649 RACIAL DISPARITY IN FETAL ANEUPLOIDY RISK IN AN ULTRASOUND SCREENINGPOPULATION: A RESULT OF SELECTION BIAS? DAVID STAMILIO1, ANTHONYODIBO1, HARISH SEHDEV2, LINDA DUNN3, GEORGE MACONES1, 1University ofPennsylvania, Obstetrics and Gynecology, Philadelphia, Pennsylvania, 2Penn-sylvania Hospital, Maternal Fetal Medicine, Philadelphia, Pennsylvania,3Chestnut Hill Hospital, Obstetrics and Gynecology, Philadelphia,Pennsylvania

OBJECTIVE: There is evidence for racial differences in the incidence of fetalaneuploidy, utilization of prenatal genetic tests, and predictive value ofscreening markers. Our aim is to compare the risk of fetal aneuploidy acrossmaternal race & to explore potential causes of disparity.

STUDY DESIGN: Between 2002 & 2005 we performed a multicenterprospective cohort study of 2900 pregnant patients of variable risk levelreferred for a fetal ultrasound that included standard aneuploidy markers. Astandardized ultrasound was performed between 15 & 22 gestational weeks.Using bivariate and multivariable statistical methods we compared fetalaneuploidy rates across maternal race. We used logistic regression to explorefor confounding and sources of racial differences in aneuploidy rates.

RESULTS: Patients of African origin were younger, 47% less likely to havean aneuploidy risk factor, underwent a screening ultrasound later in gestationand more commonly received care at the community versus universityhospitals than other races. After controlling for multiple confounders, patientsof African origin had a fetal aneuploidy rate 80% less than other races.

Maternal ethnic origin and fetal aneuploidy risk

CaucasianN = 1271

AfricanN = 1004

AsianN = 157

OtherN = 103

Fetal aneuploidy rate 2.4% 0.2% 3.2% 0.0%Adjusted odds ratio* reference 0.18 1.12 NC95% confidence interval reference 0.04-0.76 0.41-3.07 NC

NC = not calculable.* Adjusted for age, gestational age, hospital, & risk factors.

CONCLUSION: In our cohort, African-American women appear to have areduced fetal aneuploidy rate compared to other races. The rate reduction maybe due to residual selection bias introduced by ethnicity-specific patterns ofhealth care utilization or study design. These data emphasize that ethnicity canbe an important confounder in studies on genetic counseling and screening.

650 HISTORY OF DOMESTIC VIOLENCE: PREDICTORS AND PREGNANCY OUTCOMESMARGARET SULLIVAN1, ALLISON BRYANT1, PATRICIA ROBERTSON1, REBECCAABEL1, YVONNE CHENG1, AARON CAUGHEY1, 1University of California, San Fran-cisco, Obstetrics, Gynecology and Reproductive Sciences, San Francisco,California

OBJECTIVE: To examine factors associated with a history of domesticviolence (DV) in pregnant women and their obstetric outcomes.

STUDY DESIGN: This was a retrospective cohort study of obstetric patientsat a single academic institution from 1990 to 2001. Women with a history ofDV were identified. Demographics, obstetric history, and pregnancy outcomesincluding birthweight, preterm delivery, preeclampsia, and placental abruptionwere examined. Univariate and multivariate analyses were performed.

RESULTS: Among the 20,066 women who met study criteria, 316 (1.6%)reported a history of DV. We found that African-American (4.0%, p!0.001)and Latina (2.6%, p!0.001) women were more likely to have a history of DV.Other associated factors were unmarried status (OR 3.0, 95% CI=2.0-4.4),and history of depression (OR 6.6, 95% CI=4.0-11.0); while college education(OR=0.6, 95% CI=0.4-0.9) and nulliparity (OR=0.5, 95% CI=0.4-0.7) wereprotective. For pregnancy outcomes, DV history was significantly associatedwith preterm delivery prior to 37 and 32 weeks gestation, low birthweight(LBW), and the mother not breastfeeding (Table). These findings persisted inmultivariate analyses when controlling for potential cofounders.

CONCLUSION: Women with a history of DV are more likely to deliverpreterm, have a LBW infant, and not breastfeed. It is important to screenpregnant women for DV with the intent to facilitate social services as well ascounsel them regarding pregnancy outcomes.

