of0
Export
 
CDE Detailed Report
This report contains detailed information about the selected CDEs.
Note: If at least one CDE was selected from a copyright- or trademark-protected instrument/scale then all of the CDEs from that instrument/scale are included in this report.
Disease:
Sub-Domain: General Health History
CRF: Prenatal and Perinatal History - SMA
Item count: 24 (24 distinct CDEs)
CDE ID
CDE Name
Variable Name
Definition / Description
Question Text
Permissible Value
Description
Data Type
Instructions
References
Population
Classification (e.g., Core)
Version #
Version Date
Aliases for Variable Name
CRF Module / Guideline
© or TM
Sub-Domain
Domain
Previous Title
Size
Input Restrictions
Min Value
Max Value
Measurement Type
LOINC ID
SNOMED
caDSR ID
CDISC ID
C12614
Pregnant more than once maternal indicator
PregPriorHistInd
Indicator of whether the mother of the participant/subject has a history of other pregnancies (both term and not to term) besides the pregnancy with the participant/subject
Mother's pregnancy history: prior pregnancy (both term and not to term) ?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Yes = History reported and/or confirmed in medical record; No = History reported as negative and/or confirmed as negative in medical record; Unknown = History reported as unknown or medical record unclear about history If No or Unknown, go to Pregnancy or delivery risk factor type
No references available
Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
Pregnant more than once maternal indicator
 
Single Pre-Defined Value Selected
       
C11065
Gravida maternal value
GravidaMaternalVal
Total number of times the participant's/subject's mother has been pregnant, regardless of whether these pregnancies were carried to term
Number of prior pregnancies
  
Numeric Values
Record as an integer the number of times the participant/subject (female) has been pregnant. History can be obtained from participant/ subject, family member, friend, or chart/ medical record.
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
Gravida maternal value
 
Free-Form Entry
1
99
     
C12615
Delivery or pregnancy termination maternal last date and time
PregDelvMscryTrmnLstYrDateTime
Date and time (if applicable and known) of the participant's/subject's mother's last delivery, miscarriage or medical termination
Year of last delivery/miscarriage/medical termination
  
Date or Date & Time
Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http://www.iso.org/iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).
No references available
Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
Delivery or pregnancy termination maternal last date and time
 
Free-Form Entry
       
C12616
Pregnant prior history miscarry count
PregPriorHistMiscarryCt
Count of prior miscarriages (spontaneous abortions) that the participant/subject's mother has had
Number of miscarriages
  
Numeric Values
Record as an integer the number of spontaneous abortions/miscarriages. History can be obtained from participant/ subject, family member, friend, or chart/ medical record.
No references available
Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
Spontaneous abortion maternal number
 
Free-Form Entry
0
30
     
C12617
Pregnant prior history medical terminate count
PregPriorHistMedTrmnatCt
Count of prior medical terminations (abortions) that the participant/subject's mother has had
Number of medical terminations of prior pregnancy
  
Numeric Values
Record as an integer the number of medical terminations/abortions. History can be obtained from participant/ subject, family member, friend, or chart/ medical record
No references available
Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
Pregnancy medical termination maternal number
 
Free-Form Entry
0
30
     
C11066
Pregnancy or delivery risk factor type
PregnDeliveryRiskFactTyp
Type of risk factor to the participant's/subject's health that may have been experienced during the prenatal period (i.e., during time mother pregnant), at the time of delivery, or soon after delivery
Was there a history of any of the following during the prenatal period (i.e., during time mother pregnant), at the time of delivery, or soon after delivery?
Oligohydramnios; Polydramnios;Decreased fetal movement;Absence of fetal movement;Second stage of labor more than two hours;Intervention(s) for neonate breathing problems during labor or while giving birth;Any interventions for breathing problems at birth;Any oxygen during neonatal period;Hypotonia (floppiness);
Oligohydramnios; Polydramnios;Decreased fetal movement;Absence of fetal movement;Second stage of labor more than two hours;Intervention(s) for neonate breathing problems during labor or while giving birth;Any interventions for breathing problems at birth;Any oxygen during neonatal period;Hypotonia (floppiness);
Alphanumeric
For each pregnancy condition record whether the mother experienced it using the element "Pregnancy condition maternal indicator".
No references available
Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
Pregnancy or delivery risk factor type
 
