Krakowiak Paula, Walker Cheryl K, Tancredi Daniel J, Hertz-Picciotto Irva
Divisions of Epidemiology and of Environmental and Occupational Health, Department of Public Health Sciences, School of Medicine, University of California, Davis, CA, USA,
Matern Child Health J. 2015 Sep;19(9):1925-35. doi: 10.1007/s10995-015-1723-0.
To assess validity of maternally-reported diabetes and hypertensive disorders, and reliability of BMI measurements during periconception and pregnancy compared with medical records when mothers are interviewed 2-5 years after delivery. To investigate whether reporting accuracy differed by child's case status (autism, delays, typical development). Participants were mothers of 2-5 year old children with and without neurodevelopmental disorders from the CHARGE (CHildhood Autism Risks from Genetics and the Environment) Study who had both prenatal/delivery records and telephone interviews. Sensitivity and specificity of self-report in telephone interview was assessed by comparison with medical records; agreement was evaluated by kappa statistics. Deviations in reported BMI were evaluated with Bland-Altman plots and concordance correlation coefficient (CCC). Mothers of children with neurodevelopmental disorders (autism or developmental delay) reported metabolic conditions slightly more accurately than control mothers. For diabetes, sensitivity ranged from 73 to 87% and specificity was ≥98% across groups. For hypertensive disorders, sensitivity ranged from 57 to 77% and specificity from 93 to 98%. Reliability of BMI was high (CCC = 0.930); when grouped into BMI categories, a higher proportion of mothers of delayed children were correctly classified (κ(wt) = 0.93) compared with the autism group and controls (κ(wt) = 0.85 and κ(wt) = 0.84, respectively; P = 0.05). Multiparity was associated with higher discrepancies in BMI and misreporting of hypertensive disorders. For purposes of etiologic studies, self-reported diabetes and hypertensive disorders during periconception and pregnancy show high validity among mothers irrespective of child's case status. Recall of pre-pregnancy BMI is reliable compared with self-reported values in medical records.
为评估母亲报告的糖尿病和高血压疾病的有效性，以及与产后2至5年接受访谈时的病历相比，孕期及围孕期体重指数（BMI）测量值的可靠性。调查报告准确性是否因孩子的病例状况（自闭症、发育迟缓、正常发育）而有所不同。研究对象为参与CHARGE（遗传与环境导致的儿童自闭症风险）研究的2至5岁患有或未患神经发育障碍儿童的母亲，她们均有产前/分娩记录且接受了电话访谈。通过与病历比较评估电话访谈中自我报告的敏感性和特异性；用kappa统计量评估一致性。用Bland-Altman图和一致性相关系数（CCC）评估报告的BMI偏差。患有神经发育障碍（自闭症或发育迟缓）儿童的母亲报告代谢状况的准确性略高于对照母亲。对于糖尿病，各群体的敏感性范围为73%至87%，特异性≥98%。对于高血压疾病，敏感性范围为57%至77%，特异性为93%至98%。BMI的可靠性较高（CCC = 0.930）；按BMI类别分组时，发育迟缓儿童的母亲被正确分类的比例较高（加权κ = 0.93），而自闭症组和对照组分别为加权κ = 0.85和加权κ = 0.84；P = 0.05）。多胎妊娠与BMI差异较大及高血压疾病报告错误有关。对于病因学研究而言，无论孩子的病例状况如何，母亲在围孕期和孕期自我报告的糖尿病和高血压疾病具有较高的有效性。与病历中的自我报告值相比，孕前BMI的回忆是可靠的。
