87. Modified Working Ability, Location, Intensity, Days of Pain Dysmenorrhea (WaLIDD) Score and Quality of Life Impact in Early Adolescents

Background Dysmenorrhea has consequences for adolescents including school absenteeism. Clinical usefulness of scales to measure dysmenorrhea, such as the Verbal Rating Score, is uncertain. In adults, the Working ability, Location, Intensity, Days of pain, Dysmenorrhea (WaLIDD) score was found to have adequate internal consistency and be predictive of medical leave among university students. The aim of this study was to examine the association of a modified WaLIDD scale and its subcomponents with quality of life (QoL) measures in early adolescents. Methods A prospective, observational IRB approved study utilizing a multi-platform mobile application allowing real-time assessment of menses was conducted. English speaking, post-menarcheal, biological female adolescents, age 10-14 years, who had regular access to a smart device were enrolled from primary and specialty clinics. Participants could document the following during each menses: 1) modified WaLIDD score excluding working ability (score 0-9), 2) QoL effects in 6 domains (family, friends, health, extracurriculars, school, job) from which a total QoL impact rating was calculated per cycle, and 3) pattern and flow of menses using the Pictorial Blood Loss Assessment Chart (PBAC). General linear mixed models with a binomial link (with and without adjustment for PBAC score) were used to estimate the association of total modified WaLIDD score and its subcomponents with any QoL impact. Results 126 participants were included in analyses with a median age of 13.0 years. Among all participants, 506 menstrual cycles were documented with a median number of four cycles per participant. Median (IQR) modified WaLIDD score per menstrual cycle was 5.0 (0.0 – 6.0). Of 506 cycles, 232 (46%) reported at least one QoL impact. Median (IQR) total QoL impact rating per cycle was 0 (0-3) with a range of 0-16. Higher WaLIDD scores were associated with greater QoL impact (OR 1.64, 95% CI 1.43-1.88), i.e. with each one-point increase in the total modified WaLIDD score, the odds of having a QoL impact was 1.64. Each WaLIDD subcomponent score showed a similar association with QoL. Adjustment for PBAC score had no significant impact on calculated ORs and CIs. Duration of menses was also not associated with QoL. Conclusions Among early adolescents, a modified WaLIDD score appears to have clinical utility with higher scores associated with greater odds of QoL impact during menses. In contrast, quantity and duration of menstrual flow were not associated with QoL. Findings support the use of a modified WaLIDD in the clinical care of early adolescents.