Reports of birthweight by adolescents and their mothers: comparing accuracy and identifying correlates

Low birth weight and childhood health: the role of maternal education

PURPOSE

Low birth weight (LBW) is associated with myriad health and developmental problems in childhood and later in life. Less well-documented is the variation in the relationship between LBW status and subsequent child health by socioeconomic status-such as education levels and income. This article examines whether differences exist in the relationship between LBW and subsequent child health by maternal education.

METHODS

We used data from the 1998-2017 National Health Interview Survey to estimate multivariate logistic regression models to determine whether the association between LBW and subsequent child health as measured by general health status, developmental disability, and asthma diagnosis differed by maternal education, net of differences in children's sociodemographic factors, family background, and medical access.

RESULTS

The negative association between LBW and subsequent health was typically weaker for children of mothers with less than high school education than it was for children of mothers with higher levels of education.

CONCLUSIONS

The findings on the enduring impact of LBW status on child health for all children, especially those born to mothers with higher levels of education, suggest that all children born LBW should be provided appropriate medical and support services to reduce the lifelong repercussions of poor health at birth.

Reliability of birth weight recall by parent or guardian respondents in a study of healthy adolescents

Objective

Birth weight, which can be an indicator for risk of chronic diseases throughout the lifespan, is one of the most commonly used measures in the study of developmental origins of health and disease. There is limited information on the reliability of parent/guardian reported birth weight by race or by respondent type (i.e., mother, father, other caregiver).

Results

Birth weight was reported by a respondent for 309 of the 333 (92.8%) study participants; of these, chart obtained birth weight was available for 236 (76.4%). There was good agreement between respondent report and chart obtained birth weight. Over half (N = 145, 61.4%) of respondents reported a birth weight within ± 100 g of what was in the chart; 60.9% of black participants (n = 81) and 62.1% of white participants (n = 64) fell within 100 g. Overall, mothers were 3.31 (95% CI 1.18, 9.33) times more likely than fathers to correctly recall the child’s birthweight within ± 100 g (p = 0.023). Respondent reported birth weight is a reliable alternative to chart obtained birth weight. Mothers were found to be most accurate in reporting birth weight of the child. Race/ethnicity was not significantly associated with reliability of birth weight reporting.

Electronic supplementary material

The online version of this article (10.1186/s13104-018-3977-2) contains supplementary material, which is available to authorized users.

Validade da informação sobre o peso ao nascer para estudos fundamentados na programação fetal

Peso ao nascer é uma informação essencial nos estudos de programação fetal e, em geral, obtida retrospectivamente. No Sistema de Informações sobre Nascidos Vivos (SINASC), peso ao nascer é uma informação válida, mas nem sempre acessível. Objetivou-se estabelecer um algoritmo para seleção da fonte de dados de maior confiabilidade do peso ao nascer na ausência da informação do SINASC. No estudo seccional de estudantes de 6-14 anos, Niterói, Rio de Janeiro, Brasil, 2010, peso ao nascer foi coletado por meio de questionário de autopreenchimento, entrevista, prontuários do Programa Médico de Família (PMF), além do SINASC. Foram calculados coeficientes de correlação intraclasse (CCI) e diferenças das médias de peso ao nascer. CCIs variaram de 0,90 a 0,99. Todas as fontes apresentaram médias de peso ao nascer maiores do que SINASC, considerando-se aceitáveis diferenças até 100g. O peso ao nascer é registrado no nascimento (SINASC) ou próximo deste (PMF) e, na ausência dessas fontes, a lembrança do peso ao nascer de 6-14 anos após o nascimento é uma opção confiável. Para complementar a informação sobre peso ao nascer na ausência do SINASC, recomenda-se a seguinte ordenação: PMF, entrevista e questionário.

