Physical Activity Moderately Ups Bleed Risk in Hemophilia

Absolute increase in risk of bleeds associated with vigorous physical activity is small, transient

TUESDAY, Oct. 9 (HealthDay News) -- There is a moderate but significant transient increased risk in bleeding following vigorous physical activity in children and adolescent boys with hemophilia, according to a study published in the Oct. 10 issue of the Journal of the American Medical Association.

Carolyn R. Broderick, M.B.B.S., from the University of Sydney in Australia, and colleagues conducted a case-crossover study involving 104 children and adolescent boys aged 4 through 18 years with moderate or severe hemophilia A or B participating in a multicenter prospective cohort. Patients were monitored for one year and, following each bleed, the child or parent was interviewed to ascertain physical activity exposure.

The researchers found that, over the follow-up period, 436 bleeds occurred. The bleeds used in the primary risk analysis were 336 bleeds that occurred more than two weeks after the preceding bleed. Category 2 activities (such as basketball) were associated with a significant transient increase in the risk of bleeding (odds ratio, 2.7) compared to inactivity or category 1 activities (such as swimming). There was a greater significant transient increase in risk (odds ratio, 3.7) associated with category 3 activities (such as wresting). For a child who participates in an average of category 2 activities twice weekly and category 3 activities once weekly and who bleeds five times per year, these activities were associated with only one of the annual bleeds. Bleeding incidence was significantly lower (2 percent; P = 0.004) for every 1 percent increase in clotting factor level.

"In children and adolescents with hemophilia, vigorous physical activity was transiently associated with a moderate relative increase in risk of bleeding," the authors write.

Several authors disclosed financial ties to the pharmaceutical and health care industries.

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