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母亲回忆妊娠期年龄和出生体重的有效性:结构访谈与病历比较。

Validity of maternal recall of gestational age and weight at birth: Comparison of structured interview and medical records.

机构信息

Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.

Slone Epidemiology Center at Boston University, Boston, MA, USA.

出版信息

Pharmacoepidemiol Drug Saf. 2019 Feb;28(2):269-273. doi: 10.1002/pds.4699. Epub 2018 Nov 29.

Abstract

PURPOSE

To assess agreement between maternal recall and medical records for gestational age (GA) at birth as derived from dating information and birthweight.

METHODS

In the case-control Slone Birth Defects Study, within 6 months of delivery, trained nurses conducted standardized telephone interviews with mothers of infants with and without major structural malformations. In a subset of approximately 5000 case and control mothers from five US centers (2008-2012), a research nurse abstracted subjects' medical records. GA at delivery was calculated as date of delivery minus (estimated date of confinement [EDC] minus 280); if EDC was unknown, last menstrual period served as a proxy for start of pregnancy. Positive and negative predictive values (PPV and NPV, respectively) were calculated, using medical records as the standard, for categories of GA at delivery (ie, early preterm <238, late preterm <258, and term ≥259 d) and birthweight (low <2500, normal 2500 to 4500, and high >4500 g).

RESULTS

The gestational age and birthweight validation samples comprised 3122 and 4760 women, respectively, with diverse characteristics. The PPV and NPV were high (>92% and >99%, respectively) for all categories of delivery GA and birthweight.

CONCLUSIONS

Our findings suggest that mothers' recall may be a valid alternative to medical records to estimate delivery GA and birthweight. This study used standardized interviews conducted by trained research nurses, had a short recall period (<6 months post delivery), and for delivery GA, focused on date-derived GA. Further research is needed on the potential impact of study design, population characteristics, and comparison to other data sources.

摘要

目的

评估通过约会信息和出生体重推断的出生时孕龄(GA)的母体回忆与医疗记录之间的一致性。

方法

在病例对照 Slone 出生缺陷研究中,训练有素的护士在分娩后 6 个月内对有和没有主要结构畸形的婴儿的母亲进行标准化电话访谈。在来自五个美国中心的大约 5000 名病例和对照母亲的亚组中(2008-2012 年),一名研究护士摘录了受试者的病历。分娩时的 GA 计算为分娩日期减去(估计的预产期 [EDC] 减去 280);如果 EDC 未知,则末次月经作为妊娠开始的替代。使用病历作为标准,计算了分娩时 GA(即早产 <238、晚期早产 <258 和足月≥259 天)和出生体重(低 <2500、正常 2500 至 4500 和高>4500 克)的阳性和阴性预测值(PPV 和 NPV)。

结果

GA 和出生体重验证样本分别由 3122 名和 4760 名女性组成,具有不同的特征。所有分娩 GA 和出生体重类别均具有较高的 PPV(>92%和>99%)和 NPV(>99%)。

结论

我们的研究结果表明,母亲的回忆可能是估计分娩 GA 和出生体重的医疗记录的有效替代方法。本研究使用了经过培训的研究护士进行的标准化访谈,回忆期较短(<6 个月),并且对于分娩 GA,侧重于日期推断的 GA。需要进一步研究研究设计、人群特征以及与其他数据源比较对潜在影响。

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