Anastasija Arechvo, Argyro Syngelaki, Moritz Döbert, Anna Nektaria Varouxaki, Min Yi Tan, Liona Poon, Peter von Dadelszen, Kypros H Nicolaides, Laura A Magee
{"title":"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。","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":"<p><strong>Objective: </strong>To compare pre-eclampsia screening strategies among Black vs. White ethnicity women.</p><p><strong>Methods: </strong>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<sub>11-13</sub> ' for preterm pre-eclampsia) and 35-36 weeks ('model<sub>35-36</sub> ' for late preterm/term pre-eclampsia). To compare screening performance, models' screen-positive rates were adjusted to match 'clinical' screening.</p><p><strong>Results: </strong>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<sub>11-13</sub> ' (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<sub>11-13</sub> ' (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<sub>35-36</sub> ' (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<sub>35-36</sub> ' (vs. 'clinical-modified') was 84.1% from 85.0% for Black women, and 78.5% from 33.1% for White.</p><p><strong>Conclusions: </strong>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.</p>","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":"{\"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\":\"<p><strong>Objective: </strong>To compare pre-eclampsia screening strategies among Black vs. White ethnicity women.</p><p><strong>Methods: </strong>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<sub>11-13</sub> ' for preterm pre-eclampsia) and 35-36 weeks ('model<sub>35-36</sub> ' for late preterm/term pre-eclampsia). To compare screening performance, models' screen-positive rates were adjusted to match 'clinical' screening.</p><p><strong>Results: </strong>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<sub>11-13</sub> ' (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<sub>11-13</sub> ' (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<sub>35-36</sub> ' (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<sub>35-36</sub> ' (vs. 'clinical-modified') was 84.1% from 85.0% for Black women, and 78.5% from 33.1% for White.</p><p><strong>Conclusions: </strong>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.</p>\",\"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}","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}
Optimising Pre-Eclampsia Screening in Black Women; a Secondary Analysis of Data from Non-Intervention Screening Studies.
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.
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.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
