Neighborhood deprivation is not associated with abortion consideration or completion in patients with fetal myelomeningocele

Author:

Papastefan Steven T.12ORCID,Bian Yuqi34,Singh Manmeet1,Marriott William S.1,Ito Joyceline A.1,Fry Jessica5,Shaaban Aimen F.12,Premkumar Ashish6ORCID

Affiliation:

1. Division of Pediatric Surgery The Chicago Institute for Fetal Health Ann & Robert H. Lurie Children's Hospital of Chicago Chicago Illinois USA

2. Department of Surgery Northwestern University Feinberg School of Medicine Chicago Illinois USA

3. Northwestern University Feinberg School of Medicine Chicago Illinois USA

4. Department of Medical Humanities and Bioethics Northwestern University Feinberg School of Medicine Chicago Illinois USA

5. Neonatology and Palliative Care Ann & Robert H. Lurie Children's Hospital of Chicago Chicago Illinois USA

6. Department of Obstetrics and Gynecology Section of Maternal Fetal Medicine Pritzker School of Medicine at the University of Chicago Chicago Illinois USA

Abstract

AbstractObjectiveThe objective of this study was to evaluate whether patient‐level neighborhood deprivation index (NDI) was associated with termination of pregnancy consideration and completion in patients presenting with fetal myelomeningocele.MethodsThis was a retrospective cohort analysis of patients with fetal myelomeningocele presenting to a fetal treatment center (FTC) in Illinois between 2018 and 2024. The exposure was NDI calculated from patient zip codes. The NDI was analyzed as both a dichotomous and ordinal exposure. The co‐primary outcomes were abortion consideration prior to FTC consultation, ascertained by nurse intake, and abortion completion after consultation. Bivariate and log‐binomial regression analyses were performed. Covariates were selected based on p < 0.10 on bivariate analyses. Otherwise, p < 0.05 indicated statistical significance.ResultsA total of 157 participants were included. Evaluation of neighborhood deprivation as a dichotomous exposure revealed no association with abortion consideration or completion. AdditionallLy, no association was found on log binomial modeling after controlling for gestational age at presentation to the FTC and maternal race or ethnicity for abortion consideration (aRR 0.87, 95% CI 0.59–1.28) or completion (aRR 0.86, 95% CI 0.59–1.28). These results were similar when treating the NDI as an ordinal exposure.ConclusionsContrary to our hypothesis, NDI is not associated with abortion consideration or completion in patients with fetal myelomeningocele.

Publisher

Wiley

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