Frequency and Results of Pregnancy Screening in Critically Ill Adolescents in Multiple Health Care Organizations

• Published in: Journal of adolescent health 2022-11, Vol.71 (5), p.552-558
• Main Authors: Roberts, Catherine M., Williams, Duane, Ceneviva, Gary D., Walter, Vonn, Thomas, Neal J., Krawiec, Conrad
• Format: Article
• Language: English
• Subjects: Adolescent females; Critical care; Pregnancy
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/j.jadohealth.2022.05.008

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. 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. 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. 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.