Single Pre-Defined Value Selected
       
C18819
Pregnancy or delivery risk factor other text
PregnDeliveryRiskFactOTH
The free-text field related to 'Pregnancy or delivery risk factor type' specifying other text. Type of risk factor to the participant's/subject's health that may have been experienced during the prenatal period (i.e., during time mother pregnant), at the time of delivery, or soon after delivery
Other, specify
  
Alphanumeric
For each pregnancy condition record whether the mother experienced it using the element "Pregnancy condition maternal indicator".
No references available
Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C11067
Pregnancy or delivery risk factor indicator
PregDeliveryRiskFactInd
Whether the specific risk factor to the participant's/subject's health was experienced during the prenatal period (i.e., during time mother pregnant), at the time of delivery, or soon after delivery
Was there a history of any of the following during the prenatal period (i.e., during time mother pregnant), at the time of delivery, or soon after delivery?
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one for each pregnancy or delivery risk factor
No references available
Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
Pregnancy or delivery risk factor indicator
 
Single Pre-Defined Value Selected
       
C12625
Respiratory intervention neonatal problem type
RespIntervntnNeonatlProbTyp
Type of intervention for breathing problems at or soon after the participant/subject's delivery
If yes, type
Oxygen by nose or mask;Nasal CPAP;Intubation/Ventilation (tube down to lungs/on ventilator);Other, specify;
Oxygen by nose or mask;Nasal CPAP;Intubation/Ventilation (tube down to lungs/on ventilator);Other, specify;
Alphanumeric
Choose all that apply
No references available
Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
Respiratory support at birth type
 
Multiple Pre-Defined Values Selected
       
C18864
Respiratory intervention neonatal problem other text
RespIntervntnNeonatlProbOTH
The free-text field related to 'Respiratory intervention neonatal problem type' specifying other text. Type of intervention for breathing problems at or soon after the participant/subject's delivery
Other, specify
  
Alphanumeric
Choose all that apply
No references available
Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C12627
Respiratory intervention neonatal oxygen required indicator
RespIntervntnNeonatlO2ReqInd
Whether oxygen was needed during the neonatal period (i.e., first 28 days of life)
NULL
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one
No references available
Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
Neonate oxygen required indicator
 
Single Pre-Defined Value Selected
       
C12631
Deliver condition hypotonia grade
DelivrConditnHypotoniaGrade
Grade of any hypotonia (floppiness) that was present at or soon after the participant/subject's delivery
If Yes, hypotonia is
Mild;Moderate;Severe;Unknown;
Mild;Moderate;Severe;Unknown;
Alphanumeric
Choose one
No references available
Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
Hypotonia at birth severity type
 
Single Pre-Defined Value Selected
       
C18829
Delivery mode induced other text
DeliveryModeOTH
The free-text field related to 'Delivery mode type' for induced delivery mode. Type of delivery mode of the neonate.
Induced, specify reason
  
Alphanumeric
Choose one
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
 
4000
Free-Form Entry
       
C11078
Delivery mode type
DeliveryModeTyp
Type of delivery mode of the neonate
Mode of delivery of the neonate
Spontaneous;Induced;Induced, specify reason;Unknown;
Spontaneous;Induced;Induced, specify reason;Unknown;
Alphanumeric
Choose one
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
Delivery mode type
 
Single Pre-Defined Value Selected
       
C11079
Neonate delivery route type
NeonateDelivRteTyp
Route of delivery of the neonate
Route of delivery of the neonate
Vaginal;Caesarean;Unknown;
Vaginal;Caesarean;Unknown;
Alphanumeric
Choose one
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
Delivery route
 
Single Pre-Defined Value Selected
       
C11080
Delivery modality type
DeliveryModltyTyp
Type of modality of the participant/subject's intrauterine orientation at delivery
Delivery modality type of the neonate
Breech;Cephalic;Unknown;
Breech;Cephalic;Unknown;
Alphanumeric
Choose one
No references available
Adult;Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
Delivery modality type
 
Single Pre-Defined Value Selected
       
C11083
Delivery extraction type
DeliveryExtractionTyp
Type of extraction used to assist with the delivery of the participant/subject
Instrument(s) used to assist with the delivery of the participant/subject
None;Vacuum;Forceps;Vacuum and Forceps;Unknown;
None;Vacuum;Forceps;Vacuum and Forceps;Unknown;
Alphanumeric
Choose one
No references available
Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
Delivery extraction type
 
