436 - Screening for Chronic Diseases During Preconception Care by Race and Ethnicity

Poster Number: 436
Publication Number: 436.219

Elissa Dunlap, Maria Fareri Children's Hospital at Westchester Medical Center, New York, NY, United States; KRITI DAMODARAN, Maria Fareri Children's Hospital at Westchester Medical Center, White Plains, NY, United States; Sarah M. Sanchez, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, NY, United States; Shetal Shah, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, NY, United States; Heather L. Brumberg, New York Medical College, Maria Fareri Children's Hospital at Westchester Medical Center, White Plains, NY, United States

Background: 30% of women report receiving preconception care screening (PCCS), despite the Centers for Disease Control & Prevention’s recommendation for screening all women of childbearing age. Though racial/ethnic disparities exist in receipt of any PCCS, little is known about specific chronic disease screenings during PCCS by race/ethnicity. Further, previous studies do not account for social determinants of health (SDH).

Objective: To determine if maternal self-reported race/ethnicity is associated with differences in PCCS for diabetes (DM), hypertension (HTN), or family medical history while controlling for SDH.

Design/Methods:

This was a cross sectional (2016 - 2021), multicenter survey study of mothers (≥ 18 years) of singleton live-born infants. Mothers were divided into 4 self-reported racial/ethnic groups [Non-Hispanic White (NHW), Non-Hispanic Black (NHB), Hispanic, or Other]. Chi-square, Fisher’s exact test, T-test, and ANOVA were used to evaluate differences in PCCS & demographic information by race/ethnicity. Logistic regression assessed PCCS by racial/ethnic groups controlling for age, marital status, education, substance use, adverse life events, obesity, exercise, insurance, foreign born status, and pre-existing DM & HTN.

Results:

1,053 women were included [387 (37%) identified as NHW, 186 (17%) as NHB, 423 (40%) as Hispanic, and 57 (5%) as Other]. PCCS differed by race/ethnicity with highest rates observed in NHB and the lowest in Other (Table 1). Employment, marital status, substance use, education, obesity, adverse life events & insurance status also differed by race/ethnicity. In adjusted analyses, NHB women had higher odds of PCCS for DM (OR 2.07, 95% CI [1.25 - 3.44]), HTN (OR 2.05, 95% CI [1.26 - 3.33]) & counseling about family medical history (OR 1.95, 95% CI [1.21 - 3.14]) compared to NHW women. Hispanic women & Others did not differ in receipt of PCCS for DM, HTN & counseling about their family medical history compared to NHW.

Conclusion(s): NHB women were more likely to receive PCCS for chronic diseases. Hispanic women were as likely as NHW women to receive PCCS despite being a high risk population for these conditions. Absence of higher screening rates in Hispanic women may represent a novel healthcare disparity. Awareness may need to be raised about enhanced PCCS for Hispanic women due to an increased risk for chronic illnesses.