Pregnancy Screening Inconsistent in Female Adolescents Before Chemotherapy Exposure

Pregnancy Screening Inconsistent in Female Adolescents Before Chemotherapy Exposure
Pregnancy Screening Inconsistent in Female Adolescents Before Chemotherapy Exposure

Pregnancy screening rates before teratogenic exposures are low for female adolescent patients with acute leukemia and those with emergency room (ER) visits including computer tomography (CT) of the abdomen/pelvis, a study in Cancer has shown.1

Because adolescents may be sexually active, pregnancy should be ruled out before exposure to teratogenic chemotherapy or abdominal/pelvic CT; however, no data are available on pregnancy screening patterns in this patient group.

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In this study, researchers analyzed data from the Pediatric Health Information System from 1999 to 2011 on a cohort of female adolescents, 10 to 18 years old, with newly diagnosed acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML), and a cohort of same age females who had an ER visit with abdominal/pelvic CT.

Primary outcome measure was a pregnancy test billed on the same day or before the teratogenic exposure. Pregnancy screening was compared in the leukemia cohorts and ER cohort, with prevalence ratios and 95% confidence intervals (CIs) computed with log-binomial regressions.

The researchers identified 35,650 admissions that met their criteria. Appropriately timed pregnancy tests were obtained from 35% of the patients with ALL (n = 889), 64% of the patients with AML (n = 127), and 58% of patients in the ER cohort (n = 34,634).

Compared with the patients in the ER cohort, patients in the ALL cohort were significantly less likely to undergo pregnancy screening (adjusted prevalence ratio, 0.71; 95% CI, 0.65-0.78), but no significant difference was seen between the ER cohort and the patients in the AML cohort (adjusted prevalence ratio, 1.12; 95% CI, 0.99-1.27). The researchers noted substantial hospital-level variation in pregnancy screening patterns.

Reference

1. Rao P, Li Y, Getz KD, et al. Low rates of pregnancy screening in adolescents before teratogenic exposures in a national sample of children's hospitals. Cancer. 2016 Sep 12. doi: 10.1002/cncr.30225. [Epub ahead of print]

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