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Validation of Parent-reported Gestational Age Categories for Children Less Than 6 Years of Age
Alexandra M Palumbo1, David Kirkwood2, Cornelia M Borkhoff3,4,5
1From the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Insights
Parent-reported gestational age categories for preterm birth are highly accurate, with over 97% correct classification. This finding is crucial for epidemiological research when administrative data is unavailable.
Area of Science:
- Pediatric Epidemiology
- Reproductive Health Research
- Biostatistics
Background:
- Preterm birth is a critical factor in epidemiological studies.
- Parent-reported gestational age is often used when administrative data is unavailable, but may introduce bias.
- Limited research exists on the validity of parent-reported gestational age categories.
Purpose of the Study:
- To assess the criterion validity of parent-reported gestational age categories.
- To evaluate accuracy for term, late preterm, and moderately preterm birth classifications.
- To explore potential influences of parent and socioeconomic factors on recall accuracy.
Main Methods:
- Linked data from TARGet Kids! and ICES administrative healthcare records (2011-2020).
- Calculation of sensitivity and specificity for gestational age categories against administrative data.
- Subgroup analyses examining parent and socioeconomic factors.
Main Results:
- 97.3% of participants correctly classified gestational age categories.
- Sensitivity ranged from 83.7% to 98.5%; specificity ranged from 88.3% to 99.8%.
- All subgroup analyses showed sensitivity and specificity ≥70%, with minor variations.
Conclusions:
- Parent-reported gestational age categories demonstrate high accuracy in this cohort.
- Criterion validity showed minimal variation across parent and socioeconomic factors.
- Findings support the use of parent-reported data and inform bias analyses.
Background:
Preterm birth is an important outcome or exposure in epidemiologic research. When administrative data on measured gestational age is not available, parent-reported gestational age can be obtained from questionnaires, which is subject to potential bias. To our knowledge, few studies have assessed the validity of parent-reported gestational age categories, including commonly defined categories of preterm birth.
Methods:
We used linked data from primarily healthy children <6 years of age in TARGet Kids! in Toronto, Canada, and ICES administrative healthcare data from April 2011 to March 2020. We assessed the criterion validity of questionnaire-based parent-reported gestational age by calculating sensitivity and specificity for term (≥37 weeks), late preterm (34-36 weeks), and moderately preterm (32-33 weeks) gestational age categories, using administrative healthcare records of gestational age as the criterion standard. We conducted subgroup analyses for various parent and socioeconomic factors that may influence recall.
Results:
Of the 4684 participants, 97.3% correctly classified the gestational age category according to administrative healthcare data. Parent-reported gestational age sensitivity ranged from 83.7% to 98.5% and specificity ranged from 88.3% to 99.8%, depending on category. For each subgroup characteristic, sensitivity and specificity were all ≥70%. Lower educational attainment, lower family income, father reporting, ≥1 year since birth, ≥2 children, lower parent age, and reported gestational diabetes and/or hypertension were associated with slightly lower sensitivity and/or specificity.
Conclusions:
In this linked cohort, parent-reported gestational age categories had high accuracy. Criterion validity varied minimally among some parent and socioeconomic factors. Our findings can inform future quantitative bias analyses.
