Journal of pediatric and adolescent gynecology最新文献

{"title":"Menstrual Dysphoria and Preferences for Menstrual Suppression in Transgender and Gender-Diverse Youth.","authors":"Öykü Sarıkaya, Melis Pehlivantürk Kızılkan, Zeynep Tüzün, Koray Başar, Zeynep Alev Özön, Orhan Derman, Sinem Akgül","doi":"10.1016/j.jpag.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.05.006","url":null,"abstract":"<p><strong>Introduction: </strong>Menstruation can present a significant challenge for transgender and gender-diverse (TGD) individuals. While menstrual suppression can help alleviate this experience, research on the topic remains scarce. This study aimed to assess menstruation-related discomfort experienced by TGD individuals and to identify their preferences for menstrual suppression methods MATERIAL AND METHOD: This cross-sectional study was conducted between December 2021 and September 2023 with a sample of TGD individuals (n=21) aged 12-24, experiencing menstrual dysphoria. Participants completed an initial questionnaire assessing menstruation-related discomfort, followed by counseling on menstrual suppression options, including combined oral contraceptives, progestin-only pills, depot medroxyprogesterone acetate injection, levonorgestrel-releasing intrauterine device, and the etonogestrel implant. A second questionnaire evaluated factors influencing method preferences and documented the chosen suppression method. Descriptive statistical analyses were performed, with continuous variables presented as mean ± standard deviation and ordinal variables as numbers and percentages.</p><p><strong>Results: </strong>The conditions most frequently associated with severe discomfort related to menstruation were gender incongruence (81%), the carrying and use of menstrual products (95.2%), and the purchase of menstrual products (85.7%). The most popular method of menstrual suppression was combined oral contraceptives (63.1%). Several factors were identified as influencing the choice of method, including the estrogen content, frequency of use, and the necessity of a gynecological examination or visiting a different health facility.</p><p><strong>Conclusions: </strong>The study underscores the considerable distress that menstruation can cause in TGD youth. Moreover, the importance of personalized, patient-centered counseling is emphasized, with the objective of empowering individuals to make decisions based on their specific needs.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Impact of the Affordable Care Act on the Teen Birth Rate, Access to Care, and Cesarean Section Births in Pennsylvania.","authors":"John Omole-Matthew, Heather B Edelblute, Zeinab Baba","doi":"10.1016/j.jpag.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.05.005","url":null,"abstract":"<p><strong>Study objective: </strong>The teen birth rate in the US has been relatively higher than other developed countries. Given the complexity of this issue, this study aimed to use state-level birth data to examine changes in teen birth rates, access to care, and birth outcomes in pregnant teenagers before and after implementation of the Affordable Care Act (ACA).</p><p><strong>Methods: </strong>This is a retrospective cross-sectional study of births to mothers aged 13-19 in Pennsylvania between 2008-2012 (pre-ACA) and 2015-2018 (post-ACA).</p><p><strong>Results: </strong>A total of 52,180 pre-ACA and 21,994 post-ACA births were included in this study. The mean age at birth increased from 17.9 years to 18.0 years from pre- to post-ACA periods. The overall teen birth rate declined from 10.0% to 5.0%, a 50% reduction. The largest decrease in teen births from pre-ACA to post-ACA was seen in the non-Hispanic Black population whose teen birth rate declined by 55.%. There was also an increase in Medicaid paid births and in first trimester prenatal care and a reduction in Cesarean sections from pre-ACA to post-ACA periods.</p><p><strong>Discussion: </strong>Overall, our finding indicate that the implementation of the ACA contributed to decreased teen birth rates in Pennsylvania and reduced racial disparities in the incidence of teen births. This decline and improved prenatal care usage point to how the implementation of comprehensive sexual education and improved access to care through the ACA promote maternal health and prevent births for young women.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preferences and Experiences of Parents/Guardians of Adolescents and Young Adults with Epilepsy and Intellectual Disability on Decision-Making Surrounding Contraception.","authors":"Geetha Vasudevan, Robyn Filipink, Jenna Gaesser, Traci M Kazmerski, Yoshimi Sogawa, Laura Kirkpatrick","doi":"10.1016/j.jpag.