Validation of Self-reported Maternal and Infant Health Indicators in the Pregnancy Risk Assessment Monitoring System
Validation of Self-reported Maternal and Infant Health Indicators in the Pregnancy Risk Assessment Monitoring System
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DOI：
10.1007/s10995-014-1487-y
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发表时间：
2014-12-01
影响因子：
2.3
通讯作者：
Taylor, Allan
中科院分区：
文献类型：
--
作者：
Dietz, Patricia;Bombard, Jennifer;Taylor, Allan
评估母亲在分娩后平均4个月报告的自我报告的母婴健康指标的有效性。2009年在纽约市（NYC）（n = 603）和佛蒙特州（n = 664）分娩活产的母亲代表性样本的妊娠风险评估监测系统（PRAMS）问卷中，计算了妊娠史、妊娠并发症、医疗保健利用和婴儿健康指标的三个有效性指标-敏感性、特异性和阳性预测值（PPV）。从医院记录中提取的数据作为金标准。所有数据都经过加权，以代表研究期间在纽约市或佛蒙特州分娩活产的妇女。大多数PRAMS指标具有> 90%的特异性。两个地点敏感性和PPV> 90%的指标包括先前的活产、任何糖尿病和分娩时的医疗补助保险，仅佛蒙特州的指标包括婴儿进入NICU和在医院母乳喂养。两个部位敏感性和PPV（<70%）较差的指标（即，纽约市和佛蒙特州）包括前置胎盘和/或胎盘脱垂、尿路感染或肾脏感染，仅纽约市包括早产、既往低出生体重儿和既往早产。仅在佛蒙特州，妊娠期间接受HIV检测的敏感性和PPV较差。母亲准确地报告了以前的活产和医疗保险的信息，在交付，但是，母亲的某些妊娠并发症和妊娠史的回忆是穷人。这些结论可用于确定收集高有效性指标数据的优先次序。
To assess the validity of self-reported maternal and infant health indicators reported by mothers an average of 4 months after delivery. Three validity measures-sensitivity, specificity and positive predictive value (PPV)-were calculated for pregnancy history, pregnancy complications, health care utilization, and infant health indicators self-reported on the Pregnancy Risk Assessment Monitoring System (PRAMS) questionnaire by a representative sample of mothers delivering live births in New York City (NYC) (n = 603) and Vermont (n = 664) in 2009. Data abstracted from hospital records served as gold standards. All data were weighted to be representative of women delivering live births in NYC or Vermont during the study period. Most PRAMS indicators had > 90 % specificity. Indicators with > 90 % sensitivity and PPV for both sites included prior live birth, any diabetes, and Medicaid insurance at delivery, and for Vermont only, infant admission to the NICU and breastfeeding in the hospital. Indicators with poor sensitivity and PPV (< 70 %) for both sites (i.e., NYC and Vermont) included placenta previa and/or placental abruption, urinary tract infection or kidney infection, and for NYC only, preterm labor, prior low-birth-weight birth, and prior preterm birth. For Vermont only, receipt of an HIV test during pregnancy had poor sensitivity and PPV. Mothers accurately reported information on prior live births and Medicaid insurance at delivery; however, mothers' recall of certain pregnancy complications and pregnancy history was poor. These findings could be used to prioritize data collection of indicators with high validity.