Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland; Gynecologic Oncology Service, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and the Down Syndrome Clinic and Research Center, Kennedy Krieger Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.
Obstet Gynecol. 2020 Sep;136(3):518-523. doi: 10.1097/AOG.0000000000003997.
To estimate receipt of recommended gynecologic care, including cancer screening and menstrual care, among women with Down syndrome in the United States.
We conducted a retrospective cohort study of women participating in DS-Connect, the National Institute of Health's registry of women with Down syndrome. Using 2013-2019 survey data, we estimated the proportion of women receiving recommended age-appropriate well-woman care (Pap tests, mammogram, breast examination, pelvic examination) and compared receipt of gynecologic care to receipt of other preventive health care. We also estimated proportion receiving care for menstrual regulation.
Of 70 participants with Down syndrome, 23% (95% CI 13-33) of women received all recommended gynecologic components of a well-woman examination. Forty-four percent (95% CI 32-56) of women aged 18 years and older reported ever having a gynecologic examination, and 26% (95% CI 15-37) reported ever having a Pap test. Of women aged 40 years or older, 50% (95% CI 22-78) had had a mammogram. Fifty-two percent (95% CI 41-65) had tried medication for menstrual regulation, and 89% (95% CI 81-96) received all recommended components of nongynecologic routine health care.
Women with Down syndrome received gynecologic care, including cancer screening, at lower-than-recommended rates and at substantially lower rates than other forms of health care. Efforts to improve gynecologic care in this vulnerable population are needed.
评估美国唐氏综合征女性接受推荐的妇科保健服务（包括癌症筛查和月经保健）的情况。
我们对美国国立卫生研究院唐氏综合征女性注册机构 DS-Connect 的女性参与者进行了回顾性队列研究。利用 2013 年至 2019 年的调查数据，我们估计了接受推荐的适龄女性常规保健（巴氏涂片检查、乳房 X 光检查、乳房检查、盆腔检查）的女性比例，并比较了妇科保健服务的接受情况与其他预防保健服务的接受情况。我们还估计了接受月经调节保健的比例。
在 70 名唐氏综合征患者中，23%（95%可信区间 13-33）的女性接受了所有推荐的妇科常规检查项目。44%（95%可信区间 32-56）的 18 岁及以上女性报告曾进行过妇科检查，26%（95%可信区间 15-37）的女性报告曾进行过巴氏涂片检查。40 岁及以上的女性中，50%（95%可信区间 22-78）接受过乳房 X 光检查。52%（95%可信区间 41-65）曾尝试过调节月经的药物治疗，89%（95%可信区间 81-96）接受了所有推荐的非妇科常规保健服务。
唐氏综合征女性接受妇科保健服务（包括癌症筛查）的比例低于推荐水平，且明显低于其他形式的保健服务。需要努力改善这一弱势群体的妇科保健服务。
