Introduction
Childhood and adolescence are critical periods for reproductive development and long-term health maintenance. Some gynecological problems resulting from inappropriate advice and care and mishandling in adult clinics can have a significant impact on the reproductive, physical and mental health of patients that can last years, even into adulthood.1,2 They might therefore place a heavy economic burden on patients, families and society.
Pediatric and Adolescent Gynecology (PAG) is a subspecialty under the umbrella of Obstetrics and Gynecology that focuses on the diagnosis and medical and surgical management of female reproductive health problems from birth through young adulthood. It requires a multidisciplinary approach and involves a range of female reproductive healthcare services, from first gynecologic visits to specialized care for congenital conditions and other reproductive disorders.3 PAG in western countries such as the U.S., Europe, and Australia1,4,5 have established for some decades and continue to focus on caring the gynecological and reproductive health of female children and adolescents. Even in these more advanced settings, studies have reported a substantially unmet need for specific health concerns among children and adolescents.1,6 The need is even greater in resource-poor and developing settings. Despite the deemed significance of the problem, very few large-scale studies, looking at the problem in a granular and robust way, exist to elucidate the pattern and characteristics of PAG problems worldwide, especially in developing countries. Currently, there are few hospitals in China equipped with a specialized PAG department. One of these is the children’s hospital of Zhejiang University School of Medicine (ZJU), and it has carried out clinical gynecological work for children and adolescents for nearly 20 years, providing clinical outpatient services to more than 100,000 patients thus far. Because of the department’s longstanding efforts in this area, it is in a unique position to evaluate the patterns of PAG problems over time in China. This retrospective study analyzed 13 years of the hospital’s patient data and aimed to describe the pattern, distribution characteristics, and trends in PAG problems over time. Additionally, we conducted a systematic review focused on previous studies examining PAG problems in China.