013, 1-8. doi:10.1155/2013/423263
The purpose of this study was to explore the association between iron depletion with menstruation and the effect that diet has on it in pubertal females. This study was a large cross-sectional epidemiological study, which had a sample size of 1222 girls from ages of 9-13. Data were collected to assess the biochemical, anthropometrical, dietary, and physical activity of the participants. Iron depletion was measured through biochemical blood tests and was determined depleted, by having serum ferritin levels less than 12 micrograms per liter. A food frequency questionnaire was used to determine the participant’s food consumption habits. Physical activity was assessed by waist-mounted pedometers that were worn by the participants for seven consecutive weekdays, from Monday to Sunday. The study concluded that iron depletion was much higher for girls with menses compared to those without menses. This source is relevant because it confirms the fact that adolescent females who have attained menarche have more depleted iron stores than those who have not attained menarche.
Stapleton, F. Bruder, MD. “Menorrhagia Associated with Anemia Is Underrecognized in
Adolescents.” NEJM Journal Watch. March 28, 2012. Accessed December 08, 2018.
https://www.jwatch.org/pa201203280000002/2012/03/28/menorrhagia-associated-with-
anemia.
F. Bruder Stapleton, MD, a Professor of Pediatrics at the University of Washington reviewed a study that explored underdiagnosed menorrhagia in adolescents and its association with underdiagnosed anemia. The study surveyed 705 high-school girls in Israel that attended a lecture on menstruation. This study concluded that a significant amount of girls with menorrhagia had a history of anemia than those without menorrhagia. Professor Stapleton recommends that medical professionals should be more attentive and careful when questioning adolescents about menstruation. In addition, he acknowledges the fact that menorrhagia is very common in adolescents but not recognized or diagnosed as often. This source is relevant to my topic because it confirms that menstruation is associated with iron deficiency or anemia in adolescents.