Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA; Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Magee-Womens Research Institute, Pittsburgh, PA.
Paediatr Perinat Epidemiol. 2014 May;28(3):203-12. doi: 10.1111/ppe.12120. Epub 2014 Mar 27.
Studies using vital records-based maternal weight data have become more common, but the validity of these data is uncertain.
We evaluated the accuracy of prepregnancy body mass index (BMI) and gestational weight gain (GWG) reported on birth certificates using medical record data in 1204 births at a teaching hospital in Pennsylvania from 2003 to 2010. Deliveries at this hospital were representative of births statewide with respect to BMI, GWG, race/ethnicity, and preterm birth. Forty-eight strata were created by simultaneous stratification on prepregnancy BMI (underweight, normal weight/overweight, obese class 1, obese classes 2 and 3), GWG (<20th, 20-80th, >80th percentile), race/ethnicity (non-Hispanic white, non-Hispanic black), and gestational age (term, preterm).
The agreement of birth certificate-derived prepregnancy BMI category with medical record BMI category was highest in the normal weight/overweight and obese class 2 and 3 groups. Agreement varied from 52% to 100% across racial/ethnic and gestational age strata. GWG category from the birth registry agreed with medical records for 41-83% of deliveries, and agreement tended to be the poorest for very low and very high GWG. The misclassification of GWG was driven by errors in reported prepregnancy weight rather than maternal weight at delivery, and its magnitude depended on prepregnancy BMI category and gestational age at delivery.
Maternal weight data, particularly at the extremes, are poorly reported on birth certificates. Investigators should devote resources to well-designed validation studies, the results of which can be used to adjust for measurement errors by bias analysis.
基于生命记录的孕产妇体重数据的研究变得越来越普遍，但这些数据的准确性尚不确定。
我们评估了宾夕法尼亚州一家教学医院 2003 年至 2010 年间 1204 例分娩的医疗记录数据中，出生证明上报告的孕前体重指数（BMI）和妊娠体重增加（GWG）的准确性。该医院的分娩情况在 BMI、GWG、种族/民族和早产方面与全州的分娩情况具有代表性。通过同时对孕前 BMI（体重不足、正常体重/超重、肥胖 1 类、肥胖 2 类和 3 类）、GWG（<第 20 百分位、第 20-80 百分位、>第 80 百分位）、种族/民族（非西班牙裔白人、非西班牙裔黑人）和孕龄（足月、早产）进行分层，创建了 48 个分层。
出生证明衍生的孕前 BMI 类别与医疗记录 BMI 类别之间的一致性在正常体重/超重和肥胖 2 类和 3 类中最高。在不同的种族/民族和孕龄分层中，一致性从 52%到 100%不等。出生登记处的 GWG 类别与医疗记录相符的比例为 41-83%，对于非常低和非常高的 GWG，一致性往往最差。GWG 的分类错误是由于报告的孕前体重而不是分娩时的产妇体重错误所致，其程度取决于孕前 BMI 类别和分娩时的孕龄。
出生证明上孕产妇体重数据，尤其是在极端情况下，报告得很差。研究人员应投入资源进行精心设计的验证研究，其结果可用于通过偏差分析来调整测量误差。
