dress a series of questions regarding the diagnosis of PCOS during adolescence including the following: clinical and biochemical evidence of hyperandrogenism, criteria for oligoanovulation and polycystic ovary morphology, diagnostic criteria to exclude other causes of hyperandrogenism and amenorrhea, role of insulin resistance, and intervention. Results and Conclusion: Features of PCOS overlap normal pubertal development. Hence, caution should be taken before diagnosing PCOS without longitudinal evaluation. However, treatment may be indicated even in the absence of a definitive diagnosis. While obesity, insulin resistance, and hyperinsulinemia are common findings in adolescents with hyperandrogenism, these features should not be used to diagnose PCOS among adolescent girls. © 2015 S. Karger AG, Basel Key WordsHyperandrogenism · Ovarian hyperandrogenism · Ovary · Polycystic ovary syndrome · Puberty Abstract Background/Aims: The diagnostic criteria for polycystic ovary syndrome (PCOS) in adolescence are controversial, primarily because the diagnostic pathological features used in adult women may be normal pubertal physiological events. Hence, international pediatric and adolescent specialty societies have defined criteria that have sufficient evidence to be used for the diagnosis of PCOS in adolescents. Methods: The literature has been reviewed and evidence graded to ad-

Study Objective To investigate the outcomes of adolescent pregnancy. Design Retrospective cohort study from the Consortium on Safe Labor between 2002 and 2008. Setting 12 clinical centers with 19 hospitals in the United States. Participants 43,537 nulliparous women <25 years, including 1,189 younger adolescents (age ≤15.9), 14,703 older adolescents (age 16–19.9)], and 27,645 young adults (age 20–24.9). Interventions aOR with 95%CI were calculated, controlling for maternal characteristics and pregnancy complications (young adults as a reference group). Main outcome Measure Maternal, neonatal outcomes, cesarean indications, and length of labor. Results Younger adolescents had increased risk of maternal anemia (aOR=1.25; 95%CI=1.07–1.45), preterm delivery <37 weeks of gestation (aOR=1.36; 95%CI=1.14–1.62), postpartum hemorrhage (aOR=1.46; 95%CI=1.10–1.95), preeclampsia/HELLP syndrome (aOR=1.44; 95%CI= 1.17–1.77) but had decreased risk of cesarean delivery (aOR=0.49; 95%CI= 0.42–0.59), chorioamnionitis (aOR=0.63; 95%CI=0.47–0.84), and neonatal intensive care unit (NICU) admission (aOR=0.80; 95%CI=0.65–0.98). Older adolescents had increased risk of maternal anemia (aOR=1.15; 95%CI= 1.09–1.22), preterm delivery at <37 weeks of gestation (aOR=1.16; 95%CI=1.08–1.25), and blood transfusion (aOR=1.21; 95%CI=1.02–1.43), but had decreased risk of cesarean delivery (aOR=0.75; 95%CI= 0.71–0.79), chorioamnionitis (aOR=0.83; 95%CI=0.75–0.91), major perineal laceration (aOR=0.82; 95%CI= 0.71–0.95), and NICU admission (aOR=0.89; 95%CI=0.83–0.96). Older adolescents were less likely to have cesarean for failure to progress or cephalopelvic disproportion (aOR=0.89; 95%CI 0.81–0.98). For adolescents who entered spontaneous labor, second stage of labor was shorter (P<.01). Conclusion Adolescents were less likely to have cesarean delivery. Failure to progress or cephalopelvic disproportion were decreased in older adolescents. Adolescents who entered spontaneous labor had shorter second stage of labor.

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Similar to adults, IUD use in adolescents and nulliparous women is effective and associated with low rates of serious complications. Health practitioners should therefore consider IUDs for contraception in all females. Teenagers and young women are more likely to request premature discontinuation of their IUDs and may benefit from additional counseling.

Testosterone use was associated with increased hemoglobin and hematocrit, increased BMI, and lowered high-density lipoprotein levels; estrogen was associated with lower testosterone and alanine aminotransferase levels. Otherwise, cross-sex hormone administration in adolescents was not associated with significant differences in the selected metabolic parameters over time.

Despite research exploring autism in gender-diverse adolescents, no studies have elicited these individuals' perspectives. In-depth interviews with 22 well-characterized autistic gender-diverse adolescents revealed critical themes, including: recollections of pre-pubertal gender nonconformity; vivid experiences of gender dysphoria; a fear of social gender expression due to perceived animosity toward transgender people; and specific challenges that result from the interplay of gender diversity and neurodiversity. During the ~ 22 month study social gender affirmation increased in six participants and gender dysphoria attenuated in four participants. Given the ethical imperative to understand and prioritize the voiced perspectives and needs of autistic gender minority adolescents as well as the discovery of shared themes and experiences in this population, results should inform clinical research approaches and priorities.

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