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Abstract
Discussion Forum (0)
Introduction:
Genetic carrier screening is ideally performed before pregnancy to provide patients with a full range of reproductive options. In 2018, our academic medical center began offering Expanded Carrier Screening (ECS), which was universally reimbursed. The aim of this study was to compare the demographics of women who obtained ECS preconception to women who obtained ECS during pregnancy.

Methods:
This was a descriptive retrospective cohort study. From 2018-2021, ECS was ordered by genetic counselors, residents, fellows, and attendings. Demographics were reviewed to evaluate age, race, ethnicity, insurance payer, marital status, and language spoken by patient. Chi square tests were performed as appropriate.

Results:
During our study, 98 women underwent ECS preconception and 1090 women obtained ECS during pregnancy. The majority of patients obtaining preconception ECS were white (58%), non-Hispanic (84.7%), married (66.3%), English speaking (86.7%), and had commercial insurance (77.6%). Ordering providers were predominantly genetic counselors (89%). White women were more likely than Black women to obtain ECS preconception (p < 0.0001), as were women with commercial insurance compared to those with public insurance (P < 0.0001). There was a nonsignificant trend toward married women being more likely to obtain ECS preconception than unmarried women (p=0.06).

Conclusion/Implications:
Our data suggests race and insurance payer were different in patients who obtained ECS preconception compared to those who obtained ECS during pregnancy. In order to provide complete reproductive autonomy, it is important that ECS be offered to all reproductive age women prior to pregnancy. Future directions include assessing patient comprehension of ECS, and access to screening and care.
Introduction:
Genetic carrier screening is ideally performed before pregnancy to provide patients with a full range of reproductive options. In 2018, our academic medical center began offering Expanded Carrier Screening (ECS), which was universally reimbursed. The aim of this study was to compare the demographics of women who obtained ECS preconception to women who obtained ECS during pregnancy.

Methods:
This was a descriptive retrospective cohort study. From 2018-2021, ECS was ordered by genetic counselors, residents, fellows, and attendings. Demographics were reviewed to evaluate age, race, ethnicity, insurance payer, marital status, and language spoken by patient. Chi square tests were performed as appropriate.

Results:
During our study, 98 women underwent ECS preconception and 1090 women obtained ECS during pregnancy. The majority of patients obtaining preconception ECS were white (58%), non-Hispanic (84.7%), married (66.3%), English speaking (86.7%), and had commercial insurance (77.6%). Ordering providers were predominantly genetic counselors (89%). White women were more likely than Black women to obtain ECS preconception (p < 0.0001), as were women with commercial insurance compared to those with public insurance (P < 0.0001). There was a nonsignificant trend toward married women being more likely to obtain ECS preconception than unmarried women (p=0.06).

Conclusion/Implications:
Our data suggests race and insurance payer were different in patients who obtained ECS preconception compared to those who obtained ECS during pregnancy. In order to provide complete reproductive autonomy, it is important that ECS be offered to all reproductive age women prior to pregnancy. Future directions include assessing patient comprehension of ECS, and access to screening and care.
Patterns in preconception expanded carrier screening: race, wealth, and marriage
Dr. Tirtza Spiegel Strauss
Dr. Tirtza Spiegel Strauss
Affiliations:
null
ACOG ePoster. Spiegel Strauss T. 05/08/2022; 350996; A142
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Dr. Tirtza Spiegel Strauss
Affiliations:
null
Abstract
Discussion Forum (0)
Introduction:
Genetic carrier screening is ideally performed before pregnancy to provide patients with a full range of reproductive options. In 2018, our academic medical center began offering Expanded Carrier Screening (ECS), which was universally reimbursed. The aim of this study was to compare the demographics of women who obtained ECS preconception to women who obtained ECS during pregnancy.

Methods:
This was a descriptive retrospective cohort study. From 2018-2021, ECS was ordered by genetic counselors, residents, fellows, and attendings. Demographics were reviewed to evaluate age, race, ethnicity, insurance payer, marital status, and language spoken by patient. Chi square tests were performed as appropriate.

Results:
During our study, 98 women underwent ECS preconception and 1090 women obtained ECS during pregnancy. The majority of patients obtaining preconception ECS were white (58%), non-Hispanic (84.7%), married (66.3%), English speaking (86.7%), and had commercial insurance (77.6%). Ordering providers were predominantly genetic counselors (89%). White women were more likely than Black women to obtain ECS preconception (p < 0.0001), as were women with commercial insurance compared to those with public insurance (P < 0.0001). There was a nonsignificant trend toward married women being more likely to obtain ECS preconception than unmarried women (p=0.06).

Conclusion/Implications:
Our data suggests race and insurance payer were different in patients who obtained ECS preconception compared to those who obtained ECS during pregnancy. In order to provide complete reproductive autonomy, it is important that ECS be offered to all reproductive age women prior to pregnancy. Future directions include assessing patient comprehension of ECS, and access to screening and care.
Introduction:
Genetic carrier screening is ideally performed before pregnancy to provide patients with a full range of reproductive options. In 2018, our academic medical center began offering Expanded Carrier Screening (ECS), which was universally reimbursed. The aim of this study was to compare the demographics of women who obtained ECS preconception to women who obtained ECS during pregnancy.

Methods:
This was a descriptive retrospective cohort study. From 2018-2021, ECS was ordered by genetic counselors, residents, fellows, and attendings. Demographics were reviewed to evaluate age, race, ethnicity, insurance payer, marital status, and language spoken by patient. Chi square tests were performed as appropriate.

Results:
During our study, 98 women underwent ECS preconception and 1090 women obtained ECS during pregnancy. The majority of patients obtaining preconception ECS were white (58%), non-Hispanic (84.7%), married (66.3%), English speaking (86.7%), and had commercial insurance (77.6%). Ordering providers were predominantly genetic counselors (89%). White women were more likely than Black women to obtain ECS preconception (p < 0.0001), as were women with commercial insurance compared to those with public insurance (P < 0.0001). There was a nonsignificant trend toward married women being more likely to obtain ECS preconception than unmarried women (p=0.06).

Conclusion/Implications:
Our data suggests race and insurance payer were different in patients who obtained ECS preconception compared to those who obtained ECS during pregnancy. In order to provide complete reproductive autonomy, it is important that ECS be offered to all reproductive age women prior to pregnancy. Future directions include assessing patient comprehension of ECS, and access to screening and care.

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