Abstract
Study Objective
Medically complex adolescent girls have significantly increased risk of disease exacerbation
from pregnancy, and their use of teratogenic medications poses a risk to a developing
fetus. Pediatric subspecialists have an opportunity to screen for sexual activity
and refer to gynecology if indicated.
Methods
Subspecialist pediatricians (n = 39) completed a survey of their screening and referral practices. A retrospective
chart review of a proportion of visits by these providers in the previous 6 months
(n = 222) was conducted to compare documented sexual activity, contraception counseling,
and referral practices with self-report data.
Results
Less than half of providers reported routinely asking about sexual activity (46%),
whereas 69% reported routinely referring sexually active adolescents to gynecology.
Documentation indicated 11 instances of sexual activity screening (4.9%) and 7 referrals
(2.7%).
Conclusion
Despite frequent contact with the medical field and use of teratogenic medications,
medically complex adolescent girls are inconsistently screened for sexual activity
and are rarely referred to gynecology.
Key Words
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References
- Adverse pregnancy outcomes in adolescents and young women with systemic lupus erythematosus: a national estimate.Pediatr Rheumatol. 2018; 16: 1-6
- Pediatric subspecialists’ practices and attitudes regarding sexual and reproductive healthcare for adolescent and young adult women prescribed teratogenic medications.J Pediatr. 2021; 233: 227-232
- Communication about contraception with adolescent females with asthma in pediatric visits.J Pediatr Adolesc Gynecol. 2020; 33: 372-376
- Contraceptive provision to adolescent females prescribed teratogenic medications.Pediatrics. 2016; 137
SAS Institute Inc. SAS 9.4. Cary, NC, 2013
- Pediatricians’ attitudes and beliefs about long-acting reversible contraceptives influence counseling.J Pediatr Adolesc Gynecol. 2017; 30: 47-52
Article info
Publication history
Published online: August 17, 2022
Accepted:
August 11,
2022
Received in revised form:
August 6,
2022
Received:
May 13,
2022
Footnotes
The findings were presented at the North American Society for Pediatric and Adolescent Gynecology Virtual Annual Clinical and Research Meeting, March 18-20, 2021, in an oral presentation entitled, “A missed opportunity? Sexual activity screening and referral to gynecology services among adolescent women with chronic disease in the pediatric subspecialty setting.”
Identification
Copyright
© 2022 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
