Accuracy of Maternal Self-Report of Recent Preeclampsia Among Healthy Women
The accuracy of medical history is critical for the care of any patient. Preeclampsia increases the risk of complications in future pregnancies and is also associated with an increased risk of cardiovascular disease (CVD). The ability of patients to accurately recall a specific diagnosis depends on their healthcare provider clearly articulating (or communicating) it to them during the stressful conditions surrounding childbirth.
Researchers aimed to measure how well individuals recalled a preeclampsia diagnosis using data from the Heart Health 4 Moms study, which was conducted by Brigham and Women’s Hospital and the Preeclampsia Foundation. They examined medical records of 290 women who responded to online and social media recruitment efforts.
The study found that 92.1% of participants had a medical record confirmation of preeclampsia based on at least one set of criteria from ACOG. Clinician diagnosis had an 88.3% positive predictive value (PPV) of preeclampsia. In other words, of the 290 persons, the clinician noted a diagnosis on 266 charts. Of the remaining 34 women, 23 had some type of hypertension or HELLP diagnosis and 11 women did not meet a diagnosis of preeclampsia based on what was in the chart.
59% of the charts met the 2002 ACOG criteria for diagnosis (hypertension and proteinuria) while 65.2% met the 2013 ACOG criteria (new onset hypertension with at least one systemic symptom, without proteinuria).
Overall, the study confirms that most persons accurately remember the diagnosis of preeclampsia if their healthcare effectively informs them. However, it is also highlighted some limitations such as the majority of participants being non-Hispanic white, generally educated, and not on medications, suggesting that the findings might not represent the broader population fully.
Take Home: The majority of persons accurately self-report the diagnosis of preeclampsia given to them by their clinicians. Patient history of preeclampsia should be taken into consideration when determining the risk of CVD as documentation by clinicians in the medical record to confirm the diagnosis were present only two-thirds of the time.
Link: https://pubmed.ncbi.nlm.nih.gov/38551220/
Citation: Stuart JJ, Skurnik G, Roche AT, Tsigas E, Rich-Edwards JW, Seely EW. Accuracy of Maternal Self-Report of Recent Preeclampsia among Healthy Women. J Womens Health (Larchmt). 2024 Mar 29. doi: 10.1089/jwh.2023.0930. Epub ahead of print. PMID: 38551220.
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