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Kouba I, Del Pozzo J, Alvarez A, Keller NA, Palmer A, Bracero LA, Blitz MJ. Social vulnerability and prenatal diagnosis. J Perinat Med 2024; 0:jpm-2024-0177. [PMID: 39155568 DOI: 10.1515/jpm-2024-0177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 07/31/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVES There are limited data on how neighborhood-level risk factors affect the likelihood of having prenatal diagnosis. Neighborhood social vulnerability can be quantified and ranked using the social vulnerability index (SVI), a tool that measures the cumulative effect of external stressors in the local environment that may affect health outcomes. The objective of the study was to determine the relationship between SVI and prenatal diagnosis among pregnant patients who received genetic counseling. METHODS Retrospective cohort study of all pregnant patients who had genetic counseling at two hospitals in New York between January 2019 and December 2022. For each patient, the address of residence was linked to an SVI score (primary exposure) based on census tract. SVI scores were subdivided into fifths and analyzed categorically. The primary outcome was prenatal diagnosis (yes/no). Multivariable logistic regression was performed. RESULTS A total of 5,935 patients were included for analysis and 231 (3.9 %) had prenatal diagnosis. On regression analysis, no association between SVI and prenatal diagnosis was observed. Patients who had a diagnostic procedure were more likely to be English speaking (aOR 1.80; 95 % CI 1.13-2.87), carriers of a genetic disorder (aOR 1.94; 95 % CI 1.32-2.86), had increased NT (aOR 6.89; 95 % CI 3.65-13.00), abnormal NIPS (aOR 9.58; 95 % CI 5.81-15.80), or had fetal structural anomalies (aOR 10.60; 95 % CI 6.62-16.96). No differences were seen based on race and ethnicity group, insurance type, or marital status. CONCLUSIONS SVI score does not affect rate of prenatal diagnosis. Findings may differ in other geographic regions and populations.
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Affiliation(s)
- Insaf Kouba
- Northwell, New Hyde Park, NY, USA
- Department of Obstetrics and Gynecology, South Shore University Hospital, Bay Shore, NY, USA
- Zucker School of Medicine, Hempstead, NY, USA
| | - Jaclyn Del Pozzo
- Northwell, New Hyde Park, NY, USA
- Department of Obstetrics and Gynecology, South Shore University Hospital, Bay Shore, NY, USA
- Zucker School of Medicine, Hempstead, NY, USA
| | - Alejandro Alvarez
- Northwell, New Hyde Park, NY, USA
- Biostatistics Unit, Office of Academic Affairs, Northwell Health, New Hyde Park, NY, USA
| | - Nathan A Keller
- Northwell, New Hyde Park, NY, USA
- Department of Obstetrics and Gynecology, South Shore University Hospital, Bay Shore, NY, USA
- Zucker School of Medicine, Hempstead, NY, USA
| | - Alexis Palmer
- Northwell, New Hyde Park, NY, USA
- Department of Obstetrics and Gynecology, South Shore University Hospital, Bay Shore, NY, USA
- Zucker School of Medicine, Hempstead, NY, USA
| | - Luis A Bracero
- Northwell, New Hyde Park, NY, USA
- Department of Obstetrics and Gynecology, South Shore University Hospital, Bay Shore, NY, USA
- Zucker School of Medicine, Hempstead, NY, USA
| | - Matthew J Blitz
- Northwell, New Hyde Park, NY, USA
- Department of Obstetrics and Gynecology, South Shore University Hospital, Bay Shore, NY, USA
- Zucker School of Medicine, Hempstead, NY, USA
- Institute of Health Systems Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
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Yanikkerem E, Ay S, Çiftçi AY, Ustgorul S, Goker A. A survey of the awareness, use and attitudes of women towards Down syndrome screening. J Clin Nurs 2012; 22:1748-58. [DOI: 10.1111/j.1365-2702.2012.04333.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2012] [Indexed: 11/28/2022]
Affiliation(s)
| | - Semra Ay
- Vocational School of Health; Celal Bayar University; Manisa
| | | | - Sema Ustgorul
- Psychiatry Department; Faculty of Medicine; Celal Bayar University; Manisa
| | - Asli Goker
- Faculty of Medicine; Department of Obstetrics and Gynecology; Celal Bayar University; Manisa; Turkey
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Duwe KN, Reefhuis J, Honein MA, Schieve LA, Rasmussen SA. Epidemiology of Fertility Treatment Use Among U.S. Women with Liveborn Infants, 1997–2004. J Womens Health (Larchmt) 2010; 19:407-16. [DOI: 10.1089/jwh.2009.1499] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kara N. Duwe
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Jennita Reefhuis
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Margaret A. Honein
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Laura A. Schieve
