Findings to be presented at ADLM 2024
CHICAGO, July 30,
2024 /PRNewswire/ -- In a new study, researchers have
demonstrated that there is an insufficient basis for incorporating
race in prenatal screening for birth defects. In a second, separate
study, researchers have found that HIV-exposed uninfected children
are at higher risk for health problems compared to uninfected,
unexposed children. Both of these studies will be presented today
at ADLM 2024 (formerly the AACC Annual Scientific Meeting
& Clinical Lab Expo) and could help to improve medical care for
Black pregnant patients and HIV-exposed uninfected children,
respectively.
Rethinking the role of race in prenatal AFP screening
As the use of race in a variety of clinical testing algorithms
continues to be reevaluated, the medical community has debated
incorporating race in tests for alpha-fetoprotein (AFP), which is
used to diagnose a class of birth defects known as open neural tube
defects (ONTD) during pregnancy. Current testing algorithms for AFP
account for race because self-reported Black individuals on average
have higher AFP levels than White individuals. However, many
question whether the clinical benefit of incorporating race into
AFP screening models is great enough to justify doing so.
Dr. William Butler and a team of
researchers from the Hospital of the University of Pennsylvania compared the risk
classification for ONTD given by two different models, one of which
accounted for self-reported maternal race and one that did not.
Their study involved 7,702 patients who were pregnant with one
child, 2,360 of whom self-identified as Black. The researchers
found that self-reported Black race or ethnicity had a small, yet
statistically significant association with AFP concentration.
However, only 0.2% of patients were classified differently when
race was not accounted for. Furthermore, none of these discordantly
classified patients had children born with ONTD.
"As race is a social construct that should not be used as a
surrogate to explain biological differences, we should require
strong evidence that its use confers substantial benefit that
cannot be achieved through other approaches if we are to consider
incorporating it into clinical practice algorithms," Dr. Butler
said. "The modest improvement in normalizing AFP concentrations is
outweighed by the harms of continuing a race-based practice and
additional studies are warranted to consider patient factors other
than race to improve ONTD risk stratification."
Health issues in HIV-exposed uninfected children in the
Bronx
The global rates of HIV transmission from mother to child have
dropped drastically thanks to a treatment regimen known as
combination antiretroviral therapy (cART). This has led to an
increase in the number of HIV-exposed uninfected children, who
currently total 16 million worldwide. Although HIV-free and
generally healthy, these children may face heightened risks of
adverse health outcomes due to prenatal exposure to cART, including
growth restriction, increased susceptibility to infections, and
neurobehavioral disorders. Furthermore, infants with growth
restriction are at a greater risk of developing chronic diseases
such as cardiometabolic and neurological disorders later in life —
a risk that is worsened by low socioeconomic status.
Drs. Eros Qama and Kayode Balogun of Montefiore Medical Center and
Albert Einstein College of Medicine
sought to assess the prevalence of neurodevelopmental disorders and
hyperlipidemia in HIV-negative children born to HIV-infected
mothers in the Bronx, New York, an
area of low socioeconomic status. They compared the medical records
of 127 HIV-exposed uninfected children from the Bronx to 157 HIV-unexposed and uninfected
children from the Bronx, aged
0-15. HIV-exposed uninfected children were found to have
significantly higher rates of attention-deficit/hyperactivity
disorder, autism spectrum disorder, unspecified developmental
delay, and abnormal cholesterol levels.
"It's important for the sake of public health to start
understanding the health trajectory of these kids, so that we can
intervene early, and so that we know what regimen might be best for
HIV-positive women when they decide to get pregnant to prevent the
sequelae of [antiretroviral] drugs," Dr. Balogun said.
Session Information
ADLM 2024 registration is free for
members of the media. Reporters can register online here:
https://xpressreg.net/register/adlm0824/media/landing.asp
Abstract A-321: Rethinking the role of race in prenatal AFP
screening for open neural tube defects
Abstract A-310: Neurodevelopmental disorders and hyperlipidemia
in HIV-exposed uninfected children in the Bronx, New York
Both abstracts will be presented during:
Scientific poster session
Tuesday, July 30
9:30 a.m. – 5
p.m. (presenting authors in attendance from 1:30 –
2:30 p.m.)
The session will take place in the Poster Hall on the Expo
show floor of McCormick Place, Chicago.
About ADLM 2024
ADLM 2024 (formerly the AACC Annual Scientific Meeting &
Clinical Lab Expo) offers 5 days packed with opportunities to learn
about exciting science from July 28-August
1 in Chicago. Plenary
sessions will explore the projected consequences of ending abortion
protection, new HIV prevention options, lymphoma biomarkers and
therapeutic targets, pharmacogenetic testing in precision health,
and the need for clinical trials of laboratory tests.
At the ADLM 2024 Clinical Lab Expo, more than 900 exhibitors
will fill the show floor of the McCormick Place Convention Center
in Chicago, with displays of the
latest diagnostic technology, including but not limited to
artificial intelligence, point-of-care, and automation.
About the Association for Diagnostics & Laboratory
Medicine (ADLM)
Dedicated to achieving better health through laboratory
medicine, ADLM (formerly AACC) brings together more than 70,000
clinical laboratory professionals, physicians, research scientists,
and business leaders from around the world focused on clinical
chemistry, molecular diagnostics, mass spectrometry, translational
medicine, lab management, and other areas of progressing laboratory
science. Since 1948, ADLM has worked to advance the common
interests of the field, providing programs that advance scientific
collaboration, knowledge, expertise, and innovation. For more
information, visit www.myadlm.org.
Contact:
Christine DeLong
ADLM
Associate Director, Communications & PR
(p) 202.835.8722
cdelong@myadlm.org
Molly Polen
ADLM
Senior Director, Communications & PR
(p) 202.420.7612
(c) 703.598.0472
mpolen@myadlm.org
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SOURCE Association for Diagnostics & Laboratory Medicine
(ADLM)