title: 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.
authors.affiliation: a Department of Obstetrics and Gynecology , Beth Israel Deaconess Medical Center , Boston , MA, USA .
authors.forename: Miriam J
authors.initials: MJ
authors.lastname: Haviland
authors.affiliation: a Department of Obstetrics and Gynecology , Beth Israel Deaconess Medical Center , Boston , MA, USA .|b Department of Obstetrics , Gynecology, and Reproductive Biology, Harvard Medical School , Boston , MA, USA .
authors.forename: Scott A
authors.initials: SA
authors.lastname: Shainker
authors.affiliation: a Department of Obstetrics and Gynecology , Beth Israel Deaconess Medical Center , Boston , MA, USA .|b Department of Obstetrics , Gynecology, and Reproductive Biology, Harvard Medical School , Boston , MA, USA .
authors.forename: Michele R
authors.initials: MR
authors.lastname: Hacker
authors.affiliation: c Department of Neonatology , Beth Israel Deaconess Medical Center , Boston , MA, USA , and.|d Department of Pediatrics , Harvard Medical School , Boston , MA, USA.
authors.forename: Heather H
authors.initials: HH
authors.lastname: Burris
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D044466:Asian People; D054791:Cervical Length Measurement / Q000706:statistics & numerical data*; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D057210:Delayed Diagnosis; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D008403:Mass Screening; D008404:Massachusetts; D011247:Pregnancy; D011248:Pregnancy Complications; D044469:Racial Groups / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D044465:White People; D055815:Young Adult
keywords: Antenatal screening; racial/ethnic disparity; risk of preterm birth; transvaginal cervical length screening; universal screening program