Universal prenatal screening: a initiative from Guanajuato, Mexico to improve equity in perinatal healthcare

Frontiers in Medicine · 6 authors, 3 centres

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TL;DR

This paper describes a universal prenatal screening initiative implemented in Guanajuato, Mexico, designed to improve equity in perinatal healthcare. The initiative proposes a horizontal, interdisciplinary care model integrating screening at three levels of care to identify obstetric risks and reduce perinatal morbidity and mortality.

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The paper describes the design and rationale of a universal prenatal screening initiative in Guanajuato, Mexico, aimed at improving equity in perinatal healthcare. The authors discuss the strengths of the model, such as its horizontal structure and interdisciplinary approach, and note weaknesses including the current lack of first-trimester biochemical markers. They cite other studies to support the potential benefits of early screening for specific conditions but clarify that subsequent studies will be needed to verify the results of their care model. This publication serves as a precedent for implementation, not as a report of study outcomes.

STUDY TYPE

other

SPECIALTY

obstetrics and gynecology

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ORIGINAL PAPER

PMC10233497

Universal prenatal screening: a initiative from Guanajuato, Mexico to improve equity in perinatal healthcare

Frontiers in Medicine

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ABSTRACT

Abstract The prenatal approach from a preventive perspective is necessary to reduce perinatal complications. A perinatal care model with a holistic and horizontal approach is required. Mexico is currently considered an emerging market economy with inequality and an economic gap that impacts the accessibility and distribution of healthcare services. Guanajuato is one of the 32 states of Mexico and represents 1.6% of the country’s surface. Strategies during the prenatal approach allow prediction, diagnosis, and anticipation of the principal causes of morbidity and mortality. Combining data from maternal characteristics and history with findings of biophysical and biochemical tests at 11 to 13 weeks of gestation can define the patient-specific risk for a large spectrum of complications that include miscarriage and fetal death, preterm delivery, preeclampsia, congenital disorders, and fetal growth abnormalities. We aim to describe the care model designed and implemented in the State Center for Timely Prenatal Screening of the Maternal and Child Hospital of Leon, Guanajuato, Mexico. Previous research showed there is a lack of information for low and middle-income countries regarding how to integrate prenatal screening strategies in the absence of resources to perform cell-free fetal DNA or biochemical serum markers in countries with emergent economies. This care model is carried out through horizontal processes where the screening is provided by trained and certified general practitioners who identify the population at risk in a timely manner for specialized care, and could help guide other Mexican states, and other countries with emergent economies with limited financial, professional, and infrastructural resources to improve prenatal care with a sense of equity, equality, and social inclusion as well as the timely evaluation of specialized perinatal care of high-risk patients. Keywords: pregnancy, prenatal care, prevention, prenatal diagnosis, congenital abnormalities, preeclampsia, premature birth, pregnancy complications

CITATION EXPORT

Ma de la Luz Bermudez Rojas, Virginia Medina Jimenez, Javier Ivan Manzanares Cuadros et al.. Universal prenatal screening: a initiative from Guanajuato, Mexico to improve equity in perinatal healthcare. Frontiers in Medicine. (2023). https://doi.org/10.3389/fmed.2023.1127802

AUTHORS

6 · 3 CENTRES

Ma de la Luz Bermudez Rojas, Virginia Medina Jimenez, Javier Ivan Manzanares Cuadros, Daniel Alberto Diaz Martínez, Nicolas Padilla Raygoza, Elia Lara Lona

1State Center for Timely Prenatal Screening, Maternal and Child Hospital of Leon Guanajuato, Maternal-Fetal Unit, Institute of Public Health, Leon, Guanajuato, Mexico
2Institute of Public Health, Leon, Guanajuato, Mexico
3Department of Research and Technological Development, Directorate of Teaching and Research Institute of Public Health, Leon, Guanajuato, Mexico