title: Concordance between Women's Self-Reported Reasons for Cesarean Delivery and Hospital Discharge Records.
abstract: Women's self-reports of whether they had a cesarean delivery are nearly 100% accurate, but there is little extant research on how accurately women self-report reasons for cesarean delivery when asked to recall this information in the postpartum period.
  
  
  
  We compared women's self-reported reasons for cesarean with their hospital discharge records and examined correlates of variability in agreement between sources.
  
  
  
  Data are from the First Baby Study, a cohort of 3,006 women who gave birth to their first baby between 2009 and 2011. Survey data were linked to hospital discharge records. Among women who delivered by cesarean (n = 846), we assessed the probability that women's self-reported reasons for cesarean delivery were confirmed by hospital discharge records (positive predictive value [PPV]), and whether agreement differed by reason for cesarean or by women's characteristics.
  
  
  
  Overall, 91% of women reported a reason for their cesarean that was present in the discharge data. PPV varied by reason for cesarean, with high PPV for dystocia, macrosomia, and cephalopelvic disproportion (91.1%), and lower PPV for malposition (81.7%). In multivariable models, women with more education and higher family income had higher odds of concordance.
  
  
  
  Despite some variation in the probability that women's self-reported reason for cesarean is supported by the hospital discharge record, more than 90% of women reported a reason that was found in their discharge record. Accurate recall of reasons for prior cesarean may help women and clinicians to manage future pregnancies.
authors.affiliation: Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota. Electronic address: lbattana@sewanee.edu.
authors.forename: Laura B
authors.initials: LB
authors.lastname: Attanasio
authors.affiliation: Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota.
authors.forename: Katy B
authors.initials: KB
authors.lastname: Kozhimannil
authors.affiliation: Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Sindhu K
authors.initials: SK
authors.lastname: Srinivas
authors.affiliation: Department of Public Health Sciences and Department of Obstetrics and Gynecology, College of Medicine, Penn State University, Hershey, Pennsylvania.
authors.forename: Kristen H
authors.initials: KH
authors.lastname: Kjerulff
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000523:psychology / Q000706:statistics & numerical data; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D008499:Medical Records; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010414:Pennsylvania; D011203:Poverty; D011247:Pregnancy; D057566:Self Report