Ellison G T, de Wet T, Matshidze K P, Cooper P
Social Science Research Unit, Institute of Education, University of London.
Curationis. 2000 Dec;23(4):76-80. doi: 10.4102/curationis.v23i4.753.
To assess whether self-reports of reproductive history and obstetric morbidity provide an accurate basis for clinical decision-making. SETTING, PARTICIPANTS AND METHODS: Self-reports of maternal age and reproductive history, together with clinical measurements of five medical disorders, were abstracted from the obstetric notes of 517 mothers whose children were enrolled in the Birth to Ten study. These data were compared to self-reported information collected by interview during the Birth to Ten study.
The reliability of self-reported age and gravidity was high (R = 0.810-0.993), yet self-reports of previous miscarriages, terminations, premature- and stillbirths were only fairly reliable (Kappa = 0.48-0.50). Self-reported diabetes and high blood pressure had specificities of more than 95% for glycosuria, hypertension and pre-eclampsia. However, the specificity of self-reported oedema for hypertensive disorders and the specificity of self-reported urinary tract infection for STD seropositivity were only around 65%.
The modest reliability and limited validity of self-reported obstetric morbidity undermines the clinical utility of this information.
These results strengthen the case for providing mothers with "Home-based Maternal Records" to facilitate access to accurate obstetric information during subsequent clinical consultations.
评估生殖史和产科发病率的自我报告是否能为临床决策提供准确依据。
设置、参与者与方法：从517名母亲的产科记录中提取产妇年龄和生殖史的自我报告，以及五种医学病症的临床测量数据，这些母亲的孩子参与了“从出生到十岁”研究。将这些数据与“从出生到十岁”研究期间通过访谈收集的自我报告信息进行比较。
自我报告年龄和妊娠次数的可靠性较高（R = 0.810 - 0.993），然而，既往流产、终止妊娠、早产和死产的自我报告仅具有中等可靠性（Kappa = 0.48 - 0.50）。自我报告的糖尿病和高血压对糖尿、高血压和先兆子痫的特异性超过95%。然而，自我报告的水肿对高血压疾病的特异性以及自我报告的尿路感染对性传播疾病血清阳性的特异性仅约为65%。
自我报告的产科发病率可靠性一般且有效性有限，削弱了该信息的临床实用性。
这些结果进一步证明了为母亲提供“家庭孕产妇记录”的必要性，以便在后续临床咨询中获取准确的产科信息。