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.05.004","url":null,"abstract":"<p><strong>Objective: </strong>To explore the preferences of parents/guardians of adolescents and young adults (AYA) of childbearing potential with co-occurring epilepsy and intellectual disability (ID) regarding decision making on contraception.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with parents/guardians of female AYAs (12-28 years old) with co-occurring epilepsy and ID recruited from a tertiary-care children's hospital. We confirmed the diagnoses of epilepsy and ID with the patient's neurologist and parent/guardian. All degrees of ID (e.g. mild/moderate/severe) were eligible. We audio-recorded and transcribed interviews. Two coders performed qualitative thematic analysis.</p><p><strong>Results: </strong>Twenty-five parents/guardians completed interviews. Themes included: 1) Parents/caregiver's desire for birth control for their child was more centered around menstruation-related concerns rather than pregnancy prevention; 2) Many parents were afraid of potential adverse side effects of contraception for their children, including perceptions that risks might outweigh benefits; 3) A common important factor in contraceptive decision making was ease of administration and generally the pill form was preferred, 4) Longer-acting methods, if chosen, were largely selected due to trusting recommendations from healthcare providers, yet were often feared due to perceptions of lower ease of reversibility if problems arise as well as greater challenges in delivery or placement.</p><p><strong>Conclusions: </strong>Findings may inform interventions to improve contraceptive care for AYAs with epilepsy and ID including development of discussion guides and decision aids for parents/caregivers.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144158804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal outcomes in adolescent pregnancies: A retrospective analysis of 3.6 million deliveries from 2000-2019 in Florida.","authors":"Anna M Scipioni, Holly VanDeman, Jean Paul Tanner, Jason L Salemi, Jose R Duncan","doi":"10.1016/j.jpag.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.05.001","url":null,"abstract":"<p><strong>Study objective: </strong>We aimed to compare the risk of adverse obstetrical outcomes in adolescent deliveries to adult deliveries in Florida, and to compare the risks between younger and older teenage deliveries.</p><p><strong>Methods: </strong>We conducted a population-based retrospective cohort study using a linked maternal-infant database of livebirths in Florida from 2000 to 2019. Demographic and clinical characteristics, and obstetric and neonatal outcomes of interest were compared by groups with 5-year intervals, using ages 25-29 as reference. Marginal standardization was used to estimate risk ratios (RR) and 95% confidence intervals (CI) representing the association between maternal age and outcomes of interest. A p-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Of the 3,614,274 deliveries, adolescent pregnancy (10-19-year-olds) comprised 8.1% of deliveries. Teenage deliveries had higher rates of fetal growth restriction and low birth weight, and were less likely to have a cesarean birth, premature rupture of membranes, and adequate prenatal care. Preterm birth, respiratory distress syndrome, neonatal/infant death, and maternal sepsis were also significantly higher in teens, with highest rates among the youngest teen deliveries. Younger teens also had selectively increased risk of hypertensive disorders (HTNP).</p><p><strong>Conclusion: </strong>Adolescent mothers are at increased risk for several obstetric and neonatal outcomes, with the youngest mothers are at highest risk of certain outcomes. These results suggest that tailoring prenatal and intrapartum care in teenage pregnancies may be warranted, however larger studies are needed to corroborate our findings.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A developmentally-informed model of adolescent decision-making around pregnancy: a qualitative study.","authors":"Lauren A Bell, Elizabeth I Harrison, Traci M Kazmerski, Margaret R Russell, Tahniat Syed, Nicholas A Szoko, Crystal P Tyler, Laura A Kirkpatrick","doi":"10.1016/j.jpag.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.05.002","url":null,"abstract":"<p><strong>Study objective: </strong>This study sought to formulate a model of the process through which adolescents and young adults (AYAs) progress when making decisions around pregnancy.