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Use of ethnic‐specific medians for Hispanic patients reduces ethnic disparities in multiple marker screening
Author(s) -
Wetta Luisa,
Biggio Joseph,
Owen John
Publication year - 2011
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.2650
Subject(s) - medicine , ethnic group , trisomy , median , genetics , biology , sociology , transport engineering , anthropology , engineering
Objective To estimate whether midtrimester maternal serum analyte concentrations differ between Caucasian and Hispanic women and whether using ethnic‐specific medians affects quad screen performance. Method Caucasian and Hispanic patients with singletons who underwent maternal serum screening in our laboratory were identified. Alfa‐fetoprotein (AFP), estriol, human chorionic gonadotrophin (hCG), and inhibin‐A medians were derived separately for Caucasians, Hispanics, and for the composite group. Using composite medians, intergroup mean multiples of the medians (MoMs) for each analyte were compared. Using ethnic‐specific medians, new MoMs were calculated and utilized in a risk estimation algorithm. Results A total of 5478 Caucasian and 2246 Hispanic pregnancies were evaluated. Intergroup MoMs were significantly different for all analytes. AFP, hCG, and inhibin‐A were lower in Hispanics, while estriol was higher ( P < 0.0001). Using composite medians, the screen‐positive rate (SPR) for trisomy 21 was 5.39% in Caucasians and 3.29% in Hispanics. Ethnic‐specific medians reduced this disparity: 4.76% in Caucasians and 4.05% in Hispanics. The SPR for neural tube defects with composite medians was 1.44% for Caucasians and 0.89% for Hispanics; with ethnic‐specific medians, the SPR was 1.42% for Caucasians and 1.07% for Hispanics. Conclusion Serum analyte concentrations differ between Caucasian and Hispanic gravidas. Use of ethnic‐specific medians reduces the disparity in SPR for trisomy 21 and neural tube defects. Copyright © 2011 John Wiley & Sons, Ltd.