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Agreement Between Prospective and Retrospective Reports of Maternal Exposure to Chemicals During Pregnancy

Till, Christine MA; Koren, Gideon MD, FRCPC; Rovet, Joanne F. PhD

Journal of Occupational and Environmental Medicine: August 2002 - Volume 44 - Issue 8 - p 708-713
ORIGINAL ARTICLES: CME
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Learning Objectives 
  • Compare how well, in previous studies, retrospectively and prospectively collected information on exposure of mothers to chemicals or drugs have agreed with medical records data.
  • Recall the reported agreement—or lack thereof—between self-reported exposure to organic solvents at the time of pregnancy and at follow-up 3 to 7 years later.
  • Describe the implications of these findings and how more valid maternal exposure data might be acquired.

Compare how well, in previous studies, retrospectively and prospectively collected information on exposure of mothers to chemicals or drugs have agreed with medical records data.Recall the reported agreement—or lack thereof—between self-reported exposure to organic solvents at the time of pregnancy and at follow-up 3 to 7 years later.Describe the implications of these findings and how more valid maternal exposure data might be acquired. As part of a prospective study of solvent exposure and child behavior, it occurred that women’s responses about exposure history during pregnancy differed from the information documented during the postpartum period. The objective of the study was to examine the levels of agreement in 29 self-reports of exposure information obtained before and 3- to 7-years after pregnancy. Percent agreement was low for duration of exposure (41%), protective barrier use (48%), and symptomatology (41%). When reports were not in perfect agreement, women tended to report longer durations of exposure (r = 0.67), increased use of protective barriers (r = 0.39), and more symptoms at time of follow-up (r = 0.57). Agreement of report was not substantially associated with time since pregnancy or concurrent child behavior. Low levels of agreement may reflect response biases in the data collected at time of pregnancy or recall biases at time of follow-up. These variations in self-reports are of concern because they can severely affect estimates of human teratological risk.

From the Department of Psychology, University of Toronto, Toronto, Ontario, Canada (Ms Till); Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada (Dr Koren, Dr Rovet); The Motherisk Program, The Hospital for Sick Children, Toronto, Ontario, Canada (Dr Koren, Dr Rovet); Division of Clinical Pharmacology, The Hospital for Sick Children, Ontario, Canada (Dr Koren).

Address correspondence to: Christine Till, Department of Psychology, The Hospital for Sick Children, 555 University Ave., Toronto, ON M5G 1X8; christine.till@sickkids.ca.

This research was funded in part by the Workers Safety Insurance Board (WSIB), (Ontario, Canada) and the Physicians Services Incorporated (Ontario, Canada). Christine Till was supported by the National Science and Engineering Research Council of Canada (NSERC). Gideon Koren is a Senior Scientist of the Canadian Institute for Health Research (CIHR), and holder of the Research Leadership for Better Pharmacotherapy During Pregnancy and Lactation.

Christine Till has no commercial interest related to this article.

Copyright © by American College of Occupational and Environmental Medicine

Copyright © 2002 by the American College of Occupational and Environmental Medicine