TY - JOUR
T1 - Beyond Routine Abortion Practice
T2 - Identifying Adolescents and Young Adults at Risk for Anemia
AU - Shim, Jessica Y.
AU - Madrigal, Jessica M.
AU - Aparicio, Juan
AU - Patel, Ashlesha
N1 - Funding Information:
Dr Patel reports grants from Bayer, personal fees from Merck, grants and personal fees from Actavis, outside the submitted work. The remaining authors indicate no conflicts of interest.
Publisher Copyright:
© 2018 North American Society for Pediatric and Adolescent Gynecology
PY - 2018/10
Y1 - 2018/10
N2 - Study Objective: To evaluate the prevalence of anemia among female adolescents and young adults seeking abortion care at a county hospital, and to determine its associated factors. Design: A cross-sectional retrospective study. Setting: John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois. Participants: Young women (N = 2916; ages 11-24 years) who underwent first trimester medical or surgical termination in 2016. Interventions and Main Outcome Measures: Hemoglobin concentration at time of presentation, age, gestational age, body mass index, race/ethnicity, education, sexually transmitted infection status, and insurance status. Results: On average, women were 21 (SD, 2.2) years old, 87% (2545 of 2916) African-American, and 64% (1863 of 2916) were Medicaid recipients. Gestational age at time of presentation ranged from 4 weeks 6 days to 13 weeks 6 days, and 58% (1695 of 2916) had surgical termination. Overall, 16% (451 of 2916) had hemoglobin concentrations of less than 11 g/dL. Categorization of severity showed that 4% (126 of 2916) of women had moderate and 11% (325 of 2916) had mild anemia. Only 2.6% of women (75 of 2916) had any history of anemia, and 91% (412 of 451) of anemic women did not have a preexisting anemia diagnosis. Fifteen percent of anemic women (51 of 451) had positive sexually transmitted infection screening, but positive status was not associated with anemia in crude or multivariable models (P =.4-.6). In a multivariable model, later gestational age, decreasing body mass index, and multiparity were significantly associated with anemia prevalence after adjustment. Conclusion: Our study showed an elevated prevalence of undiagnosed anemia. Ultimately, the abortion care setting can be an intersection for continued ambulatory care and provides an important opportunity to diagnose and educate young women on anemia management.
AB - Study Objective: To evaluate the prevalence of anemia among female adolescents and young adults seeking abortion care at a county hospital, and to determine its associated factors. Design: A cross-sectional retrospective study. Setting: John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois. Participants: Young women (N = 2916; ages 11-24 years) who underwent first trimester medical or surgical termination in 2016. Interventions and Main Outcome Measures: Hemoglobin concentration at time of presentation, age, gestational age, body mass index, race/ethnicity, education, sexually transmitted infection status, and insurance status. Results: On average, women were 21 (SD, 2.2) years old, 87% (2545 of 2916) African-American, and 64% (1863 of 2916) were Medicaid recipients. Gestational age at time of presentation ranged from 4 weeks 6 days to 13 weeks 6 days, and 58% (1695 of 2916) had surgical termination. Overall, 16% (451 of 2916) had hemoglobin concentrations of less than 11 g/dL. Categorization of severity showed that 4% (126 of 2916) of women had moderate and 11% (325 of 2916) had mild anemia. Only 2.6% of women (75 of 2916) had any history of anemia, and 91% (412 of 451) of anemic women did not have a preexisting anemia diagnosis. Fifteen percent of anemic women (51 of 451) had positive sexually transmitted infection screening, but positive status was not associated with anemia in crude or multivariable models (P =.4-.6). In a multivariable model, later gestational age, decreasing body mass index, and multiparity were significantly associated with anemia prevalence after adjustment. Conclusion: Our study showed an elevated prevalence of undiagnosed anemia. Ultimately, the abortion care setting can be an intersection for continued ambulatory care and provides an important opportunity to diagnose and educate young women on anemia management.
KW - Abortion care
KW - Adolescents
KW - Anemia
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U2 - 10.1016/j.jpag.2018.06.002
DO - 10.1016/j.jpag.2018.06.002
M3 - Article
C2 - 29929018
AN - SCOPUS:85050103827
SN - 1083-3188
VL - 31
SP - 468
EP - 472
JO - Journal of pediatric and adolescent gynecology
JF - Journal of pediatric and adolescent gynecology
IS - 5
ER -