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.