Pregnancy perinatal complications.

Introduction
Only 34% of Canadian surgeons in 2022 were female. The protracted length of surgical residency training, concerns regarding infertility, and increased rates of obstetrical complications have been shown to contribute to the disproportionate lack of females in surgical specialties.
Methods
A novel online survey was sent to all surgical residents in Canada. Respondents were asked about perceptions of pregnancy and parenthood during surgical training, and parents were asked about parental leave, accommodations they received, and pregnancy complications. Chi squared tests were used to compare opinions of male and female residents.
Results
A total of 272/2,419 (11.2%) responses were obtained, with a high response from females (61.8%) and orthopaedic residents (29.0%). There were 56 women reporting 76 pregnancy events during training, 62.5% of which had complications. Notably, 27.3% of men and 86.7% of women ‘agreed’ or ‘strongly agreed’ that surgeons have higher pregnancy complication rates than the general population (p<0.001). Men were much less likely to believe that pregnant residents should be offered modified duties (74.2% of men, 90.0% of women, p = 0.003). Women were much more likely to experience significant stigma or bias due to their status as a parent (43% of women, 0% of men, p<0.001). Women reported negative comments from others at a higher rate (58.5% of women, 40.7% of men, p = 0.013). Women believe there is negative stigma attached to being pregnant during training (62.7% of women, 42.7% of men, p = 0.01). The limitations of our study include a small sample size and response bias.
Conclusion
Challenges and negative perceptions exist around pregnancy and parenthood in surgical residency, which disproportionately affect women trainees.

Introduction
2022年加拿大外科医师中女性占比仅为34%。既往研究表明，外科住院医师培训周期冗长、不孕相关顾虑以及产科并发症发生率升高，均是导致外科专科领域女性占比严重偏低的重要因素。
Methods
本研究设计新型线上问卷，面向加拿大所有外科住院医师发放。问卷内容涵盖受访者对外科培训期间妊娠与育儿的认知；对于已为人父母的受访者，额外询问其育儿假、所获职场适配措施（accommodations）及妊娠并发症相关情况。采用卡方检验（Chi squared tests）比较男女住院医师的观点差异。
Results
本研究共回收有效问卷272份，总回收率为11.2%（272/2419），其中女性受访者占比偏高（61.8%），骨科住院医师占比为29.0%。共有56名女性受访者报告了培训期间共计76次妊娠事件，其中62.5%发生了并发症。值得注意的是，27.3%的男性住院医师与86.7%的女性住院医师“同意”或“完全同意”外科医师的妊娠并发症发生率高于普通人群（p<0.001）。男性住院医师更不认同应为妊娠住院医师提供调整型工作任务（仅74.2%的男性持支持态度，女性支持率为90.0%，p=0.003）。女性住院医师因为人父母的身份遭遇严重污名化或偏见的比例显著更高（43%的女性报告此类经历，男性为0%，p<0.001）。女性受访者报告遭受他人负面评价的比例更高（58.5%的女性报告，男性为40.7%，p=0.013）。女性住院医师普遍认为培训期间妊娠会面临负面污名（62.7%的女性持该观点，男性为42.7%，p=0.01）。本研究的局限性包括样本量较小及存在应答偏倚。
Conclusion
外科住院医师培训期间，妊娠与育儿相关挑战及负面认知普遍存在，且对女性受训者造成了不成比例的负面影响。