Adams M
World Health Organization Collaborating Center in Perinatal Care and Health Services Research in Maternal Child Health, Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Am J Epidemiol. 2001 Nov 15;154(10):883-8. doi: 10.1093/aje/154.10.883.
The author evaluated the validity of four historically based variables collected on Georgia birth certificates: outcome of preceding pregnancy, history of delivery of a low- (<2,500 g) or high- (>4,000 g) birth-weight infant, and death of the baby resulting from the preceding pregnancy. Data were derived from birth and fetal death certificates that were linked for the first and second deliveries of 231,075 women in Georgia from 1980 through 1995. Deaths that occurred during the infant's first year of life were also linked to the birth certificate. For all but the survival variable, the outcome of the first birth as reported on the certificate for the second birth was compared with the outcome recorded on the certificate for the first birth, which was assumed to be correct. Except for ascertainment of death of the firstborn infant, sensitivities for the history of poor outcomes were low. Furthermore, sensitivities were higher when an extremely adverse outcome occurred in the first pregnancy or an adverse outcome recurred. The only high sensitivity was for past infant death (85.4%). These results suggest caution when using these variables to identify high-risk subsets for further research or control for confounding.
前次妊娠结局、低体重（<2500克）或高体重（>4000克）婴儿的分娩史，以及前次妊娠导致的婴儿死亡情况。数据来源于1980年至1995年佐治亚州231,075名女性首次和第二次分娩的出生证明和胎儿死亡证明。婴儿出生后第一年发生的死亡情况也与出生证明相关联。除生存变量外，将第二次分娩证明上报告的第一次分娩结局与第一次分娩证明上记录的结局（假定为正确的）进行比较。除了确定第一胎婴儿的死亡情况外，不良结局史的敏感性较低。此外，当第一次妊娠发生极其不良的结局或不良结局再次出现时，敏感性较高。唯一高敏感性的是既往婴儿死亡（85.4%）。这些结果表明，在使用这些变量识别高危亚组以进行进一步研究或控制混杂因素时应谨慎。
