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Maternal race in prenatal screens: Ensuring equitable care

A recent study published in the Clinical Chemistry journal highlights the importance of considering self-reported race when screening for open neural tube defects in pregnant individuals, particularly for Black patients. This research sheds light on the need for better prenatal care practices that address health disparities among different racial groups.

The medical community has been reevaluating the use of race in clinical testing algorithms following the racial reckoning in 2020. For example, race-based calculations for estimated glomerular filtration rate (eGFR) were found to lead to delayed diagnosis and poorer outcomes for Black patients with kidney disease. As a result, clinical labs are now excluding race from their eGFR calculations to promote health equity.

The study focused on the test for alpha-fetoprotein (AFP), used to diagnose open neural tube defects like spina bifida during pregnancy. While current testing algorithms account for race due to variations in AFP levels between Black and White individuals, recent research suggests omitting race when screening for these birth defects.

Research led by Glenn E. PalomakiPhD explored the clinical impact of excluding race from AFP testing. The study found that when race and maternal weight were not considered in the analysis, there was a significant difference in the positivity rate for open neural tube defects between Black and White individuals. This approach could potentially create inequitable burdens for Black patients, including additional costly and invasive diagnostic testing.

The findings of the study emphasize the importance of accounting for maternal race, weight, and other covariates to ensure reliability and equity in prenatal screening programs. By following existing recommendations and publications, healthcare providers can enhance the accuracy of prenatal serum screening and promote better health outcomes for all patients.

The Association for Diagnostics & Laboratory Medicine (ADLM) is committed to advancing health through laboratory medicine. With a focus on clinical chemistry, molecular diagnostics, and other areas of laboratory science, ADLM brings together professionals from around the world to collaborate, share knowledge, and drive innovation. For more information, visit http://www.myadlm.org.

Clinical Chemistry is a leading international journal of laboratory medicine that publishes nearly 400 peer-reviewed studies each year. Covering a wide range of healthcare areas, this research plays a crucial role in providing patients with accurate diagnoses and essential care.

For more updates and information about ADLM and the latest research in laboratory medicine, visit their website at http://www.myadlm.org.

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