Troude Pénélope, L'Hélias Laurence Foix, Raison-Boulley Anne-Marie, Castel Christine, Pichon Christine, Bouyer Jean, de La Rochebrochard Elise
INED, 133 bld Davout, Paris, France.
Eur J Epidemiol. 2008;23(8):557-64. doi: 10.1007/s10654-008-9268-9. Epub 2008 Jun 17.
As perinatal events have been linked with diseases of later onset, epidemiological studies on child development and adult health require information on the perinatal period. When national neonatal registers do not exist, review of medical records may be impractical. However, neonatal information could be obtained by asking mothers to complete a postal questionnaire using data from the Personal Child Health Record (PCHR). We assessed agreement between medical records and mothers' reports for information on delivery and the newborn's condition at birth, based on the PCHR, a short time after delivery. Of 711 women giving birth in 3 French hospitals and invited to participate in the study, 580 (82%) completed a postal questionnaire 6 weeks after delivery, copying the data recorded in the PCHR when available. Information on pregnancy, delivery and the newborn's health at birth was independently extracted from medical records by physicians of the maternity departments. Agreement between medical records and maternal reports for a range of perinatal factors was assessed in 580 newborn-mother dyads using kappa coefficients. Agreement was excellent for first and second stages of delivery, gestational age, birth weight, birth size and head circumference (kappa coefficients 0.80-1.00) and good for hospitalization during pregnancy, but poor for Apgar scores. With this exception, mothers' reports appeared reliable when compared with medical records. As PCHRs exist in most developed countries, this approach could be used in epidemiological studies on child development to increase the reliability of mothers' reports of their newborn's condition at birth.
由于围产期事件与后期发病的疾病有关,关于儿童发育和成人健康的流行病学研究需要围产期的信息。当国家没有新生儿登记册时,查阅病历可能不切实际。然而,可以通过要求母亲使用个人儿童健康记录(PCHR)中的数据填写邮政问卷来获取新生儿信息。我们在分娩后不久,基于PCHR评估了病历与母亲报告在分娩信息和新生儿出生时状况方面的一致性。在3家法国医院分娩并受邀参与研究的711名妇女中,580名(82%)在分娩后6周完成了邮政问卷,如有可用数据则复制PCHR中记录的数据。产科部门的医生从病历中独立提取了有关妊娠、分娩和新生儿出生时健康状况的信息。使用kappa系数在580对新生儿-母亲二元组中评估了一系列围产期因素在病历与母亲报告之间的一致性。分娩第一和第二阶段、胎龄、出生体重、出生尺寸和头围的一致性极佳(kappa系数为0.80 - 1.00),妊娠期间住院情况的一致性良好,但阿氏评分的一致性较差。除了这一例外情况,与病历相比,母亲的报告似乎是可靠的。由于大多数发达国家都有PCHR,这种方法可用于儿童发育的流行病学研究,以提高母亲对其新生儿出生时状况报告的可靠性。