{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T12:49:43Z","timestamp":1786625383236,"version":"build-2736575974"},"reference-count":45,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,5,21]],"date-time":"2021-05-21T00:00:00Z","timestamp":1621555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011541","name":"Division of Cancer Epidemiology and Genetics, National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011541","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Reproductive health may be adversely impacted in women with dyskeratosis congenita (DC) and related telomere biology disorders (TBD). We evaluated gynaecological problems, fertility, and pregnancy outcomes in 39 females aged 10\u201381\u00a0years who were followed longitudinally in our DC\/TBD cohort. Twenty\u2010six had bone marrow failure and 12 underwent haematopoietic cell transplantation. All attained menarche at a normal age. Thirteen women reported menorrhagia; ten used hormonal contraception to reduce bleeding. Nine experienced natural normal\u2010aged menopause. Gynaecological problems (endometriosis\u00a0=\u00a03, pelvic varicosities\u00a0=\u00a01, cervical intraepithelial neoplasia\u00a0=\u00a01, and uterine prolapse\u00a0=\u00a02) resulted in surgical menopause in seven. Twenty\u2010five of 26 women attempting fertility carried 80 pregnancies with 49 (61%) resulting in livebirths. Ten (38%) women experienced 28 (35%) miscarriages, notably recurrent pregnancy loss in five (19%). Preeclampsia (<jats:italic>n<\/jats:italic>\u00a0=\u00a06, 24%) and progressive cytopenias (<jats:italic>n<\/jats:italic>\u00a0=\u00a010, 40%) resulted in maternal\u2010fetal compromise, including preterm (<jats:italic>n<\/jats:italic>\u00a0=\u00a05) and caesarean deliveries (<jats:italic>n<\/jats:italic>\u00a0=\u00a018, 37%). Gynaecological\/reproductive problems were noted mainly in women with autosomal\u2010dominant inheritance; others were still young or died early. Although women with TBDs had normal menarche, fertility, and menopause, gynaecological problems and pregnancy complications leading to caesarean section, preterm delivery, or transfusion support were frequent. Women with TBDs will benefit from multidisciplinary, coordinated care by haematology, gynaecology and maternal\u2010fetal medicine.<\/jats:p>","DOI":"10.1111\/bjh.17545","type":"journal-article","created":{"date-parts":[[2021,5,21]],"date-time":"2021-05-21T16:44:27Z","timestamp":1621615467000},"page":"1238-1246","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Gynaecological and reproductive health of women with telomere biology disorders"],"prefix":"10.1111","volume":"193","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7353-1863","authenticated-orcid":false,"given":"Neelam","family":"Giri","sequence":"first","affiliation":[{"name":"Clinical Genetics Branch Division of Cancer Epidemiology and Genetics National Cancer Institute Rockville MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8458-7774","authenticated-orcid":false,"given":"Blanche 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