Pickett Kate E, Kasza Kristen, Biesecker Gretchen, Wright Rosalind J, Wakschlag Lauren S
Department of Health Sciences and Hull-York Medical School, University of York, Seebohm Rowntree Building, Area 3, Heslington, York YO105DD, UK.
Nicotine Tob Res. 2009 Oct;11(10):1166-74. doi: 10.1093/ntr/ntp117. Epub 2009 Jul 28.
Retrospective recall of smoking during pregnancy is assumed to be substantially biased, but this has rarely been tested empirically.
We examined the validity of an interview-based retrospective recall more than a decade after pregnancy, in a cohort with repeated, multimethod characterization of pregnancy smoking (N = 245). Retrospective smoking patterns were examined in relation to prospective reported and biological estimates of overall and trimester-specific smoking status and intensity. We also compared characteristics of women whose smoking status was misclassified by either prospective or retrospective measures with women whose status was congruent for nonsmoking across timepoints.
In general, sensitivity and specificity of recalled smoking were excellent relative to both prospective self-reported and cotinine-validated smoking status and trimester-specific intensity. However, measures were less congruent for amount smoked for women who recalled being heavy smokers. Further, retrospective measures captured some smokers not identified prospectively due to smoking that occurred prior to assessments. Women who would have been misclassified as nonsmokers based on either prospective or retrospective assessment differed significantly from congruently classified nonsmokers in a number of maternal, family, and neighborhood, but not child behavior, characteristics.
When epidemiological studies of the impact of smoking in pregnancy use retrospective methods, misclassification may not be a significant problem if prenatal smoking is assessed in terms of the pattern across pregnancy. This type of interview-based recall of pregnancy smoking may be relatively accurate, although optimal measurement should combine retrospective and prospective self-report and biological assays, as each provide unique information and sources of error.
孕期吸烟的回顾性回忆被认为存在很大偏差，但这很少经过实证检验。
我们在一个对孕期吸烟进行重复、多方法特征描述的队列（N = 245）中，研究了怀孕十多年后基于访谈的回顾性回忆的有效性。研究了回顾性吸烟模式与总体及孕期特定吸烟状况和强度的前瞻性报告及生物学估计之间的关系。我们还比较了吸烟状况在前瞻性或回顾性测量中被误分类的女性与在各时间点吸烟状况一致的非吸烟女性的特征。
总体而言，相对于前瞻性自我报告和可替宁验证的吸烟状况及孕期特定强度，回忆吸烟的敏感性和特异性都非常好。然而，对于回忆为重度吸烟者的女性，吸烟量的测量一致性较差。此外，回顾性测量捕捉到了一些因评估前吸烟而未被前瞻性识别的吸烟者。基于前瞻性或回顾性评估会被误分类为非吸烟者的女性，在许多母亲、家庭和邻里特征方面与分类一致的非吸烟者有显著差异，但在儿童行为特征方面没有差异。
当关于孕期吸烟影响的流行病学研究采用回顾性方法时，如果根据整个孕期的模式评估产前吸烟情况，误分类可能不是一个重大问题。这种基于访谈的孕期吸烟回忆可能相对准确，尽管最佳测量应结合回顾性和前瞻性自我报告以及生物学检测，因为每种方法都提供独特的信息和误差来源。
