Stefanak M A, Bourguet C C, Benzies-Styka T
Mahoning County General Health District Board of Health, Youngstown, Ohio, USA.
Obstet Gynecol. 1996 Feb;87(2):209-12. doi: 10.1016/0029-7844(95)00397-5.
To assess the accuracy of a questionnaire developed by the Centers for Disease Control and Prevention (CDC), given to pregnant women for identification of children at risk for lead poisoning.
The study population consisted of all 314 new prenatal patients enrolled in health department clinics in 1990-1992. Lead was measured in venous blood, and patients completed written questionnaires to gather information about lead exposure risk factors. The relationship between elevated maternal blood lead levels (at or greater than 10 micrograms/dL or 0.483 mumol/L) and responses to the CDC questionnaire and other questions were examined using chi 2 statistical analysis.
Two hundred ninety-nine women provided responses to questions about lead exposure risk. Thirty-nine women (13%) had elevated blood lead levels. A woman with a positive response to at least one CDC question was more likely to have elevated blood lead than a woman who answered negatively to all four CDC questions (relative risk = 2.39, 95% confidence interval 1.17-4.89; P = .01). Using the CDC definition of high risk ("yes" to at least one question), the questionnaire had a sensitivity of 75.7% and a negative predictive value of 93.1%. A questionnaire that combined housing conditions, smoking status, and high consumption of canned foods had a sensitivity of 89.2% and a negative predictive value of 96.4%. A high prevalence of elevated blood lead in children living with women with elevated blood lead was observed.
Querying pregnant women about risk factors for lead exposure can aid in assessing prenatal lead exposure risk. The sensitivity and negative predictive value of the CDC questionnaire, when used with high-risk women, are comparable to its reported accuracy in young children.
评估美国疾病控制与预防中心（CDC）编制的一份问卷在识别有铅中毒风险儿童方面的准确性，该问卷发放给了孕妇。
研究对象包括1990 - 1992年在卫生部门诊所登记的所有314名新的产前患者。检测静脉血中的铅含量，并让患者填写书面问卷以收集有关铅暴露风险因素的信息。使用卡方统计分析来研究孕妇血铅水平升高（达到或高于10微克/分升或0.483微摩尔/升）与对CDC问卷及其他问题的回答之间的关系。
299名女性回答了有关铅暴露风险的问题。39名女性（13%）血铅水平升高。对至少一个CDC问题回答为阳性的女性比所有四个CDC问题回答均为阴性的女性更有可能血铅水平升高（相对风险 = 2.39，95%置信区间1.17 - 4.89；P = 0.01）。根据CDC的高风险定义（至少一个问题回答“是”），该问卷的灵敏度为75.7%，阴性预测值为93.1%。一份综合了住房条件、吸烟状况和罐装食品高消费量的问卷，灵敏度为89.2%，阴性预测值为96.4%。观察到与血铅水平升高的女性生活在一起的儿童中血铅水平升高的患病率较高。
询问孕妇铅暴露风险因素有助于评估产前铅暴露风险。CDC问卷在用于高危女性时的灵敏度和阴性预测值与报告的在幼儿中的准确性相当。