Pregnancy outcomes in women with a history of domestic violence

Outcome DV No DV p-value AOR, 95% CI

Preterm del!32 wks 8.5% 4.1% !0.001 1.90 (1.25-2.91)Small for gest. age 11.8% 7.0% =0.001 1.37 (0.87-2.17)LBW 19.7% 10.4% !0.001 1.75 (1.18-2.59)Breast feeding 68.2% 84.0% !0.001 0.75 (0.57-0.98)

651 SOCIETY FOR MATERNAL-FETAL MEDICINE (SMFM) MEETING: WHAT ARE WEPRESENTING? ALAN TITA (F)1, DWIGHT ROUSE1, 1University of Alabama at Bir-mingham, Obstetrics and Gynecology, Birmingham, Alabama

OBJECTIVE: Monitoring the structure and content of SMFM annualscientific meeting presentations might clarify the forum’s orientation andpotential impact. We aimed to characterize and compare key attributes of oraland poster presentations, and to identify common methodologic problems.

STUDY DESIGN: Descriptive review of all 136 oral and 136 randomlyselected poster presentations from 1,359 2004 and 2005 SMFM abstracts.Attributes and methodology were assessed using a pre-established checklist.Strength of clinical study design was categorized according to the USPreventive Services Task Force (USPSTF) hierarchy for internal validity.Sample size provided the ability to estimate a randomized trial (RCT)prevalence of 10% G 5% with 95% confidence per group.

RESULTS: The table shows selected attributes of presentations. Addition-ally, the most frequent oral topics were prematurity (21%) and basicpathophysiology (17%) compared to prematurity and hypertensive disorders(12% each) for posters. 13% of presentations involved university/non-univer-sity collaborations. Use of ‘‘prospective’’ was inconsistent and at timesredundant. The most frequent methodological concerns were inadequatesample size (n=12) and in observational studies, a discrepancy betweendesignated and described designs (n=10).

CONCLUSION: Compared to posters, oral presentations involved a higherproportion with primary data, prospective timing and basic sciences and fewerdescriptive studies. Concerns include small samples and misclassification ofstudy design.

Study attributesOral(N = 136) %

Poster(N = 136) % P value

Strength of design (USPSTF)I (R 1 RCT) 11 8.1 0.42II-1 (Non-RCT) 0 0 dII-2 (Cohort or Case control) 39 41.2 0.71II-3 (Multiple time series) 0.7 1.5 0.53III (Descriptive, series, others) 13.9 34.6 !0.001Basic science-‘‘USPTF IV’’ 35.3 14.6 !0.001Primary data (vs. secondary) 75.7 42.6 !0.001Prospective timing 79.4 38.2 !0.001Positive study 88.3 83.1 0.22International site 19.9 29.4 0.07Non-university-based 1st author 5.9 12.5 0.06

652 PERIODONTAL DISEASE AND GESTATIONAL DIABETES MELLITUS XU XIONG1,PIERRE BUEKENS1, SOTIRIOS VASTARDIS2, GABRIELLA PRIDJIAN3, 1Tulane Uni-versity, Epidemiology, New Orleans, Louisiana, 2Louisiana State University,Periodontics, New Orleans, Louisiana, 3Tulane University, Maternal-FetalMedicine/Human Genetics, New Orleans, Louisiana

OBJECTIVE: An association between periodontal disease and type 1 or 2diabetes is well established. However, the association between gestationaldiabetes mellitus (GDM) and periodontal disease has never been studied. Theobjective was to examine the association between periodontal disease anddifferent types of diabetes in pregnant and non-pregnant women.

STUDY DESIGN: We conducted a secondary analysis of data from the thirdNational Health and Nutrition Examination Survey (NHANES III). Thepresent study sample included 256 pregnant women and 4,234 non-pregnantchildbearing women aged 15-44 years. A case of periodontitis was establishedif the subjects had probing depth or attachment level loss R4 mm. Based onself-reported diabetes, women were classified into those with type 1 or 2, withGDM during current pregnancy and with GDM during previous pregnancy.Univariate and multivariate logistic analyses were performed to examine theassociation between periodontal disease and different types of diabetes and toadjust for age, ethnicity, smoking, and other confounding variables.

RESULTS: In pregnant women, the prevalence of periodontitis was 44.8% inwomen with GDM and 13.2% in non-diabetic women, with adjusted oddsratio (aOR) of 9.11 [95% confidence interval (CI): 1.11-74.9]. In non-pregnantwomen, the prevalence of periodontitis was 40.3% in women with type 1 or2 diabetes, 25.0% in women with previous history of GDM and 13.9% innon-diabetic women. The aORs were 2.76 (1.03-7.35) for women with type 1 or2 diabetes, and 2.00 (0.65-6.20) for women with past history of GDM, ascompared to non-diabetic women.

CONCLUSION: There may be an association between periodontal diseaseand GDM. Further studies are needed for confirmation.

S184 SMFM Abstracts