Objective: to study in routine care the feasibility and inter-rater reliability of the Rotterdam Reproductive Risk Reduction risk score card (R4U), a new semi-quantitative score card for use during the antenatal booking visit. The R4U covers clinical and non-clinical psychosocial factors and identifies overall high risk pregnancies, qualifying for intensified antenatal care. Design: a population-based cross-sectional study (feasibility) and a cohort study (inter-rater reliability). Setting: feasibility was studied in six midwifery practices and two hospitals; the reliability study was performed in one midwifery practice. Participants: 1096 pregnant women in the feasibility study and a subsample of 133 participants in the inter-rater reliability study. Measurements: feasibility was expressed as (a) time needed to complete the R4U and (b) the missing rate at the item and client level. For inter-rater reliability (IRR) an independent, blinded, caregiver completed a re-test R4U during a second visit; inter-rater agreement for each item and all domain sum scores were computed. Findings: completion of the R4U took 5 minutes or less in 63%; and between 5 and 10 minutes in another 33%. On the participant level 0.2% of women had >20% missing values (below 4% threshold, P<0.001). One of 77 items had a >10% missing rate. The per item IRR was 100% in 20% of the items, and below the predefined 80% threshold in 13% of the items (n=9). The domain sum scores universally differed less than the predetermined ±15% margin. Key conclusion: the R4U risk score card is a feasible and reliable instrument. Implication for practice: the R4U is suitable for the assessment of clinical and non-clinical risks during the antenatal booking visit in a heterogeneous urban setting in routine practice.

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doi.org/10.1016/j.midw.2014.08.002, hdl.handle.net/1765/84602
Department of Gynaecology & Obstetrics

van Veen, M., Birnie, E., Poeran, J., Torij, H. W., Steegers, E., & Bonsel, G. (2015). Feasibility and reliability of a newly developed antenatal risk score card in routine care. Midwifery, 31(1), 147–154. doi:10.1016/j.midw.2014.08.002