Abstract
Objectives
People from marginalized and vulnerable populations present more frequently for unscheduled,
emergency obstetrical services at labour and delivery triage units. Based on our clinical
experience, pregnant adolescents visit the obstetrical triage assessment units (OTAU)
more often than adults do. This study was designed to assess this phenomenon by quantifying
and describing the frequency of unscheduled visits to the OTAU by pregnant adolescents
(age <20 y) compared with a matched cohort of adult pregnant patients (age ≥20 y).
Methods
A retrospective database review was performed for data on all adolescent patients
that delivered at our institution at ≥20 weeks gestation between January 1, 2013,
and December 31, 2017. Adolescent pregnant patients were matched in a 1:1 ratio with
adult pregnant patients. Demographic and clinical characteristics as well as the number
of visits to the OTAU were recorded.
Results
A total of 162 adolescent pregnant patients visited the OTAU during the study period.
The mean number of visits to the OTAU by adolescents was 2.77 ± 2.40 compared with
1.96 ± 1.80 visits in the adult cohort (P = 0.0001). Adolescents were 63% more likely than adults to access triage services
(incidence rate ratio [IRR] 1.63; 95% CI 1.09–2.44, P = 0.017). Diagnosis of a mental health condition was the only identified risk factor
for accessing OTAU, irrespective of age (IRR 1.64; 95% CI 1.05, 2.55, P = 0.029).
Conclusions
Adolescent pregnant patients tend to visit the OTAU on an unscheduled basis more often
than do adult patients. The presence of a mental health condition was identified as
an important predictor of unscheduled visits to OTAUs for adolescent patients.
Résumé
Objectifs
Les personnes issues de populations marginalisées et vulnérables sont plus susceptibles
de se présenter au triage de l’unité des naissances pour des services obstétricaux
d’urgence et non planifiés. D’après notre expérience clinique, les adolescentes enceintes
sont plus susceptibles que les adultes de consulter pour une évaluation au triage
obstétrical. Cette étude visait à analyser ce phénomène en quantifiant et en décrivant
la fréquence des consultations non planifiées des adolescentes enceintes (< 20 ans)
au triage, comparativement à une cohorte appariée de patientes enceintes adultes (≥
20 ans).
Méthodologie
Une analyse rétrospective de la base de données a été effectuée pour les données de
toutes les patientes adolescentes ayant accouché dans notre établissement à partir
de 20 semaines d’aménorrhée entre le 1er janvier 2013 et le 31 décembre 2017. Les adolescentes enceintes ont été appariées
selon un rapport de 1:1 avec les adultes enceintes. Les caractéristiques démographiques
et cliniques ainsi que le nombre de consultations au triage obstétrical ont été consignées.
Résultats
Au total, 162 adolescentes enceintes se sont présentées au triage obstétrical pendant
la période à l’étude. Le nombre moyen de consultations au triage obstétrical par les
adolescentes était de 2,77 ± 2,40 comparativement à 1,96 ± 1,80 dans la cohorte adulte
(p = 0,0001). Les adolescentes étaient 63 % plus susceptibles que les adultes d’accéder
aux services de triage (rapport de taux d’incidence [RTI] : 1,63; IC à 95 % : 1,09–2,44;
p = 0,017). Le diagnostic de trouble de santé mentale était le seul facteur de risque
relevé pour l’accès au triage obstétrical, peu importe l’âge (RTI : 1,64; IC à 95
% : 1,05–2,55; p = 0,029).
Conclusions
Les adolescentes enceintes sont généralement plus susceptibles que les patientes adultes
de se rendre au triage obstétrical pour une consultation non planifiée. La présence
d’un trouble de santé mentale a été désignée comme un important facteur prédictif
des consultations non planifiées par les adolescentes au triage obstétrical.
Keywords
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Article info
Publication history
Published online: June 22, 2022
Accepted:
June 3,
2022
Received:
March 16,
2022
Footnotes
Disclosures: The authors declare they have nothing to disclose.
All authors have indicated they meet the journal’s requirements for authorship.
Identification
Copyright
© 2020 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
