The Role of Social Determinants in Diagnosis Timing for Fetal Care Center-Eligible Conditions: A Scoping Review

Timely identification of fetal conditions enables comprehensive evaluation, counseling, postnatal planning, and prenatal treatments. This study assessed the existing evidence on how social determinants of health (SDOH) influence diagnosis timing of fetal conditions appropriate for care in fetal care...

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Bibliographic Details
Published in:Diagnostics (Basel) 2024-07, Vol.14 (14), p.1503
Main Authors: Wilpers, Abigail B, Eichhorn, Barbara, Batten, Janene, Francis, Katie, Powne, Amy B, Jumale, Shukri, Hansen, Kara, Kohari, Katherine, Lorch, Scott A
Format: Article
Language:English
Subjects:
Cohort analysis
Congenital heart disease
Ethnicity
fetal anomalies
fetal intervention
fetal therapy
Genetic disorders
Heart diseases
high-risk pregnancy
Hospital costs
Librarians
Medicaid
Medical research
Medicine, Experimental
Postpartum period
Pregnant women
Prenatal care
prenatal diagnosis
Research methodology
social determinants of health
Socioeconomic factors
Socioeconomic status
Spina bifida
Ultrasonic imaging
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Summary:Timely identification of fetal conditions enables comprehensive evaluation, counseling, postnatal planning, and prenatal treatments. This study assessed the existing evidence on how social determinants of health (SDOH) influence diagnosis timing of fetal conditions appropriate for care in fetal care centers (FCCs). Eligible studies were conducted in the U.S. and published in English after 1999. We employed the Healthy People 2020 SDOH framework to categorize and analyze data from 16 studies, where 86% focused solely on congenital heart disease (CHD). Studies primarily focused on individual-level SDOH, with only 36% addressing structural-level factors. A total of 31 distinct indicators of SDOH were identified, with 68% being unique to individual studies. Indicators often varied in definition and specificity. Three studies covered all five SDOH categories in the Healthy People 2020 Framework. Studies revealed varying and often conflicting associations with SDOH indicators, with race and ethnicity being the most explored (100%), followed by socioeconomic status (69%), maternal age (57%), residence (43%), and structural factors (29%). Our findings highlight the need for more comprehensive research, including conditions beyond CHD, and the establishment of consensus on indicators of SDOH. Such efforts are necessary to gain a deeper understanding of the underlying factors driving disparities in fetal diagnosis and treatment.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics14141503