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

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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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