Reducing misclassification in assignment of timing of events during pregnancy.
BACKGROUND
Perinatal epidemiology studies often collect only the calendar month in which an event occurs in early pregnancy because it is difficult for women to recall a specific day when queried later in pregnancy or postpartum. Lack of day information may result in incorrect assignment of completed gestational month because calendar months and pregnancy months are not aligned.


METHODS
To examine the direction and magnitude of misclassification, we compared 3 methods for assignment of completed gestational month: 1) calendar month difference, 2) conditional month difference, and 3) imputed month midpoint. We used data from the Pregnancy, Infection, and Nutrition Study for simulations.


RESULTS
Calendar month difference misclassified 54% of events as 1 month later in pregnancy compared with the actual completed month of gestation. Each of the other 2 methods misclassified approximately 12% of events to 1 month earlier and 12% to 1 month later.


CONCLUSIONS
Calendar month difference, a common method, has the greatest misclassification. Conditional month difference and imputed month midpoint, which require little effort to implement, are superior to calendar month difference for reducing misclassification.
Yang
Juan
J
Departments of Epidemiology, School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. juanokyang@yahoo.com
Hartmann
Katherine E
KE
Herring
Amy H
AH
Savitz
David A
DA
D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D009657:North Carolina; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D013533:Gestational Carriers; D011795:Surveys and Questionnaires; D013997:Time Factors