title: Validation of an algorithm to estimate gestational age in electronic health plan databases.
abstract: OBJECTIVE
  To validate an algorithm that uses delivery date and diagnosis codes to define gestational age at birth in electronic health plan databases.
  
  
  METHODS
  Using data from 225,384 live born deliveries to women aged 15-45 years in 2001-2007 within eight of the 11 health plans participating in the Medication Exposure in Pregnancy Risk Evaluation Program, we compared (1) the algorithm-derived gestational age versus the "gold-standard" gestational age obtained from the infant birth certificate file and (2) the prenatal exposure status of two antidepressants (fluoxetine and sertraline) and two antibiotics (amoxicillin and azithromycin) as determined by the algorithm-derived versus the gold-standard gestational age.
  
  
  RESULTS
  The mean algorithm-derived gestational age at birth was lower than the mean obtained from the birth certificate file among singleton deliveries (267.9 vs 273.5 days) but not among multiple-gestation deliveries (253.9 vs 252.6 days). The algorithm-derived prenatal exposure to the antidepressants had a sensitivity and a positive predictive value of ≥95%, and a specificity and a negative predictive value of almost 100%. Sensitivity and positive predictive value were both ≥90%, and specificity and negative predictive value were both >99% for the antibiotics.
  
  
  CONCLUSIONS
  A gestational age algorithm based upon electronic health plan data correctly classified medication exposure status in most live born deliveries, but trimester-specific misclassification may be higher for drugs typically used for short durations.
authors: Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
authors: Qian
authors: Q
authors: Li
authors: Susan E
authors: SE
authors: Andrade
authors: William O
authors: WO
authors: Cooper
authors: Robert L
authors: RL
authors: Davis
authors: Sascha
authors: S
authors: Dublin
authors: Tarek A
authors: TA
authors: Hammad
authors: Pamala A
authors: PA
authors: Pawloski
authors: Simone P
authors: SP
authors: Pinheiro
authors: Marsha A
authors: MA
authors: Raebel
authors: Pamela E
authors: PE
authors: Scott
authors: David H
authors: DH
authors: Smith
authors: Inna
authors: I
authors: Dashevsky
authors: Katherine
authors: K
authors: Haffenreffer
authors: Karin E
authors: KE
authors: Johnson
authors: Sengwee
authors: S
authors: Toh
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000928:Antidepressive Agents / Q000008:administration & dosage; D001719:Birth Certificates; D016208:Databases, Factual / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D038801:International Classification of Diseases; D008875:Middle Aged; D017891:Pharmacoepidemiology / Q000379:methods; D011237:Predictive Value of Tests; D011247:Pregnancy; D011272:Pregnancy, Multiple; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000928:Antidepressive Agents