Sexual and Reproductive Health Outcomes Among Adolescent Females During the COVID-19 Pandemic.

BACKGROUND AND OBJECTIVES: Coronavirus disease 2019 (COVID-19) posed a significant threat to adolescents' sexual and reproductive health. In this study, we examined population-level pregnancy and sexual health-related care utilization among adolescent females in Ontario, Canada during the pandemic and evaluated relationships between these outcomes and key sociodemographic characteristics. METHODS: This was a population-based, repeated cross-sectional study of >630 000 female adolescents (12-19 years) during the prepandemic (January 1, 2018-February 29, 2020) and COVID-19 pandemic (March 1, 2020-December 31, 2022) periods. Primary outcome was pregnancy; secondary outcomes were contraceptive management visits, contraception prescription uptake, and sexually transmitted infection (STI) management visits. Poisson models with generalized estimating equations for clustered count data were used to model pre-COVID-19 trends and forecast expected rates during the COVID-19 period. Absolute rate differences between observed and expected outcome rates for each pandemic month were calculated overall and by urbanicity, neighborhood income, immigration status, and region. RESULTS: During the pandemic, lower-than-expected population-level rates of adolescent pregnancy (rate ratio 0.87; 95% confidence interval [CI]:0.85-0.88), and encounters for contraceptive (rate ratio 0.82; 95% CI:0.77-0.88) and STI management (rate ratio 0.52; 95% CI:0.51-0.53) were observed. Encounter rates did not return to pre-pandemic rates by study period end, despite health system reopening. Pregnancy rates among adolescent subpopulations with the highest pre-pandemic pregnancy rates changed least during the pandemic. CONCLUSIONS: Population-level rates of adolescent pregnancy and sexual health-related care utilization were lower than expected during the COVID-19 pandemic, and below-expected care utilization rates persist. Pregnancy rates among more structurally vulnerable adolescents demonstrated less decline, suggesting exacerbation of preexisting inequities.

Menstrual health inequities and "period poverty" in Canada.

Period poverty is the lack of access to menstrual products, sexual and reproductive health education, safe waste management, and adequate facilities. Despite its being a public health issue and a significant concern for numerous Canadians, there is a lack of peer-reviewed research on period poverty in Canada. Existing Canadian research has primarily been conducted by non-profit organizations/charities or industry leaders for menstrual products, resulting in incomplete data. More research is needed to explore the menstrual inequities in Canada and their impact on the well-being of Canadians. This is a critical step to ensure the menstrual needs of Canadians are appropriately addressed.

RéSUMé: La précarité menstruelle est le manque d'accès aux produits pour la menstruation, à l'éducation à la santé sexuelle et reproductive, à la gestion sûre des déchets et à des installations adéquates. Bien que ce soit un problème de santé publique et une préoccupation importante pour bon nombre de Canadiennes et de Canadiens, il n'y a pas assez de recherche évaluée par les pairs sur la précarité menstruelle au pays. La recherche canadienne existante a principalement été menée par des organismes caritatifs/à but non lucratif ou par les grandes entreprises de produits pour la menstruation, ce qui explique que les données sont incomplètes. Il faut pousser la recherche pour explorer l'iniquité menstruelle au Canada et ses effets sur le bien-être des Canadiennes et des Canadiens. C'est une étape essentielle pour pouvoir aborder convenablement les besoins menstruels de la population.

Adolescents on an inpatient unit and their healthcare providers: what's working and what's not.

