Agreement between Self-Reports and Medical Records in the Reporting of Pregnancy Outcomes in Women with Type 1 Diabetes

Abstract

Background: Since previous studies have shown that self-reports may not be as accurate as medical record data, this secondary analysis investigated the agreement between maternal self-report (SR) and medical record (MR) documentation of pregnancy outcomes (e.g., length of hospitalization, neonatal birth weight, complications) in women with type 1 diabetes (T1D). Methods: An online SR follow-up study to evaluate long-term reproductive-health outcomes was conducted with women who previously participated in randomized controlled trials (RCT) to test a preconception counseling (PC) intervention (READY-Girls) as adolescents and included a matched comparison group of women with T1D who did not receive the PC intervention as teens. Data were collected from SR surveys and MR review. Agreement between SR and MR entries was assessed using kappa coefficients and intra-class correlation coefficients (ICC). Results: Of the 101 women with T1D (51 RCT, 50 matched controls) who were recruited for long-term follow-up (98.0% Caucasian, age range 18-34 years, 82.0% had some college, T1D duration range 0-30 years), 18 (17.8%) reported ever being pregnant and for 8 (47.1%) of these women access to MR was obtained for 14 pregnancies. These women had a mean±SD age of 28.57±1.91 years at entry and duration of T1D of 19.75±5.45 years. Perfect agreement (kappa=1.0) was observed between SR and MR for type of delivery and neonatal birth weight >9 pounds. Excellent agreement was observed for neonatal weight (ICC=.951). Lower levels of agreement were found between SR and MR for duration of post-delivery hospitalization [maternal (ICC=.269); neonatal (ICC=.657)] and maternal and neonatal complications (kappa=.639 and kappa=.025, respectively). Conclusion: There was excellent agreement for several pregnancy outcomes in these women with T1D. Self-report of pregnancy outcomes should be verified by medical record data, especially time-related variables which could be more difficult to recall, suggesting that method of reporting for these types of variables may not be interchangeable.