Risk during pregnancy—Self-report versus medical record

Objective This study was undertaken to compare the frequencies with which physicians and patients report medical and behavioral risk factors during pregnancy, with particular attention to identification of women at risk for prenatal alcohol use. Study design The sample included 278 women, drawn from a randomized trial of T-ACE (alcohol screening questionnaire) positive pregnant women receiving obstetric care. Medical records and participantsʹ self-reports were available for comparison. Results Physicians identified only 10.8% of women recognized as at risk for alcohol consumption by the T-ACE screening measure. In contrast, the physiciansʹ records were more inclusive for medical risk factors than the participantʹs self-reports. Physicians were significantly more likely to correctly identify nonwhite participants as being at risk for prenatal alcohol use (odds ratio = 3.59, P = .026), compared with their white counterparts. Conclusion Self-report on the T-ACE questionnaire is more effective than medical records in identifying women at risk for prenatal alcohol use.