Forman S F, Aruda M M, Emans S J, Woods E R
Division of Adolescent/Young Adult Medicine, Children's Hospital, Boston, MA 02115, USA.
J Adolesc Health. 1995 Sep;17(3):193-7. doi: 10.1016/1054-139X(95)00004-C.
Our study investigates the factors associated with length of time to referral appointments for pregnant teens diagnosed in a hospital-based adolescent clinic.
Ninety-six pregnancies diagnosed during a six-month period at a hospital-based adolescent clinic were followed prospectively. Demographic data, plans for pregnancy, last menstrual period (LMP), and who accompanied patient to the appointment were recorded by providers. Appointment at referral site was confirmed by the patients' primary provider, contact with the patient, and/or referral site. The time from first positive pregnancy test to kept referral appointment was determined.
Of the 96 diagnosed pregnancies, data were available for 94 patients. The mean age was 17.6 +/- 2.0 years. The average gestation was 7.4 +/- 4.2 weeks (range 4-27 weeks) at initial visit and 11.7 +/- 4.9 weeks (5-30 weeks) at referral site. The time to referral appointment was significantly shorter for patients who planned to terminate compared with those who planned to continue with the pregnancy (22.4 +/- 16.6 vs. 35.7 +/- 24.5 days, P = 0.0042). However, the final decision to continue vs. terminate the pregnancy was a stronger predictor of the interval to kept referral appointment (R2 = 0.177) than the initial plan. Those who planned to tell more people about their pregnancy had a significantly higher rate of continuing the pregnancy than those terminating.
Pregnant teens may need multiple follow-up appointments to facilitate connection to referral care. Close follow-up and communication with referral sites needed to optimize care of pregnant teens because of the delay until teens access pregnancy services.
我们的研究调查了在一家医院青少年诊所确诊的怀孕青少年转诊预约时间长短的相关因素。
对一家医院青少年诊所在六个月期间确诊的96例妊娠进行前瞻性随访。医护人员记录了人口统计学数据、妊娠计划、末次月经日期（LMP）以及陪同患者就诊的人员。患者的初级医护人员、与患者的联系以及/或者转诊机构确认了在转诊机构的预约。确定了从首次妊娠试验呈阳性到成功转诊预约的时间。
在96例确诊妊娠中，有94例患者的数据可用。平均年龄为17.6±2.0岁。初次就诊时的平均孕周为7.4±4.2周（范围4 - 27周），在转诊机构时为11.7±4.9周（5 - 30周）。与计划继续妊娠的患者相比，计划终止妊娠的患者转诊预约时间明显更短（22.4±16.6天对35.7±24.5天，P = 0.0042）。然而，与最初计划相比，继续妊娠还是终止妊娠的最终决定是转诊预约间隔时间的更强预测因素（R2 = 0.177）。那些计划告诉更多人自己怀孕的患者继续妊娠的比例明显高于终止妊娠的患者。
怀孕青少年可能需要多次随访预约，以促进与转诊医疗的衔接。由于青少年获得妊娠服务存在延迟，因此需要与转诊机构进行密切随访和沟通，以优化对怀孕青少年的护理。
