Social vulnerability and prenatal diagnosis

Insaf Kouba; Jaclyn Del Pozzo; Alejandro Alvarez; Nathan A. Keller; Alexis Palmer; Luis A. Bracero; Matthew J. Blitz

doi:10.1515/jpm-2024-0177

Article

Social vulnerability and prenatal diagnosis

Insaf Kouba , Jaclyn Del Pozzo , Alejandro Alvarez , Nathan A. Keller , Alexis Palmer , Luis A. Bracero and Matthew J. Blitz

Published/Copyright: August 19, 2024

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From the journal Journal of Perinatal Medicine Volume 52 Issue 8

Abstract

Objectives

There are limited data on how neighborhood-level risk factors affect the likelihood of having prenatal diagnosis. Neighborhood social vulnerability can be quantified and ranked using the social vulnerability index (SVI), a tool that measures the cumulative effect of external stressors in the local environment that may affect health outcomes. The objective of the study was to determine the relationship between SVI and prenatal diagnosis among pregnant patients who received genetic counseling.

Methods

Retrospective cohort study of all pregnant patients who had genetic counseling at two hospitals in New York between January 2019 and December 2022. For each patient, the address of residence was linked to an SVI score (primary exposure) based on census tract. SVI scores were subdivided into fifths and analyzed categorically. The primary outcome was prenatal diagnosis (yes/no). Multivariable logistic regression was performed.

Results

A total of 5,935 patients were included for analysis and 231 (3.9 %) had prenatal diagnosis. On regression analysis, no association between SVI and prenatal diagnosis was observed. Patients who had a diagnostic procedure were more likely to be English speaking (aOR 1.80; 95 % CI 1.13–2.87), carriers of a genetic disorder (aOR 1.94; 95 % CI 1.32–2.86), had increased NT (aOR 6.89; 95 % CI 3.65–13.00), abnormal NIPS (aOR 9.58; 95 % CI 5.81–15.80), or had fetal structural anomalies (aOR 10.60; 95 % CI 6.62–16.96). No differences were seen based on race and ethnicity group, insurance type, or marital status.

Conclusions

SVI score does not affect rate of prenatal diagnosis. Findings may differ in other geographic regions and populations.

Keywords: amniocentesis; chorionic villi sampling; genetic counseling; prenatal diagnosis; social vulnerability index

Corresponding author: Insaf Kouba, MD, Northwell, 2000 Marcus Ave, Suite 300, New Hyde Park, NY 11042-1069, USA; Department of Obstetrics and Gynecology, South Shore University Hospital, Bay Shore, NY, USA; and Zucker School of Medicine, Hempstead, NY, USA, E-mail: ikouba@northwell.edu

Acknowledgments

This research was presented at the International Society for Prenatal Diagnosis (ISPD) 27th International Conference on Prenatal Diagnosis and Therapy in Edinburgh, UK, in June 2023 (Virtual Presentation).

Research ethics: The Northwell Health Institutional Review Board approved this study as minimal-risk research using data collected for routine clinical practice.
Informed consent: The Northwell Health Institutional Review Board waived the requirement for informed consent.
Author contributions: Insaf Kouba: Investigation, Methodology, Writing: original draft writing, review & editing. Jaclyn Del Pozzo: Writing: review & editing. Alejandro Alvarez: analysis and interpretation of results. Nathan A. Keller: Investigation, Writing: review & editing. Alexis Palmer: data collection. Luis A. Bracero: Investigation, Methodology, Writing: review & editing. Matthew J. Blitz: Investigation, Methodology, Resources, Supervision, Writing: review & editing. All authors reviewed the results and approved the final version of the manuscript.
Competing interests: The authors state no conflict of interest.
Research funding: The authors report no financial support.
Data availability: The raw data can be obtained on request from the corresponding author.

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Received: 2024-04-16

Accepted: 2024-07-31

Published Online: 2024-08-19

Published in Print: 2024-10-28

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Articles in the same Issue

https://doi.org/10.1515/jpm-2024-0177

Keywords for this article

amniocentesis; chorionic villi sampling; genetic counseling; prenatal diagnosis; social vulnerability index