OBJECTIVES: Adolescents admitted to hospital can face unique medical and psychosocial challenges, and may be treated by healthcare providers who do not recognize or adequately address these needs. Our goal was to better understand the experiences of both patients and providers at a local level. METHODS: We designed a cross-sectional survey-based study of two participant groups: (1) adolescent patients (aged 10-19) admitted to general medical wards at a tertiary pediatric hospital and (2) pediatric healthcare providers representing multiple disciplines. RESULTS: A total of 65 individuals participated: 25 adolescents (mean age 14.6; range 11-17) and 40 multidisciplinary healthcare providers. Most adolescents reported being treated respectfully (88 %) and taken seriously (92 %) by their providers. Several identified structure and routine, a break from daily stressors, and quality time with loved ones as positive aspects to hospitalization, while the use of correct gender pronouns, privacy, and age-appropriate leisure activities were cited areas for improvement. The majority of providers reported enjoying caring for adolescents (82 %) and forging therapeutic connections with them (87 %). Several areas of discomfort were noted, including gender and sexuality, substance use, and suicidality. Identified care gaps included inadequate training/education, suboptimal ward environments, and lack of community resources. CONCLUSIONS: Hospitals should recognize adolescent patients' needs for privacy, youth-centered communication, and developmentally-appropriate spaces. Pediatric healthcare professionals generally enjoy providing care to adolescents in the in-patient setting, however, often have insufficient training in addressing adolescent-specific health and psychosocial issues.

Adolescents' Cannabis Knowledge and Risk Perception: A Systematic Review.

To systematically review evidence evaluating cannabis-related knowledge and perception of risk in children and adolescents. We systematically searched Medline, PsycINFO, and EMBASE using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. 133 studies from around the world (including ages 10-18 yrs) met inclusion criteria, with 70% meeting grade 2C quality. Increased knowledge and perception of risk of cannabis frequently correlated with lower levels of current use and intent to use. Studies examining correlations over time generally demonstrated increased adolescent cannabis use and decreased perception of risk. Included prevention-based interventions often enhanced knowledge and/or perception of risk in adolescents exposed to the intervention. Studies exploring outcomes relating to legislative changes for recreational marijuana use demonstrated considerable heterogeneity regarding knowledge and perception of risk whereas studies that focused on medicinal marijuana legislative changes overwhelmingly demonstrated a decrease in perception of risk post legalization. Increased knowledge and perception of risk of cannabis in adolescents often correlate with lower levels of current use and intention to use in the future. Further study and implementation of public health and clinically-oriented strategies that seek to increase knowledge among youth about the potential health harms of cannabis use should continue and be prioritized.

Appel à l'action : des recommandations pour améliorer la transition des jeunes ayant des besoins de santé complexes vers les soins aux adultes.

Les jeunes qui ont des besoins de santé complexes, définis comme ceux qui nécessitent des soins et services spécialisés en raison d'affections physiques, développementales ou mentales, sont souvent traités par des pédiatres et autres spécialistes en pédiatrie. Au Canada, l'âge auquel les bailleurs de fonds provinciaux et territoriaux exigent le transfert des soins pédiatriques aux soins pour adultes varie entre 16 et 19 ans. La délimitation actuelle entre les services de santé pédiatriques et aux adultes est fragmentaire, ce qui entrave la continuité des soins pendant une période déjà vulnérable du développement. Le peu d'intégration des soins entre les domaines peut nuire à l'engagement des jeunes en matière de santé et compromettre leur santé à l'âge adulte. Pour renverser ces obstacles et améliorer les résultats de la transition, les dispensateurs de soins pédiatriques et de soins aux adultes, de même que les médecins de famille et d'autres partenaires communautaires, doivent collaborer de manière satisfaisante à l'élaboration de stratégies systémiques qui rationalisent et préservent les soins aux jeunes en transition vers des soins aux adultes en milieu tertiaire, communautaire et primaire. Il est recommandé de privilégier des limites d'âge flexibles pour effectuer cette transition vers les soins aux adultes et de tenir compte de la phase de développement et de l'aptitude de chaque jeune, ainsi que des besoins et de la situation de chaque patient et de chaque famille. Une formation et un enseignement spécialisés sur les enjeux liés aux soins de transition s'imposent pour renforcer les capacités et s'assurer que les professionnels de la santé des diverses disciplines et des divers milieux soient mieux outillés pour accepter et traiter les jeunes qui ont des besoins de santé complexes.

