Abstract Purpose This study synthesizes and characterizes pregnancy outcomes and complications among US female physician trainees. Method In this systematic review, the PubMed, Embase, Scopus, Web of Science, and Cochrane databases were searched in May 2024 and May 2025 for peer-reviewed, English-language articles published from January 2000 to May 2025 reporting pregnancy outcomes in US female residents or fellows. Medical Subject Headings and keywords for pregnancy complications, pregnancy outcomes, and women or female physicians were used. Cross-sectional, retrospective, prospective, and case-control studies were included. Opinion articles, editorials, systematic or scoping reviews, and other non–peer-reviewed articles were excluded. Abstracts and full-text articles were screened by 3 investigators. Extracted data were documented in standardized forms. Risk of bias was assessed regarding study population and outcome reporting and summarized using standardized quality assessment tools. Results Of 792 titles and abstracts screened, 10 articles involving 4,891 trainees were included. Eight of these 10 studies described pregnancy outcomes specifically in surgical trainees; all were cross-sectional surveys. The numbers of trainees experiencing pregnancy complications ranged from 38.9% to 56.0%. The most frequently described complication was preterm labor (9 of 10 studies), affecting 5.3% to 22.9% of surveyed trainees. The most cited fetal complication was miscarriage (5 of 10 studies), affecting 20.0% to 28.0% of trainee pregnancies. Other commonly reported complications included preeclampsia or eclampsia, hyperemesis gravidarum, and gestational hypertension. Conclusions Although pregnancy complications appear to be common among female physician trainees, current data on obstetric outcomes in this population remain limited. Most studies focus specifically on surgical trainees and rely on self-reported data, limiting generalizability. Residency programs may consider findings from this review to enhance support for childbearing trainees, although prospective studies are needed to better discern the impact of medical training on maternal and fetal outcomes. Teaser Text Pregnancy often coincides with the demanding years of medical training, yet robust data on pregnancy outcomes among physician trainees remain limited. This systematic review synthesizes and characterizes pregnancy outcomes and complications among US female physician trainees. Ten unique studies involving nearly 5000 trainees were included and findings raise concern for a high frequency of pregnancy complications in this population. Reported overall complication rates ranged from 38.9% to 56.0%, with preterm labor and miscarriage among the most frequently reported outcomes. Interpretation of these findings is limited by confounding factors, study heterogeneity, and reliance on self-reported data, highlighting a notable gap in the existing literature. Nonetheless, these findings underscore persistent challenges faced by childbearing trainees and emphasize the need for prospective, standardized research to better inform residency program policies and support healthier pregnancies during medical training.
Derakshani et al. (2025) studied this question.