Miriam J Haviland1, Scott A Shainker1,2, Michele R Hacker1,2, Heather H Burris3,4. 1. a Department of Obstetrics and Gynecology , Beth Israel Deaconess Medical Center , Boston , MA, USA . 2. b Department of Obstetrics , Gynecology, and Reproductive Biology, Harvard Medical School , Boston , MA, USA . 3. c Department of Neonatology , Beth Israel Deaconess Medical Center , Boston , MA, USA , and. 4. d Department of Pediatrics , Harvard Medical School , Boston , MA, USA.
Abstract
OBJECTIVE: Determine if race or ethnicity is associated with missed or late transvaginal cervical length screening in a universal screening program. METHODS: Retrospective cohort study of nulliparous women with singleton gestations and a fetal anatomical ultrasound from 16-24 weeks' gestation from January 2012 to November 2013. We classified women into mutually exclusive racial and ethnic groups: non-Hispanic black (black), Hispanic, Asian, non-Hispanic white (white), and other or unknown race. We used log-binomial regression to calculate the risk ratio (RR) and 95% confidence interval (CI) of missed or late (≥20 weeks' gestation) screening versus optimally timed screening between the different racial and ethnic groups. RESULTS: Among the 2967 women in our study population, 971 (32.7%) had either missed or late cervical length screening. Compared to white women, black (RR: 1.3; 95% CI: 1.1-1.5) and Hispanic (RR:1.2; 95% CI: 1.01-1.5) women were more likely to have missed or late screening. Among women screened, black (versus white) women were more likely to be screened late (RR: 2.2; 95% CI: 1.6-3.1). CONCLUSIONS: Black and Hispanic women may be more likely to have missed or late cervical length screenings.
OBJECTIVE: Determine if race or ethnicity is associated with missed or late transvaginal cervical length screening in a universal screening program. METHODS: Retrospective cohort study of nulliparous women with singleton gestations and a fetal anatomical ultrasound from 16-24 weeks' gestation from January 2012 to November 2013. We classified women into mutually exclusive racial and ethnic groups: non-Hispanic black (black), Hispanic, Asian, non-Hispanic white (white), and other or unknown race. We used log-binomial regression to calculate the risk ratio (RR) and 95% confidence interval (CI) of missed or late (≥20 weeks' gestation) screening versus optimally timed screening between the different racial and ethnic groups. RESULTS: Among the 2967 women in our study population, 971 (32.7%) had either missed or late cervical length screening. Compared to white women, black (RR: 1.3; 95% CI: 1.1-1.5) and Hispanic (RR:1.2; 95% CI: 1.01-1.5) women were more likely to have missed or late screening. Among women screened, black (versus white) women were more likely to be screened late (RR: 2.2; 95% CI: 1.6-3.1). CONCLUSIONS: Black and Hispanic women may be more likely to have missed or late cervical length screenings.
Entities:
Keywords:
Antenatal screening; racial/ethnic disparity; risk of preterm birth; transvaginal cervical length screening; universal screening program
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