Validity of recalled v. recorded birth weight: a systematic review and meta-analysis

Low birth weight is associated with adverse health outcomes. If birth weight records are not available, studies may use recalled birth weight. It is unclear whether this is reliable. We performed a systematic review and meta-analysis of studies comparing recalled with recorded birth weights. We followed the Meta-Analyses of Observational Studies in Epidemiology (MOOSE) statement and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched MEDLINE, EMBASE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) to May 2015. We included studies that reported recalled birth weight and recorded birth weight. We excluded studies investigating a clinical population. Two reviewers independently reviewed citations, extracted data, assessed risk of bias. Data were pooled in a random effects meta-analysis for correlation and mean difference. In total, 40 studies were eligible for qualitative synthesis (n=78,997 births from 78,196 parents). Agreement between recalled and recorded birth weight was high: pooled estimate of correlation in 23 samples from 19 studies (n=7406) was 0.90 [95% confidence interval (CI) 0.87–0.93]. The difference between recalled and recorded birth weight in 29 samples from 26 studies (n=29,293) was small [range −86–129 g; random effects estimate 1.4 g (95% CI −4.0–6.9 g)]. Studies were heterogeneous, with no evidence for an effect of time since birth, person reporting, recall bias, or birth order. In post-hoc subgroup analysis, recall was higher than recorded birth weight by 80 g (95% CI 57–103 g) in low and middle income countries. In conclusion, there is high agreement between recalled and recorded birth weight. If birth weight is recalled, it is suitable for use in epidemiological studies, at least in high income countries.

Fetal programming and systemic sclerosis

OBJECTIVE

This study investigated whether birthweight is linked to an increased risk of the development of systemic sclerosis.

STUDY DESIGN

This was a multicenter case-control study with perinatal data that were obtained from 332 cases with systemic sclerosis and 243 control subjects. Birthweight was treated as a dichotomous variable (<2500 g vs ≥2500 g); low birthweight was defined as a weight <2500 g; small for gestational age was defined as birthweight <10th percentile for gestational age adjusted for sex. The relationship between systemic sclerosis and both low birthweight and small for gestational age was expressed with the crude (univariate analysis) and adjusted (multivariate analysis) odds ratio (OR).

RESULTS

Significantly increased ORs were observed in the univariate analysis for low birthweight (OR, 2.59; 95% confidence interval [CI], 1.39-5.05) and small for gestational age (OR, 2.60; 95% CI, 1.34-5.32) subjects. Similarly increased risks were confirmed for both conditions in the multivariate analysis (OR, 3.93; 95% CI, 1.92-8.07; and OR, 2.58; 95% CI, 1.28-5.19), respectively.

CONCLUSION

Low birthweight and small for gestational age at birth are risk factors for the adult onset of systemic sclerosis.

Comparison of birth weight between school health records and medical birth records in Denmark: determinants of discrepancies

OBJECTIVE

To compare reported birth weight (BW) information in school health records with BW from medical birth records, and to investigate if maternal and offspring characteristics were associated with any discrepancies.

DESIGN

Register-based cohort study.

SETTING

Denmark, 1973-1991.

PARTICIPANTS

The study was based on BW recorded in the Copenhagen School Health Records Register (CSHRR) and in The Medical Birth Register (MBR). The registers were linked via the Danish personal identification number.

PRIMARY AND SECONDARY OUTCOME MEASURES

Statistical comparisons of BW in the registers were performed using t tests, Pearson's correlation coefficients, Bland-Altman plots and κ coefficients. Odds of BW discrepancies >100 g were examined by logistic regressions.

RESULTS

The study population included 47,534 children. From 1973 to 1979 when BW was grouped in 500 g intervals in the MBR, mean BW differed significantly between the registers. During 1979-1991 when BW was recorded in 10 and 1 g intervals, mean BW did not significantly differ between the two registers. BW from both registers was highly correlated (0.93-0.97). Odds of a BW discrepancy significantly increased with parity, the child's age at recall and by marital status (children of married women had the highest odds).

