Data From Web-Based Questionnaires Were Valid for Gestational Diabetes and Preeclampsia, but Not Gestational Hypertension

Abstract

Objectives: We aimed to validate Web-based questionnaires for the common pregnancy complications gestational diabetes, gestational hypertension, and preeclampsia.Study Design and Setting: We included 1,809 women participating in the PRegnancy and Infant DEvelopment (PRIDE) Study who delivered in 2012e2017, for whom relevant data were complete. Sensitivity, specificity, and positive and negative predictive values of selfreported diagnoses of gestational diabetes, gestational hypertension, and preeclampsia were determined using obstetric records as reference standard. Furthermore, we assessed whether maternal characteristics affected disagreement between questionnaires and obstetric record.Results: For gestational diabetes and preeclampsia, we observed very few false-positive and false-negative reports, yielding sensitivities of 93% (95% confidence interval [CI] 86e100) and 88% (95% CI 79e98), respectively, and specificities of 100%. Depending on the definition of gestational hypertension, sensitivity and positive predictive values ranged from 62% to 89% and 53% to 64%, respectively. Disagreement on gestational hypertension was associated with prepregnancy overweight and multiparity.Conclusion: Self-reports of gestational diabetes and preeclampsia in Web-based questionnaires were valid, but the validity of gestational hypertension seemed to be lower because of relatively high numbers of false-positive reports. However, it is questionable whether an appropriate reference standard exists to validate this pregnancy complication.

Associations between late-onset preeclampsia and the use of calcium-based antacids and proton pump inhibitors during pregnancy: a prospective cohort study

“…19 Data on the diagnosis of preeclampsia were obtained from previously validated questionnaires (sensitivity 88%, specificity 100%). 20 In case of loss to follow-up, outcome data were extracted from obstetric records whenever possible.…”

“…22 We adhered to a recently published guidance on longitudinal methods for modelling medication exposures in pregnancy. 23 We evaluated exposure binarily (any versus none) in the first 237 days of pregnancy, further subdivided into early pregnancy (gestational weeks 0-16) and mid-pregnancy (gestational weeks [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33], reflecting the temporality of data collection in both sources (in weeks 17 and 34). Furthermore, we clustered women with similar individual trajectories of calcium dose or DDDs of PPIs in gestational weeks 0-33 usingk -means clustering with the R statistical software package "kml ".…”

“…The validity of self-reported data on the secondary outcome gestational hypertension is considerably lower compared to that of the primary outcome preeclampsia, mainly due to relatively high numbers of false-positive reports. 20 Due to a partial lack of data, we could not take dietary calcium intake and the dose of supplementation into account in our confounder definition. Of note, the calcium content in supplementation is usually low (120-200 mg).…”

Associations Between Late-Onset Preeclampsia and the Use of Calcium-Based Antacids and Proton Pump Inhibitors During Pregnancy: A Prospective Cohort Study

“…21 Data on the diagnosis of preeclampsia were obtained from previously validated questionnaires (sensitivity 88%, specificity 100%). 22 In case of loss to follow-up, outcome data were extracted from obstetric records whenever possible.…”

Cohort profile: the Olmsted County hypertensive disorders of pregnancy (HDP) cohort using the Rochester Epidemiology Project

“…Studies involving HDP to date have primarily used either registries, maternal recall or discharge diagnosis codes as alternatives (eg, International Classification of Diseases (ICD) or the Hospital International Classification of Diseases Adapted (HICDA)) 12 13 19–32. When compared with trained expert review, these methods of HDP ascertainment are unable to reliably diagnose HDP and to accurately identify their subtypes 16–18 29 30 33–41. In particular, codes for gestational hypertension were worse than codes for preeclampsia, illustrating that the sensitivity of the codes is dependent on the severity of the disease 34.…”