Dismantling Inequities in Adolescent and Young Adult Health through a Sexual and Reproductive Health Justice Approach.

This article provides an overview of the social determinants of adolescents and young adults' (AYAs') sexual and reproductive health (SRH), from a global health perspective. The status of AYAs' SRH constitutes leading health indicators across nations and globally, and reveals the well-being of this population. Throughout the article, AYAs' SRH is approached from a health equity perspective, which includes SRH health rights and reproductive justice. Using this health equity lens, salient topics are presented: sexual abuse/assault among AYAs; immigrant and refugee populations; child, early, and forced marriage; human trafficking; and female genital mutilation. The article also discusses access to SRH services and comprehensive education. Practical implications and resources are offered for healthcare providers for their daily encounters with AYAs, as well as for community, institutional level, and advocacy action. Healthcare providers are well positioned to advance AYAs SRH through mitigating inequities and in so doing, they are assuring the health of the population and future generations.

The impact of COVID-19 on adolescents with eating disorders: a cohort study.

BACKGROUND: There is a noticeable lack of evidence regarding the impact of COVID-19 and the associated lockdown on young people with eating disorders. The goals of this study were 1) to examine characteristics of adolescents presenting for eating disorder (ED) assessment since the onset of the COVID-19 pandemic; 2) to compare adolescents presenting for ED assessment since the onset of the COVID-19 pandemic to those that presented for assessment 1 year previously; 3) to examine implications of the pandemic on the system of care. METHODS: A retrospective chart review was completed on all patients assessed at a pediatric tertiary care ED program during the pandemic between April 1 and October 31, 2020, and on youth assessed during the same time frame 1 year previously. Data including body measurements and results of psychological measures was extracted from patients' charts. Clinician reports were utilized for accounts of ED symptoms. Referrals to our program were also compared for the two time periods. RESULTS: Of the 48 youth assessed between April and October 2020, average age was 14.6 years and average percentage of treatment goal weight was 77.7%. 40% cited the pandemic as a trigger for their ED; of these youth, 78.9% were medically unstable compared to 55.2% of those whose ED was not triggered by the pandemic. When comparing the 2020 cohort to those assessed in 2019, youth who presented for assessment during the pandemic trended towards having lower percentage of goal weights and higher rates of self-reported impairment, and were significantly more likely to be medically unstable (p = 0.005) and to require hospitalization (p = 0.005). Higher rates of inpatient admissions, emergency room consultation requests and outpatient referrals deemed "urgent" were likewise associated with the pandemic period. CONCLUSIONS: During the COVID-19 pandemic, youth assessed for an ED presented with high rates of medical instability and need for hospitalization. Caring for these youth may be more challenging during the pandemic, when access to services may be limited. Further research is required to better understand the impact of the pandemic on the clinical course and outcomes of EDs in adolescents.

The objective of this study was to examine characteristics of adolescents presenting for eating disorder (ED) assessment during the COVID-19 pandemic, and also to compare them to a similar group assessed 1 year previously. A review of medical charts was completed on patients assessed at a pediatric ED program between April 1 and October 31, 2020 and on patients assessed between April 1 and October 31, 2019. Forty-eight adolescents were assessed during the pandemic-specific timeframe and 43 were assessed during the same timeframe the year previously. Forty percent of those in the 2020 cohort cited pandemic effects as a trigger for their ED; these youth had a shorter course of illness and were somewhat more likely to be medically compromised compared to those whose ED was not triggered by the pandemic. Compared to those seen in 2019, adolescents assessed for an ED in 2020 exhibited higher rates of nutritional restriction and functional impairment, were significantly more likely to be medically unstable, and required more hospitalizations or urgent consultations. Further research is required to better understand the impact of COVID-19 on the clinical course and outcomes of EDs in youth.

Real and Perceived Effects of Caffeine on Sprint Cycling in Experienced Cyclists.

