母亲对分娩并发症的回忆与产科记录数据之间的一致性。
Concordance between maternal recall of birth complications and data from obstetrical records.
作者信息
Keenan Kate, Hipwell Alison, McAloon Rose, Hoffmann Amy, Mohanty Arpita, Magee Kelsey
机构信息
Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
Department of Psychiatry, University of Pittsburgh, 121 Meyran Ave, Pittsburgh, PA 15213, USA.
出版信息
Early Hum Dev. 2017 Feb;105:11-15. doi: 10.1016/j.earlhumdev.2017.01.003. Epub 2017 Jan 15.
BACKGROUND
Prenatal complications are associated with poor outcomes in the offspring. Access to medical records is limited in the United States and investigators often rely on maternal report of prenatal complications.
STUDY DESIGN AND AIMS
We tested concordance between maternal recall and birth records in a community-based sample of mothers participating in a longitudinal study in order to determine the accuracy of maternal recall of perinatal complications.
SUBJECTS
Participants were 151 biological mothers, who were interviewed about gestational age at birth, birthweight, and the most commonly occurring birth complications: nuchal cord and meconium aspiration when the female child was on average 6years old, and for whom birth records were obtained.
OUTCOME MEASURES
Concordance between reports was assessed using one-way random intra-class coefficients for continuous measures and kappa coefficients for dichotomous outcomes. Associations between maternal demographic and psychological factors and discrepancies also were tested.
RESULTS
Concordance was excellent for continuously measured birthweight (ICC=0.85, p<0.001) and good for gestational age (ICC=0.68, p<0.001). Agreement was good for low birthweight (<2500g) (kappa=0.67, p<0.001), fair for preterm delivery (<37weeks gestation) (kappa=0.44, p<0.001), and poor for nuchal cord or meconium aspiration. Most discrepancies were characterized by presence according to birth record and absence according to maternal recall. Receipt of public assistance was associated with a decrease in discrepancy in report of nuchal cord.
CONCLUSIONS
Concordance between maternal retrospective report and medical birth records varies across different types of perinatal events. There was little evidence that demographic or psychological factors increased the risk of discrepancies. Maternal recall based on continuous measures of perinatal factors may yield more valid data than dichotomous outcomes.
背景
产前并发症与后代不良结局相关。在美国，获取医疗记录受到限制，研究人员通常依赖母亲对产前并发症的报告。
研究设计与目的
我们在参与一项纵向研究的社区母亲样本中，测试了母亲回忆与出生记录之间的一致性，以确定母亲对围产期并发症回忆的准确性。
研究对象
参与者为151名亲生母亲，当女童平均6岁时，对她们进行了关于出生时的孕周、出生体重以及最常见的出生并发症（脐带绕颈和胎粪吸入）的访谈，并获取了她们的出生记录。
观察指标
对于连续性测量指标，使用单向随机组内相关系数评估报告之间的一致性；对于二分结局，使用kappa系数评估。还测试了母亲的人口统计学和心理因素与差异之间的关联。
结果
对于连续性测量的出生体重，一致性极佳（组内相关系数ICC = 0.85，p < 0.001）；对于孕周，一致性良好（ICC = 0.68，p < 0.001）。对于低出生体重（<2500g），一致性良好（kappa = 0.67，p < 0.001）；对于早产（孕周<37周），一致性一般（kappa = 0.44，p < 0.001）；对于脐带绕颈或胎粪吸入，一致性较差。大多数差异的特征是根据出生记录存在而根据母亲回忆不存在。接受公共援助与脐带绕颈报告差异的减少有关。
结论
母亲回顾性报告与医疗出生记录之间的一致性在不同类型的围产期事件中有所不同。几乎没有证据表明人口统计学或心理因素会增加差异的风险。基于围产期因素连续性测量的母亲回忆可能比二分结局产生更有效的数据。
Zotero 插件