Prenatal hemoglobinopathy screening practices: Areas for improvement
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Published on: January 19, 2024
Jessica E Briggs1, Ellen Fraint1, Ellen J Silver2
1Division of Pediatric Hematology, Oncology, and Cellular Therapy, Children's Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY, 10467, USA.
Objective:
To assess prenatal hemoglobinopathy screening practice patterns by Obstetrics & Gynecology (OB/GYN) and Family Medicine (FM) providers in the New York City regional area.
Study Design:
A cross-sectional electronic survey on screening practices using case scenarios was administered to OB/GYN and FM providers from six institutions. Chi-square analyses were used to compare the two provider groups on categorical variables.
Results:
Of 167 total responses; 122 were complete, with 87 OB/GYN and 33 FM. 42 % reported they ask "76-100 %" of patients about a personal history of sickle cell disease (SCD) or trait. Over 73 % report that they "always" screen patients of Mediterranean, Asian, and Middle Eastern descent, and 84 % always screen patients of Black/African American descent. Over 30 % would use SICKLEDEX screening in case scenarios for a Black/African American pregnant patient.
Conclusion:
This survey highlights differences in prenatal hemoglobinopathy screening practices based on provider type. This can lead to variations in prenatal guidance, diagnostic procedures, informed decision-making and knowledge of families referred to pediatric hematology clinics. Prenatal providers need to be educated that the use of SICKLEDEX is an inappropriate laboratory screening test since it will not detect all hemoglobinopathies.