Anderson, DE, German, RE, Harrison, ME, Bourassa, KN, and Taylor, CE. Real and perceived effects of caffeine on sprint cycling in experienced cyclists. J Strength Cond Res 34(4): 929-933, 2020-Caffeine ingestion before an exercise bout may provide ergogenic effects on anaerobic performance, particularly in trained athletes. However, the degree of influence of caffeine may be coupled with the placebo effect. A double-blind, placebo-controlled, randomized design was used to determine the real and perceived effects of caffeine on anaerobic performance. Ten competitively trained cyclists (9 men and 1 woman) completed 3 trials of the Wingate Anaerobic Test (WAnT). Subjects were given coffee that they believed contained a high caffeine dose, a low caffeine dose, or a placebo 45 minutes before WAnT. Subjects were actually given 2 placebos (decaffeinated coffee) and one dose of caffeine (280 mg). Level of significance was p ≤ 0.05. No significant differences were found between trials for blood lactate concentration and heart rate. Seven of the subjects (70%) correctly identified the caffeine trial as the high caffeine trial. Time to peak power was significantly shorter for the trial in which subjects incorrectly guessed they had consumed caffeine when given the placebo compared with placebo trial (1.6 ± 0.1 vs. 2.3 ± 0.2 seconds). Power drop was significantly higher for the trial in which subjects incorrectly guessed they had consumed caffeine when given the placebo compared with placebo trial (524 ± 37 vs. 433 ± 35 W). There seems to be a placebo effect of caffeine on anaerobic performance. Improved performance may result from psychological advantages rather than physical advantages. Coaches may find it beneficial to use a placebo to improve anaerobic performance, especially if concerned about the side effects or cost of caffeine.

Use of cyproheptadine to stimulate appetite and body weight gain: A systematic review.

OBJECTIVE: A systematic review identifying the use of cyproheptadine (CY) as an appetite stimulant was completed. METHOD: Studies of any design exploring the efficacy of CY as an appetite stimulant in all age groups and populations were included. Primary outcomes of studies included were weight gain, appetite stimulation, and/or caloric/nutritional intake increase. The review was completed in accordance with PRISMA standards. RESULTS: A total of 46 articles across 21 different treatment populations met criteria for the review, including 32 randomized controlled trials, 4 prospective cohort studies, 4 retrospective cohort studies, 4 case reports and 2 case series. Of these, 39 demonstrated that CY resulted in significant weight gain in the sample under study. Studies exploring the use of CY in those with malignant/progressive disease states, such as HIV and cancer, showed minimal to no benefit of the medication. Transient mild to moderate sedation was the most commonly reported side effect. Studies included were heterogeneous in terms of methods as well as study patient demographics, characteristics and concurrent medical conditions. Few studies provided objective measures of appetite change. DISCUSSION: CY appears to be a safe, generally well-tolerated medication that has utility in helping facilitate weight gain in patients drawn from a variety of underweight populations. Future prospective randomized controlled studies in low weight patients that include objective measures of appetite and intake are needed to better understand the mechanism by which CY augments weight gain.

Evaluation of the Effectiveness and Safety of Olanzapine as an Adjunctive Treatment for Anorexia Nervosa in Adolescents: An Open-Label Trial.

OBJECTIVES: To evaluate the effectiveness and safety of adjunctive olanzapine treatment for low weight adolescents with anorexia nervosa (AN). METHODS: A non-randomized open-label trial was conducted between 2010 and 2014. Participants received standard treatment and were invited to take olanzapine at study enrollment. Participants could accept, continue, or discontinue olanzapine as treatment progressed. Weight and psychological outcomes were monitored. RESULTS: Of 239 adolescents assessed, 65 met inclusion criteria, 38 enrolled in the study, and 32 were retained for analysis. Twenty-two participants took olanzapine (medication group) and ten participants did not (comparison group). Participants in the medication group demonstrated a higher rate of weight gain compared to those who did not receive olanzapine (p = .012). No serious adverse events were noted, although seven participants (31.8%) discontinued olanzapine due to a side effect. CONCLUSION: Preliminary results suggest that olanzapine may help facilitate weight gain in adolescents with AN. The importance of medical monitoring over the course of treatment is discussed. Evaluation of the Efficacy and Safety of Olanzapine for Anorexia Nervosa in Children and Adolescents; http://clinicaltrials.gov; NCT01184443.

