Duane Williams, MD
Assistant Professor of Pediatrics
Penn State Health Children's Hospital, United States
Disclosure information not submitted.
GARY CENEVIVA, MD
Pediatric Critical Care Medicine
Penn State Children's Hospital, United States
Disclosure information not submitted.
Neal Thomas, MD, FCCM
Professor of Pediatrics
Penn State Children's Hospital, United States
Disclosure information not submitted.
Vonn Walter, PhD
Assistant Professor
Penn State College of Medicine, United States
Disclosure information not submitted.
Conrad Krawiec, MD
Penn State Milton S. Hershey Medical Center
Hershey, Pennsylvania
Disclosure information not submitted.
Title: Frequency and Results of Pregnancy Screening in Adolescents in Multiple Healthcare Organizations
Introduction: Adolescent females may undergo pregnancy screening while receiving critical care services, but the frequency and utility is unknown. The objectives of this study are to evaluate patient characteristics, pregnancy screening frequency, and rate of incidental pregnancies in adolescent females of child-bearing age who require critical care services. We hypothesize that adolescent pregnancy screening is performed frequently in the critical care setting and that there are low rates of incidental pregnancies.
Methods: This is a retrospective observational cohort study utilizing TriNetX ®, an electronic health record (EHR) database. The following EHR data were collected and evaluated in adolescent females aged 12 to 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 5241 subjects [2242 (42.8%) pregnancy screen present; 2999 (57.2%) not present] were included in this study. Subjects aged 15 to 18 years [Odds Ratio (OR) = 1.56, 95% confidence interval (95% CI) = 1.38-1.77, p-value < 0.0001] and Hispanic or Latino ethnicity [OR=1.46, 95% CI=1.28-1.66, p-value < 0.0001] had a higher association with pregnancy screening. A positive pregnancy screen was identified in 18 (0.8%) subjects.
Conclusions: 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 increased risk of complications associated with incidental pregnancies and potential for screening bias, clinicians should consider routine pregnancy screening for all females of childbearing age.