Purpose

Adolescent females may undergo pregnancy screening while receiving critical care services, but the frequency and results are unknown. The objectives of this study are to evaluate patient characteristics, pregnancy screening frequency, and rate of positive pregnancy screens in adolescent females of childbearing age who require critical care services. We hypothesize that when adolescent pregnancy screening is performed in the critical care setting, it occurs in a higher frequency in older subjects.

Methods

This is a multicenter retrospective observational cohort study utilizing TriNetX, an electronic health record database. The following electronic health record data were collected and evaluated in adolescent females aged 12–18 years and billed for critical care services: age, race, ethnicity, diagnostic codes, selected radiology and surgical procedure codes, number of deaths, pregnancy screening laboratory codes, and pregnancy screening results.

Results

A total of 5,241 subjects (2,242 [42.8%] subjects for whom pregnancy screen was noted and 2,999 [57.2%] subjects for whom it was not noted) were included in this study. Subjects aged 15–18 years (odds ratio = 1.56, 95% confidence interval = 1.38–1.77, p value < .0001) and had Hispanic or Latina ethnicity (odds ratio = 1.46, 95% confidence interval = 1.28–1.66, p value < .0001) had a higher association with pregnancy screening. A positive pregnancy screen was identified in 18 (0.8%) subjects.

Discussion

In our study, positive pregnancy screens were infrequent, not all subjects were screened, and there was an association between pregnancy screening and ethnicity. Because of the potential for screening bias, this study suggests that clinicians should strongly consider routine pregnancy screening for all females of childbearing age and that hospital policies should require this type of screening.

中文翻译：

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多个医疗机构中危重青少年妊娠筛查的频率和结果

目的

青春期女性在接受重症监护服务时可能会接受妊娠筛查，但频率和结果尚不清楚。本研究的目的是评估需要重症监护服务的育龄青春期女性的患者特征、妊娠筛查频率和妊娠筛查阳性率。我们假设，当在重症监护环境中进行青少年妊娠筛查时，其在老年受试者中的发生频率更高。

方法

这是一项利用电子健康记录数据库 TriNetX 进行的多中心回顾性观察性队列研究。在 12-18 岁的青少年女性中收集和评估以下电子健康记录数据并为重症监护服务收费：年龄、种族、民族、诊断代码、选定的放射学和外科手术代码、死亡人数、妊娠筛查实验室代码、和妊娠筛查结果。

结果

本研究共纳入 5,241 名受试者（2,242 名 [42.8%] 受试者注意到妊娠筛查，2,999 名 [57.2%] 受试者未注意到妊娠筛查）。15-18 岁的受试者（优势比 = 1.56，95% 置信区间 = 1.38-1.77，p值 < .0001）并且具有西班牙裔或拉丁裔种族（优势比 = 1.46，95% 置信区间 = 1.28-1.66，p值< .0001) 与妊娠筛查的相关性更高。在 18 名（0.8%）受试者中确定了阳性妊娠筛查。

讨论

在我们的研究中，阳性妊娠筛查并不常见，并非所有受试者都进行了筛查，并且妊娠筛查与种族之间存在关联。由于存在筛查偏倚的可能性，本研究建议临床医生应强烈考虑对所有育龄女性进行常规妊娠筛查，并且医院政策应要求进行此类筛查。