Agreement Between Self-Report and Birth Certificate for Gestational Diabetes Mellitus: New York State PRAMS

Abstract

This study examined agreement (concordance or convergent validity) between self-report and birth certificate for gestational diabetes. Study population was 2,854 women who had live births 2-6 months earlier and responded to a questionnaire from the New York State Pregnancy Risk Assessment Monitoring System (PRAMS) survey, 2004-2006. Agreement between self-report and birth certificate was assessed for the study population overall, and for subgroups defined by race, age, education, marital status, number of previous live births, time of first prenatal care, and birth weight of the newborn. A total of 258 women self-reported gestational diabetes, while birth certificates indicated that 138 women had gestational diabetes. For the study population overall, percent agreement was 93.8% and Kappa was 0.53. Due to the moderate bias index (68.2% overall, ranged from 33.3 to 100% in subgroups) and the high skewed prevalence index (91.8% overall, ranged from 70.7 to 97.5% in subgroups), we determined Prevalence-Adjusted and Bias-Adjusted Kappa (PABAK) was a better measure of agreement. PABAK was 0.88 overall, indicating very good agreement. PABAK was uniformly high in all subgroups. The highest PABAK was found among women aged 25 years and younger (0.93), and the lowest PABAK was among Asian women (0.79). Although the absence of a gold standard for gestational diabetes hinders assessment of criterion validity, high PABAK measures suggest that self-reporting by PRAMS respondents is feasible for identifying cases of gestational diabetes for surveillance and population-based epidemiologic research.

Pregnancy Complications as Markers for Subsequent Maternal Cardiovascular Disease: Validation of a Maternal Recall Questionnaire

“…A questionnaire was designed based on a review of the maternal recall literature on gestational diabetes, 21 preeclampsia, 22,23 birthweight, [24][25][26] and gestational age at delivery. [26][27][28][29][30][31][32][33][34][35] The questionnaire was piloted among the first 10 patients scheduled on a given day in both a general obstetrics and a maternal fetal medicine practice who agreed to complete the survey.…”

Prevalence, Trend and Determining Factors of Gestational Diabetes in Germany

“…The prevalence from the German perinatal statistics -at 3.7 % for the most recent available year -is below the figure provided by the KiGGS, which even for the years 2001 to 2006 led to a value of 5.3 %. Self-reported information can lead to significantly higher values than register-based data, as two studies from the USA have also shown: in these cases, prevalences were 9.0 and 8.7 % for self-reported information, versus 4.8 % in each case for medically validated and centrally-registered diagnoses, equivalent to differences of 4.2 or 3.9 percent points [8,9]. The comparison of the data sources used in this study indicates that the diagnosis of gestational diabetes was obviously not entered into the documentation program by the maternity hospitals in all cases.…”

Maternal diabetes and renal agenesis/dysgenesis

“…A recent review of studies evaluating the validity of birth certificates in identifying maternal diabetes reported sensitivities ranging from 47 to 52% for pre-gestational diabetes and 46 to 83% for gestational diabetes when compared to various standards (Devlin et al, 2009). A study of agreement between birth certificates and self-reported data from Pregnancy Risk Assessment Monitoring System respondents observed a lower prevalence of gestational diabetes reported on birth certificates (4.8 vs. 9%), accompanied by a percent agreement of 93.8% but only moderate agreement when chance agreement was taken into consideration (Kappa 5 0.53) (Hosler et al, 2009). …”