Two-Year Test-Retest Reliability of the Breastfeeding Duration Question Used By the Pregnancy Risk Assessment...

Area of Science:

• Public Health
• Reproductive Health
• Maternal and Child Health

Background:

• Breastfeeding research often relies on maternal self-reports.
• The reliability of breastfeeding duration data from the Pregnancy Risk Assessment Monitoring System (PRAMS) has not been previously assessed.
• Existing studies on breastfeeding duration reliability have yielded mixed results depending on assessment methodology.

Purpose of the Study:

• To assess the test-retest reliability of maternal self-reported breastfeeding duration using PRAMS data.
• To compare reliability estimates between retrospective and prospective assessment methods.

Main Methods:

• Utilized data from Oregon PRAMS and PRAMS-2, collecting responses at median 3.5 and 25 months postpartum, respectively.
• Focused on women who had weaned prior to completing the PRAMS survey for direct comparison.
• Employed statistical measures including kappa and intraclass correlation coefficient (ICC) to evaluate agreement.

Main Results:

• The kappa statistic (0.014) and ICC (0.17) indicated poor agreement in reported breastfeeding duration.
• Over 80% of women reported a longer duration in the second survey (PRAMS-2).
• The median difference in reported duration was an over-reporting of +1.0 months in the later assessment.

Conclusions:

• Prospective reliability assessments of breastfeeding duration consistently show poorer agreement compared to retrospective methods.
• Maternal reports in prospective studies tend to over-report duration by approximately one month upon re-inquiry.
• Despite reliability concerns, maternal self-reported breastfeeding duration can still be useful for relative ranking of participants, but should not be used to determine optimal duration thresholds.