Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France.
Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK.
Int J Epidemiol. 2023 Aug 2;52(4):1187-1196. doi: 10.1093/ije/dyad019.
Studies examining the potential impact of mothers' health during pregnancy on the health of their offspring often rely on self-reported information gathered several years later. To assess the validity of this approach, we analysed data from a national case-control study of childhood cancer (diagnosed <15 years) that collected health information from both interviews and medical records.
Mothers' interview reports of infections and medications in pregnancy were compared with primary care records. Taking clinical diagnoses and prescriptions as the reference, sensitivity and specificity of maternal recall along with kappa coefficients of agreement were calculated. Differences in the odd ratios estimated using logistic regression for each information source were assessed using the proportional change in the odds ratio (OR).
Mothers of 1624 cases and 2524 controls were interviewed ∼6 years (range 0-18 years) after their child's birth. Most drugs and infections were underreported; in general practitioner records, antibiotic prescriptions were nearly three times higher and infections >40% higher. Decreasing with increasing time since pregnancy, sensitivity was ⩽40% for most infections and all drugs except 'anti-epileptics and barbiturates' (sensitivity 80% among controls). ORs associated with individual drug/disease categories that were based on self-reported data varied from 26% lower to 26% higher than those based on medical records; reporting differences between mothers of cases and controls were not systematically in the same direction.
The findings highlight the scale of under-reporting and poor validity of questionnaire-based studies conducted several years after pregnancy. Future research using prospectively collected data should be encouraged to minimize measurement errors.
研究孕期母亲健康对后代健康的潜在影响，通常依赖于数年后收集的自我报告信息。为了评估这种方法的有效性，我们分析了一项全国性儿童癌症病例对照研究（诊断年龄<15 岁）的数据，该研究从访谈和医疗记录中收集健康信息。
将母亲在孕期的感染和用药情况的访谈报告与初级保健记录进行比较。以临床诊断和处方为参考，计算了母体回忆的敏感性和特异性以及一致性kappa 系数。使用逻辑回归估计每个信息源的比值比（OR），并评估使用临床诊断和处方作为参考时，每个信息源的差异（使用比值比的比例变化进行评估）。
1624 例病例和 2524 例对照的母亲在孩子出生后约 6 年（0-18 岁）接受了访谈。大多数药物和感染都报告不足；在全科医生记录中，抗生素处方几乎高出三倍，感染高出 40%。随着时间的推移，敏感性逐渐降低，大多数感染和除“抗癫痫药和巴比妥类药物”之外的所有药物的敏感性均≤40%（对照中敏感性为 80%）。基于自我报告数据的个别药物/疾病类别的 OR 比基于医疗记录的 OR 低 26%到高 26%不等；病例组和对照组母亲之间的报告差异并非系统地朝着同一方向。
研究结果强调了在妊娠数年后进行基于问卷调查的研究中报告不足和有效性差的问题。应鼓励未来使用前瞻性收集的数据进行研究，以尽量减少测量误差。
