Providing a Safe Pregnancy Experience for Surgeons: A Review.

IF 15.7 1区 医学 Q1 SURGERY JAMA surgery Pub Date : 2024-10-01 DOI:10.1001/jamasurg.2024.0979
Tiffany A Glazer, Kirsten A Gunderson, Elise Deroo, Ellen C Shaffrey, Hayley Mann, Maya N Matabele, Rebecca M Minter, J Igor Iruretagoyena, John E Rectenwald
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Abstract

Importance: Childbearing has been a particular barrier to successful recruitment and retention of women in surgery. Pregnant surgeons are more likely to have major pregnancy complications, such as preterm delivery, intrauterine growth restriction, infertility, and miscarriage, compared with nonsurgeons. The average obstetric complication rate for surgeons ranges between 25% and 82% in the literature and is considerably higher than that in the general US population at 5% to 15%.

Observations: The risks that pregnant surgeons experience were individually analyzed. These risks included missed prenatal care; musculoskeletal hazards, such as prolonged standing, lifting, and bending; long work hours; overnight calls; exposure to teratogenic agents, such as ionizing radiation, anesthetic gases, chemotherapy agents, and methyl methacrylate; and psychological stress and discrimination from the long-standing stigma associated with balancing motherhood and professional life.

Conclusions and relevance: A clear, translatable, and enforceable policy addressing perinatal care of surgeons was proposed, citing evidence of the risks reviewed from the literature. A framework of protection for pregnant individuals is essential for attracting talented students into surgery, retaining talented surgical trainees and faculty, and protecting pregnant surgeons and their fetuses.

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为外科医生提供安全的孕期体验:回顾。
重要性:生育一直是外科成功招聘和留住女性的一个特殊障碍。与非外科医生相比,怀孕的外科医生更容易出现重大妊娠并发症,如早产、宫内发育受限、不孕和流产。在文献中,外科医生的平均产科并发症发生率在 25% 到 82% 之间,大大高于美国普通人群的 5% 到 15% 的发生率:对怀孕外科医生经历的风险进行了单独分析。这些风险包括错过产前护理;肌肉骨骼危害,如长时间站立、举起和弯腰;工作时间长;通宵值班;接触致畸物质,如电离辐射、麻醉气体、化疗药物和甲基丙烯酸甲酯;以及因长期以来在母亲身份和职业生活之间取得平衡而遭受的耻辱所带来的心理压力和歧视:引用文献中的风险证据,提出了一项针对外科医生围产期护理的明确、可转化和可执行的政策。一个保护孕妇的框架对于吸引优秀学生进入外科、留住优秀外科学员和教师以及保护怀孕外科医生及其胎儿至关重要。
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来源期刊
JAMA surgery
JAMA surgery SURGERY-
CiteScore
20.80
自引率
3.60%
发文量
400
期刊介绍: JAMA Surgery, an international peer-reviewed journal established in 1920, is the official publication of the Association of VA Surgeons, the Pacific Coast Surgical Association, and the Surgical Outcomes Club.It is a proud member of the JAMA Network, a consortium of peer-reviewed general medical and specialty publications.
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