Racial and ethnic disparities in universal cervical length screening with transvaginal ultrasound

Abstract

Objective: Determine if race or ethnicity is associated with missed or late transvaginal cervical length screening in a universal screening program. Methods: Retrospective cohort study of nulliparous women with singleton gestations and a fetal anatomical ultrasound from 16–24 weeks’ gestation from January 2012 to November 2013. We classified women into mutually exclusive racial and ethnic groups: non-Hispanic black (black), Hispanic, Asian, non-Hispanic white (white), and other or unknown race. We used log-binomial regression to calculate the risk ratio (RR) and 95% confidence interval (CI) of missed or late (≥20 weeks’ gestation) screening versus optimally timed screening between the different racial and ethnic groups. Results: Among the 2967 women in our study population, 971 (32.7%) had either missed or late cervical length screening. Compared to white women, black (RR: 1.3; 95% CI: 1.1–1.5) and Hispanic (RR:1.2; 95% CI: 1.01–1.5) women were more likely to have missed or late screening. Among women screened, black (versus white) women were more likely to be screened late (RR: 2.2; 95% CI: 1.6–3.1). Conclusions: Black and Hispanic women may be more likely to have missed or late cervical length screenings.