A home calendar and recall method of last menstrual period for estimating gestational age in rural Bangladesh: a validation study.
A home calendar and recall method of last menstrual period for estimating gestational age in rural Bangladesh: a validation study.
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DOI：
10.1186/s41043-016-0072-y
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发表时间：
2016-10-21
期刊：
影响因子：
--
通讯作者：
Christian P
中科院分区：
文献类型：
--
作者：
Gernand AD;Paul RR;Ullah B;Taher MA;Witter FR;Wu L;Labrique AB;West KP Jr;Christian P
评估孕周的最好方法是在妊娠早期使用超声波；然而，这种方法在农村地区的大规模现场试验中是不切实际的。我们的目的是评估从预期收集的末次月经期(LMP)日期估计的孕周的有效性，使用超声测量早期妊娠时的头臀长度(CRL)。作为在孟加拉国农村进行的一项大型整群随机对照试验的一部分，我们通过回忆收集了LMP的日期，并在可能怀孕的妇女中每5周在日历上标记一次。在那些尿检证实怀孕的人中，登记了胎龄为15周的子组(N CRL353)，进行超声随访以测量 = 。我们比较了访谈评估的LMP与CRL胎龄估计以及早产、足月和早产儿的分类。基于LMP的孕周比CRL平均高2.8d(10.7天)；不同的母亲教育程度和早产不同(P <； 005)。超声和出生时的一致性相关系数分别为0.63(95%CI 0.56，0.69)和0.77(95%CI 0.73，0.81)。早产分类的效度较高，而足月后较低，特异度分别为96%和89%，敏感度分别为86%和67%。按胎次计算，结果相似。在农村低收入环境中，前瞻性收集的LMP提供了对胎龄和早产的有效估计，在规划环境和大型现场试验中可能是超声波的合适替代品。ClinicalTrials.gov NCT00860470本文的在线版本(doi：10.1186/s41043-0160072-y)包含补充材料，授权用户可以使用。
The best method of gestational age assessment is by ultrasound in the first trimester; however, this method is impractical in large field trials in rural areas. Our objective was to assess the validity of gestational age estimated from prospectively collected date of last menstrual period (LMP) using crown-rump length (CRL) measured in early pregnancy by ultrasound. As part of a large, cluster-randomized, controlled trial in rural Bangladesh, we collected dates of LMP by recall and as marked on a calendar every 5 weeks in women likely to become pregnant. Among those with a urine-test confirmed pregnancy, a subset with gestational age of <15 weeks (n = 353) were enrolled for ultrasound follow-up to measure CRL. We compared interview-assessed LMP with CRL gestational age estimates and classification of preterm, term, and post-term births. LMP-based gestational age was higher than CRL by a mean (SD) of 2.8 (10.7) days; differences varied by maternal education and preterm birth (P < 0.05). Lin’s concordance correlation coefficient was good at ultrasound [0.63 (95 % CI 0.56, 0.69)] and at birth [0.77 (95 % CI 0.73, 0.81)]. Validity of classifying preterm birth was high but post-term was lower, with specificity of 96 and 89 % and sensitivity of 86 and 67 %, respectively. Results were similar by parity. Prospectively collected LMP provided a valid estimate of gestational age and preterm birth in a rural, low-income setting and may be a suitable alternative to ultrasound in programmatic settings and large field trials. ClinicalTrials.gov NCT00860470 The online version of this article (doi:10.1186/s41043-016-0072-y) contains supplementary material, which is available to authorized users.
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