</p><p><strong>Methods: </strong>We recruited United States-based participants aged 18-35 years in 2020-2021 who experienced pregnancy under age 20 across three pregnancy outcomes (parenting, adoption, abortion). Through semi-structured phone interviews, we explored participants' emotions around pregnancy, pregnancy disclosures, and pregnancy-related decision-making. We used qualitative analysis to identify common themes in the steps of the process experienced by participants in their decision-making and associated influences and develop a model of that process.</p><p><strong>Results: </strong>We interviewed 50 participants aged 13-19 years at the time of 1 or more pregnancies, totaling 56 pregnancies (16 parenting, 19 abortions, 18 adoptions, and 3 miscarriages). The developed Pregnancy Decision-making and Outcome Trajectories (PDOT) model incorporates varied trajectories of intention establishment/achievement. PDOT has four stages: 1) Initial Reactions, 2) Intention Analysis, 3) Planning, and 4) Action/Inaction. PDOT highlights AYA potential to experience persistent uncertainty around pregnancy but also potential to express certainty and move toward thoughtful research, support-seeking, and cost/benefit analysis. PDOT also highlights the impact of barriers and facilitators that limit AYAs from or help AYAs with achieving their desired pregnancy outcome.</p><p><strong>Conclusion: </strong>Pregnant AYAs experience difficulty making and following through with decisions around pregnancy outcomes. People interfacing with pregnant AYAs can utilize this framework to give AYAs appropriate, intentional support to boost AYA agency in making decisions around pregnancy and acting on those decisions.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Healthcare Utilization Post-Pharmacist Contraception Prescribing Among College-Age Students.","authors":"Katherine P Davis, Trexie Rudd, Tracey A Wilkinson, Mary A Ott, Ashley H Meredith","doi":"10.1016/j.jpag.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.jpag.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>Pharmacists have expanded contraceptive access through contraceptive prescribing. Concerns exist that patients will forego healthcare visits.</p><p><strong>Objective(s): </strong>Describe the intended and actual use of healthcare services by college-aged students utilizing pharmacy contraceptive prescribing.</p><p><strong>Study design: </strong>Prospective; observational; survey-based (baseline; 6- and 12-month).</p><p><strong>Results: </strong>Thirty-three participants completed a baseline survey; 25 (76%) completed the 6-month survey; 17 (68%) completed the 12-month survey. At baseline, 23 (70%) intended to see a healthcare provider within 1-3 years. At 6- and 12- months, just over 30% had visited a primary health care provider (n=8, 32% and n=6, 35%, respectively).</p><p><strong>Conclusion(s): </strong>Healthcare utilization rates of participants were similar to published rates for preventative service by college students. Pharmacist prescribing is as an additional access point for contraceptive care and provides an opportunity to refer students for recommended preventive services.</p>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PAG in the Asia-Oceania Region—Taking Little Steps Forward","authors":"Ani A. Zainuddin ,&nbsp;Sze-yan C. Cheung ,&nbsp;Eveline J. Roos","doi":"10.1016/j.jpag.2025.02.001","DOIUrl":"10.1016/j.jpag.2025.02.001","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 3","pages":"Pages 306-307"},"PeriodicalIF":1.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence (AI) and The Journal of Pediatric and Adolescent Gynecology (JPAG)","authors":"Paula J Adams Hillard MD (JPAG Editor-in-Chief)","doi":"10.1016/j.jpag.2025.04.007","DOIUrl":"10.1016/j.jpag.2025.04.007","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 3","pages":"Pages 301-303"},"PeriodicalIF":1.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menstrual Cycle Experiences, Health, and Illness","authors":"Margaret L. (Peggy) Stubbs PhD","doi":"10.1016/j.jpag.2025.01.176","DOIUrl":"10.1016/j.jpag.2025.01.176","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 3","pages":"Pages 304-305"},"PeriodicalIF":1.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Now?","authors":"Rosemary Claire Roden MD","doi":"10.1016/j.jpag.2025.03.001","DOIUrl":"10.1016/j.jpag.2025.03.001","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 3","pages":"Pages 311-312"},"PeriodicalIF":1.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}