Second trimester ultrasound receipt mediated 39 percent of the association between public insurance, prenatal diagnosis
By Elana Gotkine HealthDay Reporter
TUESDAY, Oct. 8, 2024 (HealthDay News) — Second-trimester ultrasound receipt mediates a considerable portion of the association between public insurance and prenatal diagnosis of congenital heart disease (CHD), according to a study published online Sept. 23 in Prenatal Diagnosis.
Joyce L. Woo, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues conducted a retrospective analysis of electronic health records of pregnant women whose infants received CHD surgery between 2019 and 2020 to examine the mechanism underlying insurance-related disparities in prenatal diagnosis of CHD.
A total of 496 pregnant women met the inclusion criteria: 43.3 percent were publicly insured and 61.5 percent had prenatal diagnosis. Public insurance was associated with a 12.6 percent lower probability of prenatal diagnosis in bivariate regressions. Public insurance was associated with a 13.2 percent lower probability of second-trimester ultrasound receipt in multivariable models, but was no longer associated with prenatal diagnosis after adjustment for second-trimester ultrasound receipt. Second-trimester ultrasound receipt mediated 39 percent of the association between public insurance and prenatal diagnosis in a mediation analysis.
“Understanding the reasons behind insurance-related disparities in getting prenatal diagnosis — such as getting the second-trimester ultrasound — allows for the development of policies and programs that could lessen these disparities,” Woo said in a statement.
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