Single Pre-Defined Value Selected
       
C21620
Gestational age value range
GestatnlAgeValRange
Range of time elapsed in weeks between the first day of the last normal menstrual period and the day of delivery of the participant/subject.
Gestational age (GA)
<35 weeks;35-37 weeks;38-41 weeks;>41 weeks;
<35 weeks;35-37 weeks;38-41 weeks;>41 weeks;
Alphanumeric
Record the gestation age in weeks and days. This is a pediatric-specific element.
No references available
Pediatric
Supplemental
3.0
7/25/2013
GESTA_NAT_AGE
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
     
3192017
 
C12604
APGAR one minute score
APGAR1MinScore
Score of a newborn recorded at one minute from the time of birth and expressed as a number quantifying the overall physical condition, which includes heart rate, muscle tone, respiratory effort, color, and reflex responsiveness.
APGAR 1 minute score
0;1;2;3;4;5;6;7;8;9;10;
0;1;2;3;4;5;6;7;8;9;10;
Numeric Values
Record the APGAR score (0 - 10 points, inclusive) assessed at 1 minute. This is a pediatric-specific element.
No references available
Pediatric
Supplemental
3.0
7/24/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
APGAR one minute score
 
Single Pre-Defined Value Selected
       
C00724
APGAR five minute score
APGARFiveMinuteScore
Score of a newborn recorded at five minutes from the time of birth and expressed as a number quantifying the overall physical condition, which includes heart rate, muscle tone, respiratory effort, color, and reflex responsiveness.
APGAR 5 minute score
0;1;2;3;4;5;6;7;8;9;10;
0;1;2;3;4;5;6;7;8;9;10;
Numeric Values
Record the APGAR score (0 - 10 points, inclusive) assessed at 5 minutes. This is a pediatric-specific element.
No references available
Pediatric
Supplemental
3.0
7/25/2013
APGAR_SC_FV_MIN_NUM
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
APGAR five minute score
 
Single Pre-Defined Value Selected
     
2738533
 
C00723
APGAR ten minute score
APGARTenMinuteScore
Score of a newborn recorded at ten minutes from the time of birth and expressed as a number quantifying the overall physical condition, which includes heart rate, muscle tone, respiratory effort, color, and reflex responsiveness.
APGAR 10 minute score
0;1;2;3;4;5;6;7;8;9;10;
0;1;2;3;4;5;6;7;8;9;10;
Numeric Values
Only collected if needed. Record the APGAR score (0 - 10 points, inclusive) assessed at 10 minutes. This is a pediatric-specific element.
No references available
Pediatric
Supplemental
3.0
7/25/2013
APGAR_SC_TN_MIN_NUM
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
APGAR ten minute score
 
Single Pre-Defined Value Selected
     
3181701
 
C12628
Neonatal intensive care unit stay indicator
NICUStayInd
Indicator whether the participant/subject had to stay in the neonatal intensive care unit (NICU)
Any neonatal intensive care unit (NICU) stay
Yes;No;Unknown;
Yes;No;Unknown;
Alphanumeric
Choose one
No references available
Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
NICU stay indicator
 
Single Pre-Defined Value Selected
       
C12629
Neonatal intensive care unit stay duration
NICUStayDur
Duration of the participant/subject's stay in the neonatal intensive care unit (NICU)
If Yes, length of NICU stay?
<=48 hours;>48 hours and <1 week;>=1 week;
<=48 hours;>48 hours and <1 week;>=1 week;
Alphanumeric
Only answered if Yes is answered for "Any NICU stay?"
No references available
Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
NICU stay duration range
 
Single Pre-Defined Value Selected
       
C17983
Caesarean delivery timing type
CaesarDelivTimingTyp
Type of timing conditions under which Caesarean delivery was decided upon
If yes, timing of the Caesarean
Emergency;Elective;
Emergency;Elective;
Alphanumeric
No instructions available
No references available
Pediatric
Supplemental
3.0
7/25/2013
Aliases for variable name not defined
Prenatal and Perinatal History - SMA
General Health History
Participant History and Family History
  
Single Pre-Defined Value Selected
       
12-17-2018
Page 1 of 1