OBJECTIFS: Évaluer l'efficacité et l'innocuité d'un traitement d'appoint par olanzapine pour les adolescents de faible poids souffrant d'anorexie mentale (AM). MÉTHODES: Un essai ouvert non randomisé a été mené entre 2010 et 2014. Les participants ont reçu un traitement standard et ont été invités à prendre de l'olanzapine lors de l'inscription à l'étude. Les participants pouvaient accepter, continuer ou cesser l'olanzapine à mesure que le traitement progressait. Le poids et les résultats psychologiques ont été surveillés. RÉSULTATS: Sur les 239 adolescents évalués, 65 satisfaisaient aux critères d'inclusion, 38 se sont inscrits à l'étude, et 32 ont été retenus pour analyse. Vingt-deux participants ont pris de l'olanzapine (groupe du médicament) et 10 participants n'en ont pas pris (groupe de comparaison). Les participants du groupe du médicament ont démontré un taux plus élevé de prise de poids comparativement à ceux qui n'ont pas reçu d'olanzapine (p = 0,012). Aucun effet indésirable sérieux n'a été noté, bien que 7 participants (31,8 %) aient cessé l'olanzapine en raison d'un effet secondaire. CONCLUSION: Les résultats préliminaires suggèrent que l'olanzapine peut aider à faciliter la prise de poids chez les adolescents souffrant d'AM. L'importance de la surveillance médicale en cours de traitement est discutée. Evaluation of the Efficacy and Safety of Olanzapine for Anorexia Nervosa in Children and Adolescents; http://clinicaltrials.gov; NCT01184443.

Sexual Health of Adolescent Patients Admitted to a Psychiatric Unit.

OBJECTIVE: To review sexual health screening practices during admission to an adolescent psychiatry unit. METHOD: Retrospective chart review of randomly selected youth admitted over a one-year period (2013). Data extracted included demographics, reasons for admission, sexual health history, as well as any comorbid behaviours noted. The main outcome measure was whether sexual health details were documented at any time during admission; if so, this information was extracted for analysis. Statistical analysis was done using univariate associations and logistic association. RESULTS: Mean age of subjects (n=99, 79 females and 20 males) was 15.24 years (SD = 1.30). Most common reasons for admission were suicidal gestures/self harm (n=57, 58%) and mood disorders (n=53, 54%). Thirty-seven patients (37%) had sexual health information documented in their charts. No demographic variables were significantly associated with being asked sexual health questions. Patients who had mood disorder diagnoses had 6 times the odds (95%CI: 1.18 to 29.96, P=0.03) of sexual health questions being documented compared to those not diagnosed with mood disorders. CONCLUSIONS: Screening for sexual health concerns is not being documented in the majority of adolescent psychiatry inpatients. Omitting sexual health screening during hospitalizations represents a missed opportunity for investigation and management of sexual health issues in this high-risk group. As many adolescents, particular those struggling with mental illness, do not attend preventative health visits, screening for pregnancy risk and other reproductive health needs is recommended at every adolescent encounter and in all settings.

