Pregnancy Complications as Markers for Subsequent Maternal Cardiovascular Disease: Validation of a Maternal Recall Questionnaire
Pregnancy Complications as Markers for Subsequent Maternal Cardiovascular Disease: Validation of a Maternal Recall Questionnaire
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DOI：
10.1089/jwh.2014.4953
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发表时间：
2015-09-01
影响因子：
3.5
通讯作者：
Seely, Ellen W.
中科院分区：
文献类型：
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作者：
Carter, Ebony Boyce;Stuart, Jennifer J.;Seely, Ellen W.
背景：基于2011年美国心脏协会（AHA）指南，我们设计并测试了一份问卷的有效性，以表征与未来心血管疾病风险增加相关的妊娠并发症的母亲回忆。方法：对参与队列研究的1608例孕妇971例进行妊娠史回忆问卷调查。研究怀孕期间的医疗记录是金标准。对每个问题计算患病率、敏感性（sens）、特异性（spec）、阳性预测值（PPV）、阴性预测值（NPV）和/或Spearman相关系数(r)。结果：回访者526人（54%）。受访者更有可能是年龄较大，受过教育的白人，未生育，并且在研究怀孕期间分娩低出生体重婴儿的可能性低于没有回应的个体。产后平均回忆时间为4.35年（标准差[SD] 0.46）。妊娠期糖尿病（sens: 92%, spec: 98%, PPV: 79%, NPV: 99%）、婴儿出生体重（r=0.95）和妊娠期长（r=0.85）的母亲回忆最准确。先兆子痫（sens: 79%, spec: 97%, PPV: 68%, NPV: 98%）和妊娠相关高血压，包括先兆子痫或妊娠高血压（sens: 60%, spec: 95%, PPV: 64%, NPV: 94%）的母亲回忆不高。结论：这项验证性研究表明，大多数妇女能够准确地回忆起妊娠糖尿病史、婴儿出生体重和分娩时的胎龄，平均产后4年。子痫前期和妊娠相关高血压的召回总体上是适度的。这些妊娠情况的产妇报告可以帮助临床医生确定妇女患心血管疾病的风险增加。
Background: We designed and tested the validity of a questionnaire to characterize maternal recall of pregnancy complications associated with increased future cardiovascular disease risk, based on the 2011 American Heart Association (AHA) guidelines. Methods: A maternal recall questionnaire of pregnancy history was administered to 971 patients who had participated in a previous cohort study of 1,608 pregnant women. Medical records from the study pregnancy served as the gold standard. Prevalence, sensitivity (sens), specificity (spec), positive predictive value (PPV), negative predictive value (NPV), and/or Spearman's correlation coefficients (r) were calculated for each question. Results: A total of 526 (54%) individuals recontacted responded. Respondents were more likely to be older, white, educated, and nulliparous and were less likely to deliver low-birthweight infants in the study pregnancy than were individuals who did not respond. Mean length of recall was 4.35 years (standard deviation [SD] 0.46) postpartum. Maternal recall was most accurate for gestational diabetes (sens: 92%, spec: 98%, PPV: 79%, NPV: 99%), infant birthweight (r=0.95), and gestation length (r=0.85). Maternal recall was modest for preeclampsia (sens: 79%, spec: 97%, PPV: 68%, NPV: 98%) and pregnancy-associated hypertension, including preeclampsia or gestational hypertension (sens: 60%, spec: 95%, PPV: 64%, NPV: 94%). Conclusions: This validation study demonstrated that the majority of women could accurately recall a history of gestational diabetes, infant birthweight, and gestational age at delivery, 4 years postpartum on average. Recall of preeclampsia and pregnancy-associated hypertension overall was modest. Maternal report of these pregnancy conditions may help clinicians identify women at increased risk for cardiovascular disease.