title: Validity of Self-Reported Drug Use Information Among Pregnant Women.
abstract: BACKGROUND
  This study assesses validity of self-report for the use of major classes of illicit drugs and opioid-maintenance therapy among pregnant women at a substance abuse treatment program.
  
  
  METHODS
  Analyses used data collected from 83 pregnant women in a prospective cohort study at the University of New Mexico. Study participants with a history of substance abuse were screened and, if eligible, enrolled during an early prenatal care visit. A follow-up interview was conducted shortly after delivery. Self-reported information about drug use later in pregnancy was compared with urine drug screen (UDS) results collected during the third trimester. Simple kappa (k) and prevalence-and-bias-adjusted kappa (PABAK) coefficients were calculated as the measures of agreement. Sensitivity and specificity of self-report for each drug class were estimated using UDS as the 'gold standard'.
  
  
  RESULTS
  The sample included a large proportion of ethnic minority (80% Hispanic/Latina and 7% American Indian) and socially disadvantaged (50% less than high school education and 94% Medicaid-insured) pregnant women. On average, patients had 4.8 ± 3.0 urine drug screens during the third trimester. Sensitivity of self-report was low (<60%) for all classes of illicit drugs; however, marijuana and opioids demonstrated slightly higher sensitivity (57.9 and 58.3%, respectively) than other classes (<47%).
  
  
  CONCLUSIONS
  This study found substantial underreporting for all classes of illicit drugs among pregnant women in a substance abuse treatment program. Rates of underreporting are expected to be higher among the general population of pregnant women.
authors.affiliation: Department of Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Mahek
authors.initials: M
authors.lastname: Garg
authors.affiliation: Department of Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Garrison
authors.affiliation: Department of Family and Community Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, USA.|Department of Obstetrics and Gynecology, School of Medicine, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Leeman
authors.affiliation: Department of Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Ajna
authors.initials: A
authors.lastname: Hamidovic
authors.affiliation: Department of Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Borrego
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, University of New Mexico, Albuquerque, NM, USA.
authors.forename: William F
authors.initials: WF
authors.lastname: Rayburn
authors.affiliation: Department of Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of New Mexico, Albuquerque, NM, USA. lbakhireva@salud.unm.edu.|Department of Family and Community Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, USA. lbakhireva@salud.unm.edu.
authors.forename: Ludmila
authors.initials: L
authors.lastname: Bakhireva
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D009516:New Mexico / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000517:prevention & control; D011295:Prenatal Care / Q000523:psychology; D015995:Prevalence; D011446:Prospective Studies; D057566:Self Report / Q000592:standards*; D015813:Substance Abuse Detection / Q000639:trends; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology*
keywords: Drug use; Pregnancy; Self-report; Validity