Optimising Pre-Eclampsia Screening in Black Women; a Secondary Analysis of Data from Non-Intervention Screening Studies.

IF 2.4 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Journal of Racial and Ethnic Health Disparities Pub Date : 2025-10-07 DOI:10.1007/s40615-025-02680-7

Anastasija Arechvo, Argyro Syngelaki, Moritz Döbert, Anna Nektaria Varouxaki, Min Yi Tan, Liona Poon, Peter von Dadelszen, Kypros H Nicolaides, Laura A Magee

{"title":"Optimising Pre-Eclampsia Screening in Black Women; a Secondary Analysis of Data from Non-Intervention Screening Studies.","authors":"Anastasija Arechvo, Argyro Syngelaki, Moritz Döbert, Anna Nektaria Varouxaki, Min Yi Tan, Liona Poon, Peter von Dadelszen, Kypros H Nicolaides, Laura A Magee","doi":"10.1007/s40615-025-02680-7","DOIUrl":null,"url":null,"abstract":"Objective: To compare pre-eclampsia screening strategies among Black vs. White ethnicity women.Methods: Using data from prospective non-intervention cohort studies in Europe, we evaluated pre-eclampsia risk in singleton pregnancies. Risk was determined by clinical risk factor screening ('clinical'), 'clinical' with Black ethnicity as a moderate-risk factor ('clinical-modified'), and the Fetal Medicine Foundation competing-risks model at 11-13 weeks' gestation ('model11-13 ' for preterm pre-eclampsia) and 35-36 weeks ('model35-36 ' for late preterm/term pre-eclampsia). To compare screening performance, models' screen-positive rates were adjusted to match 'clinical' screening.Results: At 11-13 weeks, 61,174 pregnancies were screened; preterm pre-eclampsia occurred in 493 (0.8%). At an overall 11.2% screen-positive-rate, 'model11-13 ' (vs. 'clinical') detection of preterm pre-eclampsia almost doubled for Black (88.0% from 46.4%) and White (66.4% from 36.7%) women. For 'clinical-modified', the overall screen-positive-rate was 18.5% and the detection rate for 'model11-13 ' (vs. 'clinical-modified') was 94.0% from 85.0% for Black women, and 77.3% from 36.7% for White. At 35-36 weeks, 29,035 pregnancies were screened; subsequent pre-eclampsia occurred in 654 (2.3%). At an overall 10.9% screen-positive-rate, 'model35-36 ' (vs. 'clinical') detection of pre-eclampsia more than doubled for both Black (74.8% from 26.2%) and White (69.6% from 33.1%) women. For 'clinical-modified', the overall screen-positive-rate was 15.5% and the detection rate for 'model35-36 ' (vs. 'clinical-modified') was 84.1% from 85.0% for Black women, and 78.5% from 33.1% for White.Conclusions: The screening performance of the competing-risks model is superior to that of clinical risk factor screening without and with addition of Black ethnicity as a moderate clinical risk factor.","PeriodicalId":16921,"journal":{"name":"Journal of Racial and Ethnic Health Disparities","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Racial and Ethnic Health Disparities","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40615-025-02680-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: To compare pre-eclampsia screening strategies among Black vs. White ethnicity women.

Methods: Using data from prospective non-intervention cohort studies in Europe, we evaluated pre-eclampsia risk in singleton pregnancies. Risk was determined by clinical risk factor screening ('clinical'), 'clinical' with Black ethnicity as a moderate-risk factor ('clinical-modified'), and the Fetal Medicine Foundation competing-risks model at 11-13 weeks' gestation ('model_11-13 ' for preterm pre-eclampsia) and 35-36 weeks ('model_35-36 ' for late preterm/term pre-eclampsia). To compare screening performance, models' screen-positive rates were adjusted to match 'clinical' screening.

Results: At 11-13 weeks, 61,174 pregnancies were screened; preterm pre-eclampsia occurred in 493 (0.8%). At an overall 11.2% screen-positive-rate, 'model_11-13 ' (vs. 'clinical') detection of preterm pre-eclampsia almost doubled for Black (88.0% from 46.4%) and White (66.4% from 36.7%) women. For 'clinical-modified', the overall screen-positive-rate was 18.5% and the detection rate for 'model_11-13 ' (vs. 'clinical-modified') was 94.0% from 85.0% for Black women, and 77.3% from 36.7% for White. At 35-36 weeks, 29,035 pregnancies were screened; subsequent pre-eclampsia occurred in 654 (2.3%). At an overall 10.9% screen-positive-rate, 'model_35-36 ' (vs. 'clinical') detection of pre-eclampsia more than doubled for both Black (74.8% from 26.2%) and White (69.6% from 33.1%) women. For 'clinical-modified', the overall screen-positive-rate was 15.5% and the detection rate for 'model_35-36 ' (vs. 'clinical-modified') was 84.1% from 85.0% for Black women, and 78.5% from 33.1% for White.

Conclusions: The screening performance of the competing-risks model is superior to that of clinical risk factor screening without and with addition of Black ethnicity as a moderate clinical risk factor.

查看原文本刊更多论文

黑人妇女子痫前期筛查的优化非干预筛查研究数据的二次分析。

目的：比较黑人和白人妇女子痫前期筛查策略。方法：使用来自欧洲前瞻性非干预队列研究的数据，我们评估了单胎妊娠的先兆子痫风险。风险是通过临床风险因素筛选（“临床”），“临床”将黑人作为中等风险因素（“临床修改”），以及胎儿医学基金会在妊娠11-13周（“模型11-13”用于早产先兆子痫）和35-36周（“模型35-36”用于晚期早产/足月先兆子痫）时的竞争风险模型来确定的。为了比较筛查表现，调整模型的筛查阳性率以匹配“临床”筛查。结果：在11-13周时，筛查了61,174例妊娠；早产子痫前期493例（0.8%）。总体筛查阳性率为11.2%，“模型11-13”(vs。黑人女性（88.0%,46.4%）和白人女性（66.4%,36.7%）的早产子痫前期（临床）检出率几乎翻了一番。对于“临床改良型”，总体筛查阳性率为18.5%，“11-13型”的检出率(vs。“临床改良”)黑人女性为94.0%，白人女性为77.3%，白人女性为36.7%。在35-36周时，对29,035名孕妇进行了筛查；654例（2.3%）发生子痫前期。总体筛查阳性率为10.9%，“35-36型”(vs。黑人女性（从26.2%增至74.8%）和白人女性（从33.1%增至69.6%）的先兆子痫“临床”检出率都增加了一倍多。对于“临床改良型”，总体筛查阳性率为15.5%，“35-36型”的检出率(vs。“临床改良”)黑人女性从85.0%上升到84.1%，白人女性从33.1%上升到78.5%。结论：竞争风险模型的筛查效果优于不加入和加入黑人作为中度临床危险因素的临床危险因素筛查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

7.30

自引率

5.10%

发文量

263

期刊介绍： Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.