title: Pregnancy Complications as Markers for Subsequent Maternal Cardiovascular Disease: Validation of a Maternal Recall Questionnaire.
abstract: BACKGROUND
  We designed and tested the validity of a questionnaire to characterize maternal recall of pregnancy complications associated with increased future cardiovascular disease risk, based on the 2011 American Heart Association (AHA) guidelines.
  
  
  METHODS
  A maternal recall questionnaire of pregnancy history was administered to 971 patients who had participated in a previous cohort study of 1,608 pregnant women. Medical records from the study pregnancy served as the gold standard. Prevalence, sensitivity (sens), specificity (spec), positive predictive value (PPV), negative predictive value (NPV), and/or Spearman's correlation coefficients (r) were calculated for each question.
  
  
  RESULTS
  A total of 526 (54%) individuals recontacted responded. Respondents were more likely to be older, white, educated, and nulliparous and were less likely to deliver low-birthweight infants in the study pregnancy than were individuals who did not respond. Mean length of recall was 4.35 years (standard deviation [SD] 0.46) postpartum. Maternal recall was most accurate for gestational diabetes (sens: 92%, spec: 98%, PPV: 79%, NPV: 99%), infant birthweight (r=0.95), and gestation length (r=0.85). Maternal recall was modest for preeclampsia (sens: 79%, spec: 97%, PPV: 68%, NPV: 98%) and pregnancy-associated hypertension, including preeclampsia or gestational hypertension (sens: 60%, spec: 95%, PPV: 64%, NPV: 94%).
  
  
  CONCLUSIONS
  This validation study demonstrated that the majority of women could accurately recall a history of gestational diabetes, infant birthweight, and gestational age at delivery, 4 years postpartum on average. Recall of preeclampsia and pregnancy-associated hypertension overall was modest. Maternal report of these pregnancy conditions may help clinicians identify women at increased risk for cardiovascular disease.
authors.affiliation: 1 Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Barnes-Jewish Hospital, Washington University School of Medicine , St. Louis, Missouri.
authors.forename: Ebony Boyce
authors.initials: EB
authors.lastname: Carter
authors.affiliation: 2 Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.|3 Connors Center for Women's Health and Gender Biology, Division of Women's Health, Brigham and Women's Hospital , Boston, Massachusetts.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Stuart
authors.affiliation: 2 Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Leslie V
authors.initials: LV
authors.lastname: Farland
authors.affiliation: 2 Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.|3 Connors Center for Women's Health and Gender Biology, Division of Women's Health, Brigham and Women's Hospital , Boston, Massachusetts.
authors.forename: Janet W
authors.initials: JW
authors.lastname: Rich-Edwards
authors.affiliation: 4 Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Brigham and Women's Hospital , Boston, Massachusetts.
authors.forename: Chloe A
authors.initials: CA
authors.lastname: Zera
authors.affiliation: 4 Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Brigham and Women's Hospital , Boston, Massachusetts.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: McElrath
authors.affiliation: 5 Department of Medicine, Division of Endocrinology, Brigham and Women's Hospital , Boston, Massachusetts.
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Seely
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D016640:Diabetes, Gestational / Q000097:blood / Q000453:epidemiology*; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood / Q000453:epidemiology*; D011939:Mental Recall; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*
chemical_list: D015415:Biomarkers