Background 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. Objective We compared women's self-reported reasons for cesarean with their hospital discharge records and examined correlates of variability in agreement between sources. Methods 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. Results 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. Conclusions 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.
Bibliographical noteFunding Information:
Funding statement: The First Baby Study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH (R01 HD052990). Dr. Attanasio's effort on this study was supported by a dissertation grant from the Agency for Healthcare Research and Quality (1R36HS024215-01).
© 2017 Jacobs Institute of Women's Health