CONCLUSIONS

Overall, BW information in school health records agreed very well with BW from medical birth records, suggesting that reports of BWs in school health records in Copenhagen, Denmark generally are valid.

Impact of time to maternal interview on interview responses in the National Birth Defects Prevention Study

Prenatal exposures often are assessed using retrospective interviews. Time from exposure to interview may influence data accuracy. We investigated the association of time to interview (TTI) with aspects of interview responses in the National Birth Defects Prevention Study, a population-based case-control study of birth defects in 10 US states. Mothers completed a computer-assisted telephone interview 1.5-24 months after their estimated date of delivery. Proxy metrics for interview quality were whether certain exposures were reported, whether the start month of reported medication use or illness was reported, or whether responses were missing. Interaction by case status was assessed. Interviews were completed with 30,542 mothers (22,366 cases and 8,176 controls) who gave birth between 1997 and 2007. Mothers of cases were interviewed later than were mothers of controls (11.7 months vs. 9.5 months, respectively). In adjusted analyses, having a TTI that was greater than 6 months was associated with only a few aspects of interview responses (e.g., start month of pseudoephedrine use). Interaction by case-control status was observed for some exposures; mothers of controls had a greater reduction in interview quality with increased TTI in these instances (e.g., report of morning sickness, start month of acetaminophen use and ibuprofen use). The results suggest that TTI might impact interview responses; however, the impact may be minimal and specific to the type of exposure.

The effect of gestational age on symptom severity in children with autism spectrum disorder

Between 2006 and 2010, two research-validated instruments, Social Communication Questionnaire (SCQ) and Social Responsiveness Scale (SRS) were filled out online by 4,188 mothers of Autism Spectrum Disorder (ASD) children, aged 4-21, as part of voluntary parental participation in a large web-based registry. Univariate and multivariate linear regression analysis (adjusted for child's sex, ability to verbalize, categorical IQ score, and fetal growth rate) demonstrated significantly higher SCQ and SRS scores for ASD children of both preterm (<37 weeks) and post-term (>42 weeks) gestational age (GA) compared to ASD children of normal GA, thus indicating that both preterm and post-term children manifest increased ASD symptomatology. Normal GA at birth appears to mitigate the severity of autistic social impairment in ASD children.

Validity of maternal birthweight recall among Colombian children

Low birthweight and preterm birth are associated with adverse health outcomes later in life, but acquisition of accurate birthweight information is not always feasible in large epidemiological studies. We examined the validity of child birthweight and gestational age recall by mothers, and the extent to which recall bias affects associations between birthweight and childhood obesity in children from Bogotá, Colombia. We surveyed mothers of 3,202 schoolchildren aged 5-12 years about child's weight and gestational age at birth, and sociodemographic characteristics. In a subsample of 279 children, we obtained hospital birth records and extracted birthweight, gestational age, and other perinatal information. Mean birthweight (SD) was 3,106 (739) grams according to maternal recall and 2,977 (462) grams according to hospital records (difference 129 g; 95% CI = 55, 203). Thirty-three percent of mothers recalled their children's birthweights exactly as they appeared in hospital records. Mother's age and fewer years of education were each significantly associated with greater birthweight recall bias. Specificity of low birthweight (<2,500 g) and preterm birth (<37 weeks gestation) from maternal recall was 0.95 and 0.86, respectively; however, sensitivity was lower (0.66 and 0.67, respectively). Associations between recalled birthweight and BMI-for-age or overweight during school age were weaker than those with hospital record birthweight. Maternal birthweight recall 5-12 years after birth differs from hospital record birthweight by a clinically meaningful amount. Birthweight recall should be used with caution in epidemiological studies conducted in this and comparable settings. Associations between birthweight and obesity may be stronger than they appear when using recalled birthweight.

