{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T19:36:21Z","timestamp":1785267381707,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Early identification of female haemophilia carriers (HC) before menarche is important to prevent potential heavy menstrual bleeding, provide preconception and prenatal care, render effective delivery and postpartum management and provide proper care towards haemostatic challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Evaluate HC women's bleeding phenotype and assess health\u2010related quality of life (HRQOL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Cross\u2010sectional, non\u2010interventional, single centre study evaluating the bleeding tendency and quality of life of female adult haemophilia A or B carriers, compared with a healthy adult female control group. We used the International Society on Thrombosis and Haemostasis\u2010Bleeding Assessment Tool (ISTH\u2010BAT), to evaluate bleeding phenotype, and the Portuguese version of the Short Form\u201036 (SF\u201036) questionnaire, to assess HRQOL. Clotting factor activity (%) and the\n                      <jats:italic>F8<\/jats:italic>\n                      or\n                      <jats:italic>F9<\/jats:italic>\n                      gene variant of HC were determined.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median ISTH\u2010BAT score was higher in carriers compared to noncarriers (2, [IQR 0\u20136] vs. 0, [IQR 0\u20131],\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). HC had significantly lower median scores in physical (84.8% vs. 90.7%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.01) and mental (70.2%\u00a0vs. 82.1%,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) SF\u201036 components than controls. The subgroup of HC with increased bleeding tendency (ISTH\u2010BAT score \u2265 6) presented significantly lower clotting factor levels and lower scores in all SF\u201036 domains than the other HC. HC\n                      <jats:italic>F8<\/jats:italic>\n                      and\n                      <jats:italic>F9<\/jats:italic>\n                      pathogenic variants showed no significant influence on bleeding phenotype, factor levels or HRQOL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our HC cohort presented worse HRQOL when compared to the general female age\u2010matched population without a direct correlation with FVIII\/FIX levels. Carriers with the severe bleeding phenotype tend to have significantly lower clotting factor levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.70082","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T03:54:43Z","timestamp":1751946883000},"page":"1008-1014","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["ImpaHCta\u2014Haemophilia Carriers Quality of Life Assessment"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7010-0651","authenticated-orcid":false,"given":"Diana","family":"Carneiro\u2010Le\u00e3o","sequence":"first","affiliation":[{"name":"Immunohemotherapy Department, Reference Centre for Congenital Coagulation Disorders S\u00e3o Jo\u00e3o Health Local Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8785-6319","authenticated-orcid":false,"given":"Rita","family":"Queir\u00f3s\u2010Pereira","sequence":"additional","affiliation":[{"name":"Immunohemotherapy Department, Reference Centre for Congenital Coagulation Disorders S\u00e3o Jo\u00e3o Health Local Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Immunohemotherapy Department, Reference Centre for Congenital Coagulation Disorders S\u00e3o Jo\u00e3o Health Local Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5005-5400","authenticated-orcid":false,"given":"L\u00eddia","family":"Costa","sequence":"additional","affiliation":[{"name":"Immunohemotherapy Department, Reference Centre for Congenital Coagulation Disorders S\u00e3o Jo\u00e3o Health Local Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8109-2098","authenticated-orcid":false,"given":"Teresa","family":"Mota","sequence":"additional","affiliation":[{"name":"Immunohemotherapy Department, Reference Centre for Congenital Coagulation Disorders S\u00e3o Jo\u00e3o Health Local Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6394-952X","authenticated-orcid":false,"given":"In\u00eas","family":"Moreira","sequence":"additional","affiliation":[{"name":"Immunohemotherapy Department, Reference Centre for Congenital Coagulation Disorders S\u00e3o Jo\u00e3o Health Local Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Immunohemotherapy Department, Reference Centre for Congenital Coagulation Disorders S\u00e3o Jo\u00e3o Health Local Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0973-6677","authenticated-orcid":false,"given":"Susana","family":"Nobre\u2010Fernandes","sequence":"additional","affiliation":[{"name":"Immunohemotherapy Department, Reference Centre for Congenital Coagulation Disorders S\u00e3o Jo\u00e3o Health Local Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0387-9783","authenticated-orcid":false,"given":"Manuela","family":"Lopes","sequence":"additional","affiliation":[{"name":"Immunohemotherapy Department, Reference Centre for Congenital Coagulation Disorders S\u00e3o Jo\u00e3o Health Local Unit  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6471-5564","authenticated-orcid":false,"given":"Fernando","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Immunohemotherapy Department, Reference 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Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/M19-1208"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2008.01721.x"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14094"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.12580"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-09-3879"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12364"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2009.02108.x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/hematology.2020000140"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15397"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-012373960-5.00336-1"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12690"},{"issue":"3","key":"e_1_2_11_13_1","first-page":"119","article-title":"View 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