Steven T Papastefan, Yuqi Bian, Manmeet Singh, William S Marriott, Joyceline A Ito, Jessica Fry, Aimen F Shaaban, Ashish Premkumar
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引用次数: 0
Abstract
Objective: The objective of this study was to evaluate whether patient-level neighborhood deprivation index (NDI) was associated with termination of pregnancy consideration and completion in patients presenting with fetal myelomeningocele.
Methods: This was a retrospective cohort analysis of patients with fetal myelomeningocele presenting to a fetal treatment center (FTC) in Illinois between 2018 and 2024. The exposure was NDI calculated from patient zip codes. The NDI was analyzed as both a dichotomous and ordinal exposure. The co-primary outcomes were abortion consideration prior to FTC consultation, ascertained by nurse intake, and abortion completion after consultation. Bivariate and log-binomial regression analyses were performed. Covariates were selected based on p < 0.10 on bivariate analyses. Otherwise, p < 0.05 indicated statistical significance.
Results: A total of 157 participants were included. Evaluation of neighborhood deprivation as a dichotomous exposure revealed no association with abortion consideration or completion. AdditionallLy, no association was found on log binomial modeling after controlling for gestational age at presentation to the FTC and maternal race or ethnicity for abortion consideration (aRR 0.87, 95% CI 0.59-1.28) or completion (aRR 0.86, 95% CI 0.59-1.28). These results were similar when treating the NDI as an ordinal exposure.
Conclusions: Contrary to our hypothesis, NDI is not associated with abortion consideration or completion in patients with fetal myelomeningocele.
研究目的本研究旨在评估患者水平的邻里贫困指数(NDI)是否与胎儿脊髓膜膨出症患者终止妊娠的考虑和完成有关:这是一项回顾性队列分析,研究对象是2018年至2024年期间前往伊利诺伊州胎儿治疗中心(FTC)就诊的胎儿脊髓膜膨出症患者。暴露是根据患者邮政编码计算出的NDI。NDI 作为二分法和序数暴露进行分析。共同主要结果是在 FTC 就诊前的流产考虑(由护士接诊确定)和就诊后的流产完成情况。进行了二元和对数二项式回归分析。根据 p 结果选择协变量:共纳入 157 名参与者。将邻里贫困作为二分暴露进行评估后发现,邻里贫困与考虑堕胎或完成堕胎没有关联。此外,在对二项式建模中,在控制了前往 FTC 的妊娠年龄和孕产妇种族或民族后,也未发现堕胎考虑(aRR 0.87,95% CI 0.59-1.28)或堕胎完成(aRR 0.86,95% CI 0.59-1.28)与之相关。当把 NDI 作为一个序数暴露时,这些结果相似:与我们的假设相反,NDI与胎儿脊髓膜膨出症患者考虑流产或完成流产无关。
期刊介绍:
Prenatal Diagnosis welcomes submissions in all aspects of prenatal diagnosis with a particular focus on areas in which molecular biology and genetics interface with prenatal care and therapy, encompassing: all aspects of fetal imaging, including sonography and magnetic resonance imaging; prenatal cytogenetics, including molecular studies and array CGH; prenatal screening studies; fetal cells and cell-free nucleic acids in maternal blood and other fluids; preimplantation genetic diagnosis (PGD); prenatal diagnosis of single gene disorders, including metabolic disorders; fetal therapy; fetal and placental development and pathology; development and evaluation of laboratory services for prenatal diagnosis; psychosocial, legal, ethical and economic aspects of prenatal diagnosis; prenatal genetic counseling