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Maternal Serum Alpha-Fetoprotein Levels Higher in Black Than White Women

These racial differences need to be accounted for in prenatal open neural tube defect screening

By Elana Gotkine HealthDay Reporter

FRIDAY, May 31, 2024 (HealthDay News) — Maternal serum alpha-fetoprotein (AFP) levels are higher in Black than White pregnant women, supporting the use of accounting for these differences in prenatal open neural tube defect (ONTD) screening, according to a study published online May 23 in Clinical Chemistry.

Geralyn Messerlian, Ph.D., from the Women & Infants Hospital and the Alpert Medical School at Brown University in Providence, Rhode Island, and colleagues conducted a retrospective analysis on deidentified prenatal screening records to compare ONTD screening performance with and without accounting for race. A sample of 13,316 records for analysis had an ultrasound-confirmed gestational age between 15 and 21 completed weeks, singleton pregnancy, and self-reported race.

The researchers found that AFP levels for pregnancies were higher in Black than White individuals (6 to 11 percent depending on gestational age). Similar screen-positive rates were seen for self-reported White and Black individuals in race-specific gestation age and maternal weight analyses at 0.74 versus 1.00 percent, respectively. However, in race-agnostic analyses, the screen-positive rate was 2.4 times higher in Black than White individuals.

“Our results, together with existing professional recommendations and other current publications, endorse the continued use of self-reported race in prenatal serum screening,” the authors write.

One author disclosed ties to the biotechnology industry.

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