Social Vulnerability Linked to Cervical Screening Gaps in Pregnant Women

A retrospective cohort study of 18,253 pregnant women at one maternity unit in France found that screening inadequacy varied across six social vulnerability profiles. Migration- or language-related barriers were associated with the largest increase in odds of inadequate screening; several violence-exposed profiles also had higher lesion detection despite lower screening participation.

Only 56.1% of participants were up to date with screening.
Migration or language barriers had the strongest association with inadequate screening.
Violence-exposed profiles had higher lesion detection despite lower participation.
The single-site observational study did not test targeted interventions.

Researchers conducted a retrospective cohort study of pregnant women aged 25 years or older who delivered at a tertiary maternity unit in France between May 2019 and May 2025. They assessed 15 indicators of social vulnerability in administrative, psychological, and violence-related domains, then used clustering to identify six profiles. The primary outcome was inadequate cervical screening, defined as no cervical sample in the previous three years; lesion detection was a secondary outcome.

Among 18,253 women, 56.1% were up to date with screening. Compared with the low-vulnerability profile, the odds of inadequate screening were higher for women with substance use and psychological vulnerability (adjusted odds ratio [AOR], 1.33), psychological violence (AOR, 2.01), sexual violence (AOR, 2.08), physical violence (AOR, 2.54), and migrant or linguistic barriers (AOR, 3.40). Violence-exposed and substance-use profiles also had higher proportions of detected intraepithelial lesions despite reduced screening participation.

The findings identify groups that may warrant focused efforts to address screening barriers, but they do not test any intervention. The single-site, retrospective design and restriction to pregnant women limit generalizability; associations do not establish causation.

In practice

Among pregnant women at a French tertiary maternity unit, screening inadequacy was associated with several social vulnerability profiles, particularly migration- or language-related barriers; violence-exposed profiles also had higher lesion detection despite lower screening participation. These findings can help clinicians and services identify populations facing screening barriers and inform consideration of tailored outreach. However, this retrospective, single-site study did not evaluate outreach strategies or establish causation, and its results may not generalize to nonpregnant populations or other settings. It does not establish a specific intervention or justify changing screening recommendations.

AI-generated clinical interpretation · Not editor-reviewed

AI summary · Not yet editor-reviewed

Is this summary clinically accurate?

Help fellow clinicians: your rating sends inaccurate summaries straight to our editors.

Source

JAMA Network Open: Multiple Dimensions of Social Vulnerability and Cervical Cancer Screening Uptake ↗

This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.