Integrated and first trimester prenatal screening in California: program implementation and patient choice for follow‐up services

Currier, Robert; Wu, Nerissa; Meter, Karla Van; Goldman, Sara; Lorey, Fred; Flessel, Monica

doi:10.1002/pd.3961

Cited by 39 publications

(49 citation statements)

References 9 publications

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“…We also broaden analyses to include maternal serum biomarkers that are routinely collected as part of prenatal screening for aneuploidies and neural tube defects in many developed and developing countries. 23;31–33 Given close ties between these markers and placental function 34–37 and the well-documented association between many of these markers and PTB, 25;38–41 we believe these data may yield important information about risk across PTB subtypes.…”

Section: Introductionmentioning

confidence: 89%

Maternal characteristics and mid‐pregnancy serum biomarkers as risk factors for subtypes of preterm birth

Jelliffe-Pawlowski

Baer

Blumenfeld

et al. 2015

BJOG

105

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Objective To examine the relationship between maternal characteristics, serum biomarkers, and preterm birth (PTB) by spontaneous and medically-indicated subtypes. Design Population-based cohort. Setting California, United States of America. Population From a total population of 1,004,039 live singleton births in 2009 and 2010, 841,665 pregnancies with linked birth certificate and hospital discharge records were included. Methods Characteristics were compared for term and preterm deliveries by PTB subtype using logistic regression and odds ratios adjusted for maternal characteristics and obstetric factors present in final stepwise models (adjORs) and 95% confidence intervals (CIs). First and second trimester serum marker levels were analyzed in a subset of 125,202 pregnancies with available first and second trimester serum biomarker results. Main Outcome Measure PTB by subtype. Results In fully adjusted models, ten characteristics and three serum biomarkers were associated with increased risk in each PTB subtype (Black race/ethnicity, preexisting hypertension with and without preeclampsia, gestational hypertension with preeclampsia, preexisting diabetes, anemia, previous PTB, one or ≥ two previous cesarean section(s), interpregnancy interval ≥ 60 months, low first trimester pregnancy-associated plasma protein A, high second trimester alpha-fetoprotein, and high second trimester dimeric inhibin A). These risks occurred in 51.6 to 86.2% of all pregnancies ending in PTB depending on subtype. The highest risk observed was for medically-indicated PTB < 32 weeks in women with preexisting hypertension and preeclampsia (adjOR 89.7, 27.3 – 111.2). Conclusions Our findings suggest a shared etiology across PTB subtypes. These commonalities point to targets for further study and exploration of risk reduction strategies.

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Section: Introductionmentioning

confidence: 89%

Maternal characteristics and mid‐pregnancy serum biomarkers as risk factors for subtypes of preterm birth

Jelliffe-Pawlowski

Baer

Blumenfeld

et al. 2015

BJOG

105

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“…Results were reported as multiples of the median adjusted for gestational age, maternal weight, race or ethnicity, smoking status, and pre-existing diabetes. 2 First-trimester risk assessment was provided for trisomy 21 and trisomy 18. Risk was calculated using a previously described algorithm.…”

Section: Methodsmentioning

confidence: 99%

“…Second-trimester screening has been offered for decades, and first-trimester screening options have been in place since 2009. 2 Detection rates for second-trimester screening in California have been previously reported. 3,4 This report summarizes outcomes for women who underwent first-trimester or sequential (first-and secondtrimester) screening.…”

mentioning

confidence: 97%

Detection Rates for Aneuploidy by First-Trimester and Sequential Screening

Baer

Flessel

Jelliffe‐Pawlowski

et al. 2015

Obstetrics &Amp; Gynecology

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“…More recent data from the San Francisco Bay area, in California, indicate no significant racial/ethnic differences in uptake of prenatal screening and testing among women under 35; among women 35 and over, only non-Hispanic African Americans were significantly more likely than women of other races/ethnicities to refuse all prenatal screening and testing (Kuppermann et al, 2006). Prior to the introduction of cfDNA screening, Latinas and Asian women who received a initial positive results from the “California screen” accepted referrals for genetic counseling at a higher rate than non-Hispanic white women; but after genetic counseling, Latinas chose invasive testing at roughly half the rate of either non-Hispanic whites or Asians (Currier et al, 2012). An early report on the introduction of cfDNA screening in California found that its availability led to higher uptake of follow-up testing in women with elevated risk pregnancies (particularly Latinas), and a reduction in invasive diagnostic testing—but Latinas were still more likely than other groups to refuse all follow-up testing (Chetty et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Spanish‐ and English‐Speaking Pregnant Women's Views on cfDNA and Other Prenatal Screening: Practical and Ethical Reflections

Floyd

Allyse²,

Michie

2016

Journal of Genetic Counseling

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The rapid clinical implementation of cell-free DNA (cfDNA) screening, a non-invasive method of prenatal genetic screening, has outpaced research on its social and ethical implications. This study is the first to compare the ethical and practical views of Spanish- and English-speaking pregnant women in the United States about cfDNA screening. Semi-structured interviews were conducted with diverse Spanish- and English-speaking women who had received prenatal care at a large academic medical center. Of the 24 interviewees, ten were Latinas who were interviewed in Spanish; English-language interviews were conducted with seven non-Hispanic Asian and seven non-Hispanic White women. Participants held positive opinions concerning the accuracy of cfDNA screening and often noted that it would enhance preparedness. Participants also expressed concerns about the possibility of inaccurate results and the potentially negative effects of cfDNA screening on the experience of pregnancy. Differences emerged between Spanish and English speakers in their portrayals of their relationships with prenatal health care providers, the extent to which they questioned providers’ advice, their ethical concerns, and their informational needs. We emphasize the importance of customizing prenatal test counseling to the needs of the individual patient, providing educationally appropriate counseling and literature, and mitigating potential language barriers.

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Integrated and first trimester prenatal screening in California: program implementation and patient choice for follow‐up services

Cited by 39 publications

References 9 publications

Maternal characteristics and mid‐pregnancy serum biomarkers as risk factors for subtypes of preterm birth

Maternal characteristics and mid‐pregnancy serum biomarkers as risk factors for subtypes of preterm birth

Detection Rates for Aneuploidy by First-Trimester and Sequential Screening

Spanish‐ and English‐Speaking Pregnant Women's Views on cfDNA and Other Prenatal Screening: Practical and Ethical Reflections

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