{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T02:25:35Z","timestamp":1779330335840,"version":"3.51.4"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Maternal serum alpha-fetoprotein (AFP) levels are used in screening for open neural tube defects (ONTD). Historical reports show that AFP levels and maternal weights are higher in self-reported Black than White individuals, but recent reports question the need to account for these variables in screening. Our study compares screening performance with and without accounting for race.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Retrospective analysis was performed on deidentified prenatal screening records including maternal weight and self-reported race of White or Black. Gestational age-specific medians and weight-adjusted multiples of the median levels were calculated separately for each group and using a race-agnostic analysis. Outcome measures included the proportion of screen-positive results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Records for analysis (n = 13 316) had an ultrasound confirmed gestational age between 15 and 21 completed weeks, singleton pregnancy, and self-reported race. Race was Black for 26.3%. AFP levels for pregnancies in Black individuals were higher than in White individuals: 6% to 11% depending on gestational age. Race-specific gestational age and maternal weight analyses resulted in similar screen-positive rates for self-reported White and Black individuals at 0.74% vs 1.00%, respectively (P = 0.14). However, use of race-agnostic analyses resulted in a screen-positive rate that was 2.4 times higher in Black than White individuals (P &amp;lt; 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>These data show that the historical method of accounting for maternal race and weight in prenatal screening for ONTD provides equitable performance. Using a race-agnostic methodology results in an increased screen-positive rate and a disproportionate rate of required follow-up care for individuals who self-identify as Black.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/clinchem\/hvae053","type":"journal-article","created":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T23:32:12Z","timestamp":1720135932000},"page":"948-956","source":"Crossref","is-referenced-by-count":6,"title":["Use of Maternal Race and Weight Provides Equitable Performance in Serum Screening for Open Neural Tube Defects"],"prefix":"10.1093","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9440-3411","authenticated-orcid":false,"given":"Geralyn","family":"Messerlian","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Women & Infants Hospital and the Alpert Medical School at Brown University , Providence, RI ,","place":["United States"]},{"name":"Department of Obstetrics and Gynecology, Women & Infants Hospital and the Alpert Medical School at Brown University , Providence, RI ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sydney Webb","family":"Strickland","sequence":"additional","affiliation":[{"name":"Women\u2019s Health and Genetics, Labcorp , Research Triangle Park, NC ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan","family":"Willbur","sequence":"additional","affiliation":[{"name":"Women\u2019s Health and Genetics, Labcorp , Research Triangle Park, NC ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Vaughan","sequence":"additional","affiliation":[{"name":"Women\u2019s Health and Genetics, Labcorp , Research Triangle Park, NC ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shelby","family":"Koenig","sequence":"additional","affiliation":[{"name":"Women\u2019s Health and Genetics, Labcorp , Research Triangle Park, NC ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taylor","family":"Wright","sequence":"additional","affiliation":[{"name":"Women\u2019s Health and Genetics, Labcorp , Research Triangle Park, NC ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6154-8449","authenticated-orcid":false,"given":"Glenn E","family":"Palomaki","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Women & Infants Hospital and the Alpert Medical School at Brown University , Providence, RI ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"key":"2025093007214382100_hvae053-B1","first-page":"1323","article-title":"Maternal serum-alpha-fetoprotein measurement in antenatal screening for anencephaly and spina bifida in early pregnancy. 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