Racial and ethnic disparities in universal cervical length screening with transvaginal ultrasound.

TitleRacial and ethnic disparities in universal cervical length screening with transvaginal ultrasound.
Publication TypeJournal Article
Year of Publication2016
AuthorsHaviland MJ, Shainker SA, Hacker MR, Burris HH
JournalJ Matern Fetal Neonatal Med
Date Published2016 Dec
KeywordsAdult, African Americans, Asian Continental Ancestry Group, Cervical Length Measurement, Cervix Uteri, Chi-Square Distribution, Continental Population Groups, Delayed Diagnosis, European Continental Ancestry Group, Female, Health Status Disparities, Hispanic Americans, Humans, Insurance Coverage, Mass Screening, Massachusetts, Pregnancy, Pregnancy Complications, Retrospective Studies, Young Adult

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.

Alternate JournalJ. Matern. Fetal. Neonatal. Med.
PubMed ID26987873
PubMed Central IDPMC5027177
Grant ListK23 ES022242 / ES / NIEHS NIH HHS / United States
UL1 TR001102 / TR / NCATS NIH HHS / United States