title: Is pediatric emergency department utilization by pregnant adolescents on the rise?
abstract: OBJECTIVE
  This study evaluates trends of pregnant adolescents' utilization of pediatric emergency departments (PEDs), describes patient demographics, and reviews common pregnancy-related conditions seen in the PED.
  
  
  METHODS
  This was a retrospective cross-sectional study of a large pediatric emergency medicine research network database including 11 freestanding PEDs, 3 separate PEDs from a site with a general ED, and 8 general EDs that see pediatric patients. Pediatric patients (<19 years old) were identified from January 1, 2003, to December 31, 2007, by any International Classification of Diseases, Ninth Revision pregnancy or pregnancy-related condition diagnosis code. Demographic information (age, race, payer type) and disposition (admit, discharge home, transfer) were recorded.
  
  
  RESULTS
  There were 15,190 unique pregnancy-related visits with an overall annual growth rate of 2.8% (P = 0.03). There was a statistically significant increase in visits to freestanding PEDs (P = 0.02) and separate PED from a site with a general ED (P = 0.03), but there was not in the general EDs (P = 0.16). The 3 most common pregnancy-related conditions were abdominal pain, genitourinary infection, and hemorrhage in early pregnancy.
  
  
  CONCLUSIONS
  Pregnant adolescents make up a small (<1%) but growing proportion of overall visits to PEDs. Future direction should include an evaluation of the educational opportunities provided during pediatric residency and pediatric emergency medicine fellowship training and, if inadequacies exist, work to develop an innovative curriculum for this particular patient population.
authors.affiliation: Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Nathan.timm@cchmc.org
authors.forename: Nathan L
authors.initials: NL
authors.lastname: Timm
authors.forename: Constance
authors.initials: C
authors.lastname: McAneney
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Alpern
authors.forename: Michelle
authors.initials: M
authors.lastname: Macy
authors.forename: Richard
authors.initials: R
authors.lastname: Ruddy
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D010343:Patient Admission / Q000639:trends*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult