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Agreement between maternal cannabis use during pregnancy according to self-report and urinalysis in a population-based cohort: the Generation R Study.
MedLine Citation:
PMID:  20975275     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
AIM: To verify self-reported information on prenatal drug use in urine because reporting in pregnancy is sensitive to stigma and might lead to misclassification.
METHODS: Using semiquantitative immunochemical analysis, the presence of the urinary metabolite (11-nor-Δ9-tetrahydrocannabinol- 9-carboxylic acid) was compared to self-reported prenatal cannabis use. Sensitivity and specificity for self-report and urinalysis outcomes were calculated and Yule's Y was used as an agreement measure.
RESULTS: Urine samples were available for 3,997 pregnant women. Of these women, 92 reported having used cannabis during pregnancy (2.3%) and 71 had positive urine screens (1.8%). In total 35% of the 92 women with self-reported cannabis use also had a positive urine screen. Positive urines were relatively frequent in women reporting cannabis use before pregnancy only (7.6%) and in women with missing information (2.6%). Sensitivity and specificity of urinalysis compared to self-report were 0.46 and 0.98. Sensitivity and specificity of self-report compared to urinalysis were 0.36 and 0.99. Yule's Y amounted to 0.77, indicating substantial agreement between the measures.
CONCLUSIONS: Our findings illustrate the difficulties in obtaining valid information on prenatal cannabis use. To improve the quality of cannabis use data, we suggest a 2-step approach starting with self-report.
Authors:
H El Marroun; H Tiemeier; V W V Jaddoe; A Hofman; F C Verhulst; W van den Brink; A C Huizink
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Publication Detail:
Type:  Journal Article     Date:  2010-10-26
Journal Detail:
Title:  European addiction research     Volume:  17     ISSN:  1421-9891     ISO Abbreviation:  Eur Addict Res     Publication Date:  2011  
Date Detail:
Created Date:  2010-12-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9502920     Medline TA:  Eur Addict Res     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  37-43     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 S. Karger AG, Basel.
Affiliation:
The Generation R Study Group, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands. h.marrounel@erasmusmc.nl
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