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sonja A. Rasmussen
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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Sher C, Romano-Zelekha O, Green MS, Shohat T. Utilization of prenatal genetic testing by Israeli Moslem women: a national survey. Clin Genet 2004; 65:278-83. [PMID: 15025719 DOI: 10.1111/j.1399-0004.2004.00228.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The number of prenatal genetic tests that are being offered to women is constantly increasing. However, there is little national data as to who is performing the tests and the reasons for doing or not doing so. The aim of the study was to evaluate the proportion of Israeli Moslem women who perform the various prenatal genetic tests and the factors affecting the performance of these tests. A 2-day survey was conducted in all the maternity departments in Israel based on a structured interview. Of the 242 women interviewed, 74.2% underwent the triple test (TT), 15.8% of the women older than 35 years who were eligible to take the test free of charge underwent amniocentesis and only 1.5% underwent fragile-X (FX) carrier testing which costs 100 dollars privately. In the stepwise regression analysis, having fewer children and having had a higher education affected the performance of the TT. None of the sociodemographic factors were associated with the performance of amniocentesis or FX carrier testing, but the sample sizes were small. The main reason reported by the women for not performing the TT and FX carrier testing was not being referred for testing. The main reason for not performing amniocentesis was that they chose not to perform the test (the majority of these women were religious or ultrareligious). Consideration should be given to providing first-trimester prenatal diagnosis when termination of pregnancy in the Moslem population is more acceptable. In addition, consideration should be given to including state-subsidized FX testing as there is a low rate of FX testing partly due to the cost. Primary care givers should be educated about the importance of prenatal genetic testing.
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Affiliation(s)
- C Sher
- Institute of Medical Genetics, Asaf Harofeh Medical Center, Zerifin, Israel.
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Sher C, Romano-Zelekha O, Green MS, Shohat T. Factors affecting performance of prenatal genetic testing by Israeli Jewish women. Am J Med Genet A 2003; 120A:418-22. [PMID: 12838566 DOI: 10.1002/ajmg.a.20047] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The number of prenatal genetic tests that are being offered to women is constantly increasing. However, there is little national data as to who is performing the tests and the reasons for doing or not doing so. This study evaluated the proportion of Jewish women in Israel who perform the various prenatal genetic tests and the factors affecting the performance of these tests. It was found that 60.9% of the women performed the triple test, 50.8% of women older than 35 years performed amniocentesis, while 63.3 and 24.3% of women performed Tay-Sachs and fragile-X carrier testing respectively. Ninety-six percent of the secular women compared to only 6.7% of the ultrareligious women performed the triple test. It was also found that94.4% of the secular women, 36.4% of the religious, and none of the ultrareligious women older than 35 years performed amniocentesis. In the stepwise regression analysis, being secular, having a higher income, fewer children, and being of Ashkenazi origin remained significant factors in determining performance of Tay-Sachs carrier testing. As regards fragile-X carrier testing, being secular, having fewer than four children, and having a higher income and a supplementary medical insurance remained significant factors. The main reason reported by the women for not performing amniocentesis or the triple test was for religious or moral grounds (53.3 and 67% respectively). The main reason given for not performing Tay-Sachs or fragile-X testing was that they were not referred for the tests (76 and 82% respectively). Consideration should be given to providing first trimester prenatal diagnosis to the ultrareligious group, including state subsidized fragile-X testing and educating the primary care givers about the importance of prenatal genetic testing. The information from the present study is vital for the planning of an equitable prenatal genetic service and provides guidelines for the implementation of such services in other countries.
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Affiliation(s)
- Carron Sher
- Institute of Medical Genetics, Asaf Harofeh Medical Center, Zerifin, Israel.
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