American Journal of Epidemiology Advance Access first published online on January 7, 2008
This version published online on February 16, 2008
American Journal of Epidemiology, doi:10.1093/aje/kwm345
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Practice of Epidemiology |
Variation between Last-Menstrual-Period and Clinical Estimates of Gestational Age in Vital Records
From the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
Correspondence to Dr. Cheng Qin, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mailstop K-23, Atlanta, GA 30341 (e-mail: caq9{at}cdc.gov).
Received for publication April 6, 2007. Accepted for publication November 1, 2007.
An accurate assessment of gestational age is vital to population-based research and surveillance in maternal and infant health. However, the quality of gestational age measurements derived from birth certificates has been in question. Using the 2002 US public-use natality file, the authors examined the agreement between estimates of gestational age based on the last menstrual period (LMP) and clinical estimates in vital records across durations of gestation and US states and explored reasons for disagreement. Agreement between the LMP and the clinical estimate of gestational age varied substantially across gestations and among states. Preterm births were more likely than term births to have disagreement between the two estimates. Maternal age, maternal education, initiation of prenatal care, order of livebirth, and use of ultrasound had significant independent effects on the disagreement between the two measures, regardless of gestational age, but these factors made little difference in the magnitude of gestational age group differences. Information available on birth certificates was not sufficient to understand this disparity. The lowest agreement between the LMP and the clinical estimate was observed among preterm infants born at 28–36 weeks' gestation, who accounted for more than 90% of total preterm births. This finding deserves particular attention and further investigation.
gestational age; pregnancy
Abbreviations: LMP, last menstrual period; NCHS, National Center for Health Statistics
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