Date pregnancy information
Item
Date pregnancy information obtained (m m/dd/yyyy):
date
C0032961 (UMLS CUI [1,1])
C1533716 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Item
Is the participant/subject pregnant?
integer
C0549206 (UMLS CUI [1])
Code List
Is the participant/subject pregnant?
CL Item
No (Skip to Q8) (2)
CL Item
Unknown (Skip to Q8) (3)
Item
Was birth control being used?
integer
C0700589 (UMLS CUI [1])
Code List
Was birth control being used?
Item
Was birth control being used? If Yes, indicate all forms of contraception used (choose all that apply):
integer
C0700589 (UMLS CUI [1])
Code List
Was birth control being used? If Yes, indicate all forms of contraception used (choose all that apply):
CL Item
Oral contraceptives–combined pill (“the pill”) (1)
CL Item
Oral contraceptives–progestin-only pill (“mini-pill”) (2)
CL Item
Transdermal patch (i.e., Ortho Evra) (3)
CL Item
Shot/injection (i.e., Depo-Provera) (4)
CL Item
Vaginal ring (i.e., NuvaRing) (5)
CL Item
Implantable devices with hormone (i.e., ParaGuard, Mirena) (6)
CL Item
None of these (8)
Contraception
Item
Last date birth control used (m m/dd/yyyy):
date
C0700589 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Date of last menstrual period
Item
Date of last menstrual period
date
C0425932 (UMLS CUI [1])
Date pregnancy confirmed
Item
Date pregnancy confirmed
date
C2584394 (UMLS CUI [1])
Estimated delivery date
Item
Estimated delivery date (EDD) (m m/dd/yyyy):
date
C1287845 (UMLS CUI [1])
Item
Was the EDD based on an ultrasound?
integer
C1287845 (UMLS CUI [1])
C0041618 (UMLS CUI [2])
Code List
Was the EDD based on an ultrasound?
Item
Was prenatal testing performed?
integer
C1456692 (UMLS CUI [1])
Code List
Was prenatal testing performed?
Item
Was prenatal testing performed?If Yes, please complete the following questions regarding prenatal testing
integer
C1456692 (UMLS CUI [1])
Code List
Was prenatal testing performed?If Yes, please complete the following questions regarding prenatal testing
CL Item
Amniocentesis (2)
CL Item
Screening for neural tube defects (3)
CL Item
Screening for gestational diabetes before or at 28 weeks (4)
CL Item
Screening for asymptomatic bacteriuria before or at 16 weeks gestation (5)
CL Item
Hepatitis B specific antigen screening at first visit (6)
CL Item
HIV screening at first visit (7)
CL Item
Group B streptococcus screening (GBS) at 35 to 37 weeks (8)
CL Item
Maternal serum alpha fetoprotein (9)
CL Item
Other, specify (10)
Item
Was prenatal testing performed?If Other, specify
text
C1456692 (UMLS CUI [1])
Code List
Was prenatal testing performed?If Other, specify
Prenatal testing
Item
Was prenatal testing performed?If Yes, please specify the date of testing
date
C1456692 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Prenatal testing
Item
Was prenatal testing performed?If Yes, please specify the result of testing
text
C1456692 (UMLS CUI [1,1])
C0456984 (UMLS CUI [1,2])
Prenatal testing comments
Item
Was prenatal testing performed? Comments
text
C1456692 (UMLS CUI [1])
C0947611 (UMLS CUI [2])
Item
Did/Has the participant/subject experienced any complications during this pregnancy?
integer
C0009566 (UMLS CUI [1,1])
C0032961 (UMLS CUI [1,2])
Code List
Did/Has the participant/subject experienced any complications during this pregnancy?
Item
Did/Has the participant/subject experienced any complications during this pregnancy? If Yes, specify
text
C0009566 (UMLS CUI [1,1])
C0032961 (UMLS CUI [1,2])
Code List
Did/Has the participant/subject experienced any complications during this pregnancy? If Yes, specify
Item
Did/Has the participant/subject experienced any infections or illnesses during this pregnancy?
integer
C0009450 (UMLS CUI [1,1])
C0221423 (UMLS CUI [1,2])
C0032961 (UMLS CUI [2])
Code List
Did/Has the participant/subject experienced any infections or illnesses during this pregnancy?
Infections or illnesses during this pregnancy
Item
Did/Has the participant/subject experienced any infections or illnesses during this pregnancy? If yes, specify
text
C0009450 (UMLS CUI [1,1])
C0221423 (UMLS CUI [1,2])
C0032961 (UMLS CUI [2])
Item
Has the participant/subject ever been pregnant?
integer
C0032967 (UMLS CUI [1])
Code List
Has the participant/subject ever been pregnant?
CL Item
Unknown (STOP) (3)
Prior pregnancy
Item
Number of prior pregnancies (both to term and not to term)
integer
C0032967 (UMLS CUI [1])
Prior pregnancy
Item
Full-term (≥ 37 weeks) births
integer
C0032967 (UMLS CUI [1])
Prior pregnancy
Item
Pre-term (≥ 37 weeks) births
integer
C0032967 (UMLS CUI [1])
Item
Did a birth defect occur in any previous pregnancy?
integer
C0000768 (UMLS CUI [1,1])
C0032967 (UMLS CUI [1,2])
Code List
Did a birth defect occur in any previous pregnancy?
Birth defect in prior pregnancy
Item
Did a birth defect occur in any previous pregnancy? If Yes, specify birth defect
text
C0000768 (UMLS CUI [1,1])
C0032967 (UMLS CUI [1,2])
Item
Did a miscarriage (≤ 20 weeks) or stillbirth (> 20 weeks) occur in any previous pregnancy?
integer
C0438080 (UMLS CUI [1])
C0595939 (UMLS CUI [2])
Code List
Did a miscarriage (≤ 20 weeks) or stillbirth (> 20 weeks) occur in any previous pregnancy?
Miscarriage or stillbirth
Item
If Yes, in what week of pregnancy did the miscarriage or stillbirth occur? week(s):
integer
C0438080 (UMLS CUI [1])
C0595939 (UMLS CUI [2])
Item
Has the participant/subject ever had exposure to any of the following during pregnancy?
integer
C0332157 (UMLS CUI [1])
Code List
Has the participant/subject ever had exposure to any of the following during pregnancy?
CL Item
Concurrent medication (1)
CL Item
Exposure to X-ray (2)
CL Item
Other specify (6)
Exposure
Item
Has the participant/subject ever had exposure to any substance during pregnancy?If Other,specify
text
C0332157 (UMLS CUI [1])