Fetal genotype for the xenobiotic metabolizing enzyme NQO1 influences intrauterine growth among infants whose mothers smoked during pregnancy

Maternal smoking during pregnancy retards fetal growth and depresses infant birth weight. The magnitude of these effects may be moderated by fetal genotype. The current study investigated maternal smoking, fetal genotype, and fetal growth in a large population sample of dizygotic twins. Maternal smoking retarded fetal growth in a dose-dependent fashion. In a subsample of 497 twin pairs whose mothers smoked during pregnancy, a functional polymorphism in the NAD(P)H:quinone oxidoreductase gene (NQO1 Pro187Ser; rs1800566) was significantly associated with fetal growth within families. The effect was strongest among moderate smokers. This is the first demonstration that fetal genotype for an enzyme involved in tobacco smoke metabolism influences intrauterine growth independent of maternal genotype. Future studies should conduct formal tests of Fetal Genotype x Maternal Smoking interactions.

Perinatal factors and adult-onset lupus

OBJECTIVE

Some evidence suggests that perinatal factors, including birth weight and breastfeeding, may influence the occurrence of autoimmune rheumatic diseases. However, few studies have investigated these factors in patients with systemic lupus erythematosus (SLE). Therefore, we evaluated the role of birth weight, being breastfed, and preterm birth on the incidence of SLE in participants in the Nurses' Health Study (NHS) and the Nurses' Health Study II (NHSII).

METHODS

We studied 87,411 NHS participants and 98,413 NHSII participants without SLE at baseline who provided information on perinatal exposures. Among these women, during 26 (NHS) and 14 (NHSII) years of followup, 222 incident SLE cases were confirmed (136 NHS and 86 NHSII) by medical record review using American College of Rheumatology criteria. We used stratified Cox models to estimate the association of perinatal factors with SLE, adjusting for race, early passive cigarette smoke exposure, and parents' occupation. A random-effects meta-analysis was used to compute combined estimates across the 2 cohorts.

RESULTS

After adjustment for multiple potential confounders, high birth weight (> or =10 pounds) was associated with increased rates of SLE compared with normal birth weight (7-8.5 pounds; rate ratio [RR] 2.7, 95% confidence interval [95% CI] 1.2-5.9), as was being born > or =2 weeks preterm (RR 1.9, 95% CI 1.2-3.0); however, being breastfed was not (RR 0.8, 95% CI 0.6-1.1).

CONCLUSION

Birth weight > or =10 pounds and preterm birth were both positively associated with incident SLE among women.

Accuracy and correlates of maternal recall of birthweight and gestational age

Objective

To determine the accuracy of maternal recall of children birthweight (BW) and gestational age (GA), using the Danish Medical Birth Register (DBR) as reference and to examine the reliability of recalled BW and its potential correlates.

Design

Comparison of data from the DBR and the European Youth Heart Study (EYHS).

Setting

Schools in Odense, Denmark.

Population

A total of 1271 and 678 mothers of school children participated with information in the accuracy studies of BW and GA, respectively. The reliability sample of BW was composed of 359 women.

Method

The agreement between the two sources was evaluated by mean differences (MD), intraclass correlation coefficient (ICC) and Bland–Altman's plots. The misclassification of the various BW and GA categories were also estimated.

Main outcome measures

Differences between recalled and registered BW and GA.

Results

There was high agreement between recalled and registered BW (MD =−0.2 g; ICC = 0.94) and GA (MD = 0.3 weeks; ICC = 0.76). Only 1.6% of BW would have been misclassified into low, normal or high BW and 16.5% of GA would have been misclassified into preterm, term or post-term based on maternal recall. The logistic regression revealed that the most important variables in the discordance between recalled and registered BW were ethnicity and parity. Maternal recall of BW was highly reliable (MD =−5.5 g; ICC = 0.93), and reliability remained high across subgroups.

Conclusion

Maternal recall of BW and GA seems to be sufficiently accurate for clinical and epidemiological use.

Please cite this paper as: Adegboye A, Heitmann B. Accuracy and correlates of maternal recall of birthweight and gestational age. BJOG 2008;115:886–893.