OBJECTIF: Examiner les pratiques de dépistage de la santé sexuelle durant l'hospitalisation dans une unité de psychiatrie pour adolescents. MÉTHODE: Une revue rétrospective de dossiers d'adolescents choisis au hasard ayant été hospitalisés sur une période d'un an (2013). Les données extraites comprenaient des données démographiques, les raisons de l'hospitalisation, les antécédents de santé sexuelle, et tout comportement comorbide observé. La principale mesure de résultat était si les détails de la santé sexuelle étaient documentés à un moment de l'hospitalisation, si c'était le cas, cette information était extraite aux fins d'analyse. L'analyse statistique a été effectuée à l'aide d'associations univariées et d'association logistique. RÉSULTATS: L'âge moyen des sujets (n = 99, 79 filles et 20 garçons) était de 15,24 ans (ET = 1,30). Les raisons les plus communes de l'hospitalisation étaient les gestes suicidaires ou l'automutilation (n = 57, 58 %) et les troubles de l'humeur (n = 53, 54 %). Trente-sept patients (37 %) avaient de l'information sur la santé sexuelle documentée dans leur dossier. Aucune variable démographique n'était significativement associée au fait d'être interrogé sur la santé sexuelle. Les patients ayant des diagnostics de troubles de l'humeur avaient 6 fois plus de probabilités (IC à 95 % 1,18 à 29,96, P = 0,03) d'avoir des questions de santé sexuelle documentées que ceux n'ayant pas de ces diagnostics. CONCLUSIONS: Le dépistage des problèmes de santé sexuelle n'est pas documenté chez la majorité des adolescents hospitalisés en psychiatrie. L'omission du dépistage de la santé sexuelle durant les hospitalisations représente une occasion ratée d'investigation et de prise en charge des questions de santé sexuelle dans ce groupe à risque élevé. Comme bon nombre d'adolescents, en particulier ceux qui sont aux prises avec la maladie mentale ne font pas de visites de santé préventives, le dépistage du risque de grossesse et d'autres besoins de santé reproductive est recommandé pour toute rencontre avec un adolescent et dans tous les contextes.

Adolescent pregnancy and eating disorders: a minireview and case report.

BACKGROUND: Despite the fact that eating disorders (EDs) during pregnancy and early child bearing can both individually increase risk to mother and child, there is a paucity of research exploring pregnancy in adolescence and concomitant EDs. CASE: We report the case of a 16-year-old female with atypical anorexia nervosa, who experiences a remission of her ED behavior during pregnancy, followed by a severe relapse in the post-partum period. CONCLUSION: In this case, pregnancy functioned as a motivator for remission in our patient with concomitant ED. Further research is needed to identify risks of EDs in adolescent pregnancy, to explore the trajectory of pre-existing EDs during pregnancy and to identify effective interventions for prolonging remission into the post-partum period.

Celiac disease and anorexia nervosa: a case report.

The relationship between anorexia nervosa and celiac disease remains an area of ongoing research. Identification of celiac disease in patients with restricted nutritional intake can be challenging since abdominal complaints are a common comorbidity associated with eating disorders and since diagnosis of celiac disease requires a duodenal biopsy while on a gluten containing diet. In this report, we present a 12-year-old female who developed anorexia nervosa and was thereafter diagnosed with celiac disease. The latter diagnosis occurred after a 2-year period of persistent abdominal complaints and duodenal biopsies on three separate occasions. Our case highlights the diagnostic challenge, which may include initially missing the diagnosis, associated with celiac disease in patients who are restricting their nutritional intake, and also the importance of re-testing in patients where gastrointestinal complaints are persistent for extended time periods after refeeding.

Treat Me But Don't Judge Me: A Qualitative Examination of Health Care Experiences of Pregnant and Parenting Youth.

STUDY OBJECTIVE: To share pregnant and parenting youth's experiences with health care to inform recommendations for promoting youth-friendly medical encounters. DESIGN: This exploratory study used a qualitative descriptive approach. SETTING: Three urban centers that service pregnant youth and young parents in a large Canadian city. PARTICIPANTS: A convenience sample of 26 participants (mean age of 18.7 years) was recruited across sites. INTERVENTIONS: Five focus groups were conducted. MAIN OUTCOME MEASURES: Focus groups were audio recorded, transcribed verbatim, and analyzed thematically. Analysis involved the independent, open coding of data by 2 qualitative researchers to identify and compare emerging themes. RESULTS: Three major themes emerged regarding their experiences with health care providers: characteristics of negative health care encounters, the emergence of contemporary stereotypes during these encounters, and characteristics of positive health care encounters. Negative encounters often resulted from perceived judgmental attitudes of providers and were shown to contribute to a general sense of mistrust and fear. Positive health care encounters tended to feature mutual respect, support, open dialogue, and nonjudgmental attitudes. CONCLUSION: Pregnant and parenting youth in our study have experienced many negative health care encounters that have contributed to disengagement and mistrust of the health care system. To engage this high-risk population in health care, practitioners are encouraged to consider their own biases when servicing this population and work toward fostering positive, nonjudgmental interactions, and supportive environments.

