The Effect of Self-Reported Race on Noninvasive Prenatal Screening Test Characteristics.

IF 1.5 4区医学 Q3 OBSTETRICS & GYNECOLOGY American journal of perinatology Pub Date : 2024-08-29 DOI:10.1055/s-0044-1789573

Anjali N Mitra, Aleksei Dingel, Teodora Kolarova, Hayley J MacKinnon, Ronit Katz, Christina M Lockwood, Raj Shree

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Abstract

Objective: Low fetal fraction (FF) on cell-free DNA (cfDNA)-based noninvasive prenatal screening (NIPS) is a common etiology for indeterminate results. As maternal Black race is implicated as a risk factor for low FF and more indeterminate results, we sought to evaluate this association.

Study design: This was a single-institution, retrospective cohort study of cfDNA-based NIPS performed between May 2017 and May 2022 with complete clinical data abstraction. We compared FF, indeterminate rates, and total cfDNA concentration among self-reported Black, White, and Other groups from NIPS results from 2017 to 2022 with full clinical data abstraction. Using linear regression and interaction testing, we evaluated associations between self-reported race, FF, indeterminate rate, and total cfDNA concentration.

Results: In total, 1,591 participants met the inclusion criteria; 70.8% (n = 1,126) self-identified as White, 6.9% (n = 110) as Black, and 22.3% (n = 355) self-identified with another race. Mean FF was not different between the White, Black, or Other groups (11.8 vs. 11.2 vs. 11.7%, respectively, p = 0.52). This remained true after adjusting for body mass index (BMI), gestational age (GA) at draw, and fetal sex (all p > 0.17). Interaction testing for FF and total cfDNA by race with BMI, GA at draw, and fetal sex demonstrated no effect modification.

Conclusion: In our population, maternal self-identified race, particularly Black race, does not affect FF. Biological plausibility for race-based differences on clinical tests requires ongoing thoughtful consideration.

Key points: · NIPS is widely used to screen for fetal aneuploidy.. · FF is an important test metric, and low FF is associated with adverse outcomes, like aneuploidy.. · In existing studies, Black race is implicated as a risk factor for lower FF.. · Our study found no differences in FF between groups by self-reported race.. · Biological plausibility for race-based differences on clinical tests requires ongoing consideration..

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自我描述的种族对无创产前筛查测试特征的影响》（The Effect of Self-Reported Race on Noninvasive Prenatal Screening Test Characteristics）。

目的：基于无细胞 DNA（cfDNA）的无创产前筛查（NIPS）中胎儿组分（FF）过低是导致结果不确定的常见原因。由于母亲的黑人种族被认为是低 FF 和更多不确定结果的风险因素，我们试图评估这种关联：这是一项单一机构的回顾性队列研究，研究对象是在 2017 年 5 月至 2022 年 5 月期间进行的基于 cfDNA 的 NIPS，并对临床数据进行了完整的抽取。我们比较了2017年至2022年NIPS结果中自我报告的黑人、白人和其他群体的FF、不确定率和cfDNA总浓度，并摘录了完整的临床数据。通过线性回归和交互检验，我们评估了自报种族、FF、未确定率和 cfDNA 总浓度之间的关联：共有 1,591 名参与者符合纳入标准；70.8%（n = 1,126 人）自我认同为白人，6.9%（n = 110 人）自我认同为黑人，22.3%（n = 355 人）自我认同为其他种族。白人、黑人或其他种族群体之间的平均 FF 没有差异（分别为 11.8 vs. 11.2 vs. 11.7%，p = 0.52）。在对体重指数（BMI）、抽血时的胎龄（GA）和胎儿性别进行调整后，情况依然如此（均 p > 0.17）。按种族进行的FF和cfDNA总量与体重指数、抽血时的妊娠年龄和胎儿性别的交互测试表明，没有影响修正：结论：在我们的人群中，孕产妇自我认定的种族，尤其是黑人种族，并不影响FF。临床测试中基于种族的差异的生物学合理性需要不断深思熟虑：- 要点：NIPS 被广泛用于筛查胎儿非整倍体。- FF是一项重要的检测指标，低FF与非整倍体等不良结果有关。- 在现有的研究中，黑人被认为是FF较低的一个风险因素。- 我们的研究发现，根据自我报告的种族，各组间的FF没有差异。- 临床测试中基于种族的差异在生物学上的合理性需要不断考虑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of perinatology 医学-妇产科学

CiteScore

5.90

自引率

0.00%

发文量

302

审稿时长

4-8 weeks

期刊介绍： The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields. The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field. All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication. The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.