Agreement between maternal report and medical records on use of medications during early pregnancy in New York.
Agreement between maternal report and medical records on use of medications during early pregnancy in New York.
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纽约孕产妇报告和医疗记录之间关于妊娠早期药物使用的协议。
DOI：
10.1002/bdr2.2151
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发表时间：
2023
影响因子：
2.1
通讯作者：
BirthDefectsStudyToEvaluatePregnancyExposureS
中科院分区：
文献类型：
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作者：
Howley,MeredithM;Fisher,SarahC;Fuentes,MarguerittaA;Werler,MarthaM;Tracy,Melissa;Browne,MarilynL;BirthDefectsStudyToEvaluatePregnancyExposureS
背景评估妊娠期药物使用与出生结果之间关联的研究依赖于各种暴露信息来源。我们试图评估怀孕早期自我报告的药物使用情况与产前医疗记录中的药物信息之间的一致性，以了解这些信息来源的可靠性。方法我们将怀孕早期自我报告的处方药物使用情况与参加评估妊娠暴露的出生缺陷研究的 184 名纽约妇女的医疗记录进行了比较，这些妇女于 2018 年分娩。我们评估了长期和间歇性使用的药物以及 12 个治疗组内的药物。我们使用 kappa (κ) 系数、灵敏度和特异性计算一致性。我们通过病例/对照状态、产妇年龄、教育程度、访谈时间和访谈语言来评估差异。结果长期使用的药物显示自我报告和医疗记录之间存在显着一致性（κ = 0.75、0.61-0.88），长期使用的治疗组的一致性范围从抗糖尿病药物的 κ = 0.61 到抗高血压药物的 κ = 1.00。偶尔使用的处方药表现出较差的一致性（κ = 0.40、0.25-0.54），阿片类镇痛药（κ = 0.20）和抗感染药（κ = 0.33）的一致性最低。尽管我们通过访谈语言观察到了潜在的差异，但协议并没有因所检查的特征而有所不同。结论在我们的样本中，我们观察到长期使用药物的自我报告和医疗记录之间具有良好的一致性，而对于偶尔使用的药物，一致性则要低得多。来源差异可能是由于自我报告记忆力差、不遵守处方药以及医疗记录中缺乏完整的处方信息。在流行病学研究中评估妊娠早期处方药暴露时应考虑局限性。
BackgroundStudies evaluating associations between medication use in pregnancy and birth outcomes rely on various sources of exposure information. We sought to assess agreement between self‐reported use of medications during early pregnancy and medication information in prenatal medical records to understand the reliability of each of these information sources.MethodsWe compared self‐reported prescription medication use in early pregnancy to medical records from 184 New York women with deliveries in 2018 who participated in the Birth Defects Study To Evaluate Pregnancy exposureS. We assessed medications used chronically and episodically, and medications within 12 therapeutic groups. We calculated agreement using kappa (κ) coefficients, sensitivity, and specificity. We assessed differences by case/control status, maternal age, education, time to interview, and interview language.ResultsMedications used chronically showed substantial agreement between self‐report and medical records (κ = 0.75, 0.61–0.88), with agreement for therapeutic groups used chronically ranging from κ = 0.61 for antidiabetics to κ = 1.00 for antihypertensives. Prescription medications used episodically showed worse agreement (κ = 0.40, 0.25–0.54), with the lowest agreement for opioid analgesics (κ = 0.20) and anti‐infectives (κ = 0.33). Agreement did not differ by the characteristics examined, although we observed potential differences by interview language.ConclusionsAmong our sample, we observed good agreement between self‐report and medical records for medications used chronically and substantially less agreement for medications used episodically. Differences by source may be due to poor recall in self‐reports, non‐adherence with prescribed medications and lack of complete prescription information within medical records. Limitations should be considered when assessing prescription medication exposures during early pregnancy in epidemiologic studies.