Demographic Characteristics Associated with Pregnant and Postpartum Youth Referred for Mental Health Services in a Community Outreach Center.

OBJECTIVE: Pregnancy in youth is considered high risk from a number of different standpoints. At present, limited data has explored demographic factors associated with Canadian cohorts of pregnant and postpartum youth seeking mental health services. We aimed to describe demographic characteristics associated with pregnant and postpartum youth and young adults referred for mental health services in the community and to compare this with data drawn from a hospital-based perinatal mental health clinic. METHOD: Patients were recruited at a young parents' outreach center (YPOC) in a large urban Canadian city. The patients completed questionnaires at the time of initial assessment. The number of attended and missed appointments was tracked and compared to a hospital-based control group in an effort to determine whether the community-based clinic would result in fewer missed appointments. RESULTS: A total of 28 patients were assessed at the YPOC. The mean age of all participants was 19.4 years (+/- 2.3 years) as compared to 18.57 years (± 1.81 years) for the hospital-based group. Rates of poverty were high, and high school completion and level of social support low for many patients. Patients attending the YPOC clinic missed fewer appointments overall. CONCLUSIONS: Pregnant and postpartum adolescents and young adults possess multiple risk factors across various domains that threaten short and long term health outcomes. Establishment of outreach mental health clinics may help minimize barriers to care as demonstrated in the present study by fewer missed appointments and should be investigated further as a means of improving mental health access and outcomes.

OBJECTIF: La grossesse chez les adolescentes est considérée à risque élevé d'un certain nombre de points de vue différents. À l'heure actuelle, des données limitées ont exploré les facteurs démographiques associés aux cohortes canadiennes d'adolescentes enceintes et en postpartum qui cherchent à obtenir des services de santé mentale. Nous visions à décrire les caractéristiques démographiques associées aux adolescentes et aux jeunes femmes enceintes et en postpartum adressées à des services de santé mentale dans la communauté, et à les comparer avec des données tirées d'une clinique de santé mentale périnatale en milieu hospitalier. MÉTHODE: Les patientes ont été recrutées dans un centre d'approche pour jeunes parents (CAJP) d'un grand centre urbain canadien. Les patientes ont répondu à un questionnaire au moment de leur évaluation initiale. Le nombre de rendez-vous respectés et manqués a été suivi et comparé avec celui d'un groupe témoin en milieu hospitalier en vue de déterminer si la clinique communautaire aurait moins de rendez-vous manqués. RÉSULTAT: Au total, 28 patientes ont été évaluées au CAJP. L'âge moyen de toutes les participantes était de 19,4 ans (+/− 2,3 ans) comparativement à 18,57 ans (± 1.81 an) pour le groupe en milieu hospitalier. Les taux de pauvreté étaient élevés, et ceux d'études secondaires terminées et de soutien social étaient faibles pour beaucoup de patientes. Les patientes de la clinique du CAJP ont manqué moins de rendez-vous globalement. CONCLUSIONS: Les adolescentes et les jeunes femmes enceintes et en postpartum présentent de multiples facteurs de risque dans divers domaines qui menacent les résultats de santé à court et à long terme. La création de cliniques de santé mentale d'approche peut contribuer à minimiser les obstacles aux soins comme le démontre la présente étude par le nombre réduit de rendez-vous manqués, et devrait faire l'objet de plus de recherche comme moyen d'améliorer l'accès à la santé mentale et les résultats.