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Pregnancy Form

299 Shared Subjects

N/A
Clinical Assessments
Med History
02/27/2015
pregform01
09/09/2020
View Change History
01
Query Element Name Data Type Size Required Description Value Range Notes Aliases
subjectkey GUID Required The NDAR Global Unique Identifier (GUID) for research subject NDAR*
src_subject_id String 20 Required Subject ID how it's defined in lab/project patid, randid, subject_id, subjectid
interview_date Date Required Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY pregn_event, visit_date
interview_age Integer Required Age in months at the time of the interview/test/sampling/imaging. 0::1440 Age is rounded to chronological month. If the research participant is 15-days-old at time of interview, the appropriate value would be 0 months. If the participant is 16-days-old, the value would be 1 month.
sex String 20 Required Sex of subject at birth M;F; O; NR M = Male; F = Female; O=Other; NR = Not reported gender, preg1
Query pregn_01 Integer Recommended Is information about this pregnancy available? 0;1 0=No; 1=Yes
Query pregn_01a Integer Recommended live birth 0;1 0=No; 1=Yes
Query pregn_01b Integer Recommended Clinical Termination 0;1 0=No; 1=Yes
Query pregn_01c Integer Recommended Any apparent abnormalities? 0;1 0=No; 1=Yes
pregn_01d String 250 Recommended a. list abnormalities
pregn_01e String 250 Recommended b. list abnormalities
pregn_01f String 250 Recommended c. list abnormalities
Query pregn_01g Integer Recommended stillbirth 0;1 0=No; 1=Yes
Query pregn_01h Integer Recommended miscarriage 0;1; -9 0=No; 1=Yes; -9=Incomplete
eterm6prg Date Recommended pregnant date pregn_date_reported
subject_description String 4,000 Recommended Subject related information (e.g the affection, phenotype, disease information, etc.).
site String 101 Recommended Site Study Site site_uid
Query visit String 60 Recommended Visit name prex_interval, visit_name
session_id String 20 Recommended session ID/screening ID screeningid
version_form String 121 Recommended Form used/assessment name form_name
Query pregnant Integer Recommended Patient is currently pregnant 0::2;-7; 999 0=No; 1=Yes;2=DK;-7= Refused; 999=Legimately skipped prgntyn
rprtdt Date Recommended Pregnancy Date Reported
lstmnsdt Date Recommended Pregnancy Start date of last menses
confdt Date Recommended Pregnancy Date confirmed
anbrthdt Date Recommended Pregnancy Anticipated date of childbirth
Query numpreg Integer Recommended number of pregnancies nmbrpreg
Query nrmdeliv Integer Recommended Number of Normal Deliveries
Query miscar Integer Recommended Number of miscarriages spnmscrg
prghxoth String 250 Recommended Other Pregnancy History
Query outcm Integer Recommended Pregnancy Outcome 1::7 1=Not known at this date; 2=Still Birth; 3=Uneventful (normal/healthy baby); 4=Neonatal death; 5=Induced Abortion; 6=Spontaneous Abortion; 7=Birth defects
comments_misc String 4,000 Recommended Miscellaneous comments on study, interview, methodology relevant to this form data acpreg, comments
outcmdt Date Recommended Pregnancy Outcome Date
study String 100 Recommended Study; The code for each individual study studyid
Query week Float Recommended Week in level/study 99=week 10-week 14 interval
date_updated Date Recommended Date record updated edit_date
Query prex_mnrchdat_x Integer Recommended Day of Menarche q02
Query rlhqlql Integer Recommended Patient's status is childbearing potential
1;2;9
1=No; 2=Yes; 9=unknown prex_q01, q01
Query contrac Integer Recommended Contraception use 1::5 1=None; 2=OBC; 3=Barrier; 4=Abstinence; 5=Other prex_q03
