Validade do auto-relato de diabete mellitus gestacional no pós-parto imediato

Abstract

Studies based on self-reporting of risk factors or morbidity are useful in public health, due mainly to the low cost and ease of data collection, but the accuracy of the resulting data is important for the internal validity of the research. The aim of this study was to evaluate the agreement between self-reported gestational diabetes mellitus and prenatal care medical records (gold standard). Agreement was measured by sensitivity, specificity, accuracy, kappa statistic, and confidence intervals (95%CI). From July to December 2007, all the women who gave birth in three maternity hospitals in Pelotas, Rio Grande do Sul, Brazil, were visited in the immediate postpartum. 1,047 women were interviewed, of whom 872 were in possession of their prenatal care card; of these, 869 had their blood glucose recorded on the card. Mean age was 26.7 years. Prevalence of gestational diabetes mellitus based on the gold standard was 4.3% (95%CI: 3.0-5.8), while the self-reported rate was 4% (95%CI: 2.8-5.5). Sensitivity of self-reported gestational diabetes mellitus was 72.9% (95%CI: 55.9-86.2); specificity was 99% (95%CI: 98.1-99.6); accuracy 97.9% (95%CI: 96.7-98.7); kappa 74%. For this population, self-reported gestational diabetes mellitus is valid information and can be used in population-based studies.

O que os cartões de pré-natal das gestantes revelam sobre a assistência nos serviços do SUS da Região Metropolitana da Grande Vitória, Espírito Santo, Brasil?

“…Além do seu papel no referenciamento ao parto, os cartões de gestantes funcionam como fonte de informação para o Sistema de Informações sobre Nascidos Vivos (SINASC) 5 e são utilizados em estudos que avaliam a qualidade da assistência pré-natal 6 para fundamentar políticas de saúde materno-infantil no Sistema Único de Saúde (SUS). Sua preservação pela parturiente vem sendo muito valorizada, visto que quase todas chegam para o parto com seus respectivos cartões 7,8 . Contudo, o cartão está sujeito à incompletude de registros pelos profissionais que assistem ao pré-natal e às perdas ou extravios pela gestante que, algumas vezes, têm dificuldades quanto ao entendimento dos registros anotados neles 9 .…”

Acquisition and completion of pregnant woman's medical booklet in four populational-based surveys

“…In Pelotas, a nearby city, the prevalence of acquisition was 83%, 6 while in a national hospital-based survey, it was 72%. 20 As there was no lack of the pregnant woman's medical booklet between 2007 and 2016 in Rio Grande, nor a substantial increase in the number of pregnant women who started prenatal care was from 97% to 99% in the same period, it is possible to suggest that the acquisition of this document has been undervalued, especially at the private sector.…”

“…This acquisition of the booklet ranged from 72% to 99%. [5][6][7][8][9] Studies on its completion are still very scarce. In Recife city (PE), 7 only 36% of the booklets contained the registration of anti-HIV serology, while in Vitória city (ES), 8 97% of them registered the information in their booklet .…”

Stressful life events, hypertensive disorders, and high blood sugar during pregnancy

“…For HDP, good concordance between self‐reported hypertension during previous pregnancies and actual clinical findings among those who self‐reported as positive cases (Falkegard, Schirmer, Lochen, Oian, & Acharya, ) even though the issue of low sensitivity (underreporting) remains an unneglectable issue (Stuart et al, ). On the other hand, the self‐reported GDM has been shown to highly consistent with a physical diagnosis (Dode & Santos, ), likely due to the reality that GDM is a significant pregnancy complication and a majority of women with GDM would receive lifestyle consultation and medical treatment.…”