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Racial and ethnic disparities in non-invasive prenatal testing adherence: a retrospective cohort study
Marco LA Verde1, Maria Maddalena Marrapodi2, Carlo Capristo2
1Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University of Campania, Naples, Italy - marco.laverde@unicampania.it.
Minerva Obstetrics and Gynecology
|July 2, 2024
Summary
Non-invasive prenatal testing (NIPT) and first-trimester screening show ethnic disparities. Black, Asian, and Latina women utilized NIPT and screening less, highlighting a need for equitable prenatal care access.
Area of Science:
- Perinatal Medicine
- Genetics
- Public Health
Background:
- Fetal aneuploidies (trisomies 21, 13, 18) are a significant prenatal concern.
- Non-invasive prenatal testing (NIPT) using cell-free DNA (cf-DNA) has transformed chromosomal abnormality screening.
- Understanding NIPT adherence across diverse ethnicities is crucial for addressing prenatal care disparities.
Purpose of the Study:
- To evaluate non-invasive prenatal testing (NIPT) adherence among pregnant women of various ethnicities.
- To identify potential disparities in prenatal care utilization based on ethnic background.
- To assess adherence to first-trimester screening protocols across different ethnic groups.
Main Methods:
- Retrospective, single-center study at a tertiary care university hospital in Italy (March 2021–September 2022).
- Participants categorized by ethnicity (Asian/Pacific Islander, Black, Latina, White, Middle Eastern).
- Comparative analyses included One-Way ANOVA, Tukey's post-hoc tests, and multinomial regression for bias detection.
Main Results:
- Significant disparities in NIPT uptake: Black (0%), Asian/Pacific Islander (9.5%), Latina (7.5%) vs. White (27.5%).
- Lower adherence to first-trimester screening observed in Black (30.4% nuchal translucency, 17.4% combined test) and Asian/Latina groups.
- White pregnancies demonstrated higher adherence to both NIPT and first-trimester screening protocols.
Conclusions:
- Significant ethnic disparities exist in non-invasive prenatal testing (NIPT) and first-trimester screening adherence.
- Lower utilization of cf-DNA testing and screening observed across multiple non-White ethnic groups.
- Targeted interventions and policies are essential to reduce barriers and ensure equitable access to prenatal care for all women.
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