Query pregnan Integer Recommended pregnancy test 0::6;-7;9 0=Negative; 1=Positive; 2=Test not conducted; -7=Refused; 9=NA;3=Not pregnant (per pregnancy test); 4=Not pregnant (has not reached menarche); 5=Pregnancy suspected, but not confirmed; 6 = Equivocal preg2, prex_q05, q05
Query completed Integer Recommended Checks if completed 0::3 0=No; 1=Yes; 2=Yes, lost; 3=Unverified frmcomp, prex_frmcomp, pt01
Query bcstat Integer Recommended Current Birth Control or Reproductive Status 1::12; 99 1=Oral; 2=Hormonal Injections; 3=Hormonal Implants; 4=Contraceptive Patches; 5=Ring; 6=Intrauterine device, hormonal; 7=Intrauterine device, non-hormonal; 8=Barrier method; 9=Spermicide; 10 Post-menopausal for > 1 year; 11=Bilateral tubal ligation, bilateral oophorectomy, or hysterectomy; 12=Abstinence; 99 = other q03
p_med_bc String 65 Recommended Describe type of birth control q04
Query daysrz Integer Recommended days since randomization studyday
Query ci_enrolled Integer Recommended Participant enrolled 0;1 0=No; 1=Yes enrolled
Query visnum Float Recommended Numeric Visit Number -1.5 = Pre-Screening; -1 = Screening; 0 = Baseline; ## = Visit ## (from 1 to 10); Whole numbers = standard monthly visits; #.001 - #.009 = Unscheduled; #.1 = End of Phase 1; #.2 = End of Phase 2; #.3 = End of Phase 3; #.4 = End of Open Choice Phase; #.5 = End of Study; #.6 = Genetic Analysis; 1000=all visits
specify String 200 Recommended If "Other", (pregnancy test N/A) specify - TEXT
Query ifna Integer Recommended If N/A checked (pregnancy test), please select one reason 1::3 1 = Male; 2 = Premanarche; 3 = Other (specify)
Query pepregt Integer Recommended Pregnancy test type 1::3; -9 1 = Urine 2 = Serum 3 = Test not conducted; -9=unknown
Query sigp1 Integer Recommended Physician signature present 0;1 0 = No; 1 = Yes
Query sigd1 Integer Recommended Physician/PI signature date (days since randomization)
Query sub8a_9 Integer Recommended N/A 1::3; -99; 77; 88 1= Yes ; 2= No ; -99= NA; 77= Refused ; 88= Missing; 3=not assessed
ptlot String 500 Recommended Lot Number
ptex Date Recommended Expiration Date
aescode Integer Recommended Staff code number of person completing this form 999= Missing Data
ccc2datecomp Date Recommended Date Completed pt0
preg3 Integer Recommended If equivocal, what was the retest result 1::3 1 = Positive ; 2 = Negative ; 3 = Equivocal preg03
Data Structure

This page displays the data structure defined for the measure identified in the title and structure short name. The table below displays a list of data elements in this structure (also called variables) and the following information:

  • Element Name: This is the standard element name
  • Data Type: Which type of data this element is, e.g. String, Float, File location.
  • Size: If applicable, the character limit of this element
  • Required: This column displays whether the element is Required for valid submissions, Recommended for valid submissions, Conditional on other elements, or Optional
  • Description: A basic description
  • Value Range: Which values can appear validly in this element (case sensitive for strings)
  • Notes: Expanded description or notes on coding of values
  • Aliases: A list of currently supported Aliases (alternate element names)
  • For valid elements with shared data, on the far left is a Filter button you can use to view a summary of shared data for that element and apply a query filter to your Cart based on selected value ranges

At the top of this page you can also:

  • Use the search bar to filter the elements displayed. This will not filter on the Size of Required columns
  • Download a copy of this definition in CSV format
  • Download a blank CSV submission template prepopulated with the correct structure header rows ready to fill with subject records and upload

Please email the The NDA Help Desk with any questions.