Validation of maternal recall of early pregnancy medication exposure using prospective diary data

Ann Epidemiol. 2017 Feb;27(2):135-139.e2. doi: 10.1016/j.annepidem.2016.11.015. Epub 2016 Dec 9.

Abstract

Purpose: Data about maternal recall accuracy for classifying early pregnancy medication exposure are meager. Nonetheless, studies often rely on recall to evaluate potential impact of pharmaceuticals on the developing fetus.

Methods: Right from the Start is a community-based pregnancy cohort that enrolled women from North Carolina, Tennessee, and Texas. A subset of 318 women participated in daily medication diaries initiated before conception (2006-2012). We examined nonsteroidal anti-inflammatory drugs (NSAIDs) as an example of a drug type that is difficult to study due to its intermittent and primarily over-the-counter use as well as its incomplete documentation in medical and pharmaceutical records. Selective serotonin reuptake inhibitors (SSRI) were assessed as a prescription medication comparator. Maternal recall of NSAID and SSRI use in early pregnancy was examined by comparing diary data (gold standard) to first-trimester interview.

Results: Sensitivity and specificity for recall of NSAID exposure were 78.6% and 62.3%, respectively (kappa statistic: 0.41), with 72.3% agreement for exposure classification. Sensitivity and specificity for recall of SSRI exposure were 77.8% and 99.0%, respectively (kappa statistic: 0.79), with 97.8% agreement.

Conclusions: Our findings suggest the validity of maternal recall varies with medication type and prospective data collection should be prioritized when studying early pregnancy drug exposures.

Keywords: Diary; Mental recall; Nonsteroidal anti-inflammatory agents; Pregnancy; Serotonin and noradrenaline reuptake inhibitors; Validation studies.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Data Collection / statistics & numerical data*
  • Female
  • Humans
  • Interviews as Topic
  • Maternal Exposure / statistics & numerical data*
  • Mental Recall*
  • Middle Aged
  • Nonprescription Drugs / therapeutic use*
  • North Carolina
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Pregnancy Trimester, First
  • Prescription Drugs / therapeutic use*
  • Prospective Studies
  • Sensitivity and Specificity
  • Tennessee
  • Texas
  • Young Adult

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Nonprescription Drugs
  • Prescription Drugs