title: Validation of maternal recall of early pregnancy medication exposure using prospective diary data.
abstract: Data about maternal recall accuracy for classifying early pregnancy medication exposure are meager. Nonetheless, studies often rely on recall to evaluate potential impact of pharmaceuticals on the developing fetus.
  
  
  
  Right from the Start is a community-based pregnancy cohort that enrolled women from North Carolina, Tennessee, and Texas. A subset of 318 women participated in daily medication diaries initiated before conception (2006-2012). We examined nonsteroidal anti-inflammatory drugs (NSAIDs) as an example of a drug type that is difficult to study due to its intermittent and primarily over-the-counter use as well as its incomplete documentation in medical and pharmaceutical records. Selective serotonin reuptake inhibitors (SSRI) were assessed as a prescription medication comparator. Maternal recall of NSAID and SSRI use in early pregnancy was examined by comparing diary data (gold standard) to first-trimester interview.
  
  
  
  Sensitivity and specificity for recall of NSAID exposure were 78.6% and 62.3%, respectively (kappa statistic: 0.41), with 72.3% agreement for exposure classification. Sensitivity and specificity for recall of SSRI exposure were 77.8% and 99.0%, respectively (kappa statistic: 0.79), with 97.8% agreement.
  
  
  
  Our findings suggest the validity of maternal recall varies with medication type and prospective data collection should be prioritized when studying early pregnancy drug exposures.
authors.affiliation: Vanderbilt Epidemiology Center, Institute of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Alexandra C
authors.initials: AC
authors.lastname: Sundermann
authors.affiliation: Vanderbilt Epidemiology Center, Institute of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN; Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Hartmann
authors.affiliation: Vanderbilt Epidemiology Center, Institute of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Jones
authors.affiliation: Vanderbilt Epidemiology Center, Institute of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Torstenson
authors.affiliation: Vanderbilt Epidemiology Center, Institute of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN; Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN. Electronic address: digna.r.velez.edwards@vanderbilt.edu.
authors.forename: Digna R
authors.initials: DR
authors.lastname: Velez Edwards
mesh_terms: D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003625:Data Collection / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D018811:Maternal Exposure / Q000706:statistics & numerical data*; D011939:Mental Recall; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D009657:North Carolina; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011261:Pregnancy Trimester, First; D055553:Prescription Drugs / Q000627:therapeutic use*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013714:Tennessee; D013781:Texas; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004366:Nonprescription Drugs; D055553:Prescription Drugs
keywords: Diary; Mental recall; Nonsteroidal anti-inflammatory agents; Pregnancy; Serotonin and noradrenaline reuptake inhibitors; Validation studies