Factors Influencing Pregnancy Screening in the Pediatric Intensive Care Unit

Study Objective: The objective of this study was to determine the rate of incidental pregnancy, pregnancy screening frequency, and factors associated with pregnancy screening in the pediatric intensive care unit (PICU). Design: A cross-sectional, descriptive study. Setting: The research was conducted at Penn State Health Children's Hospital evaluating PICU admissions between January 1, 2011, and January 31, 2019. Participants: Female adolescents 14-21 years of age who were admitted to the PICU. Interventions: The study population was divided into 2 groups (Presence and Non-Presence of Pregnancy Screening), and data were collected from the electronic health record. Main Outcome Measures: We evaluated for patient characteristics and for presence and results of urine pregnancy screening. Results: A total of 431 patients were included in the study. Of these, 275 patients (63.8%) had a pregnancy screen performed. No patients with incidental pregnancy were found. There was a statistically significant relationship between pregnancy screening and patient age, type of admission, and origin of transfer (P < .01). Analysis of secondary diagnoses (co-morbidities) indicated lower screening rates in patients with developmental delay, cerebral palsy, and/or mental retardation (15, 5.5%) [p < 0.0001] and chromosomal abnormalities (9, 3.3%) [p =0.021]. Conclusion: Incidental pregnancy is uncommon in female adolescents of childbearing age who are admitted to the PICU, but not all patients were screened, thus potentially jeopardizing maternal and fetal care. Clinicians should consider routine pregnancy screening of female patients of childbearing age admitted to the PICU and should be cognizant of individual factors that could preclude screening prior to or during their presentation.