CDE Detailed Report

Disease: Friedreich's Ataxia
Sub-Domain: General Health History
CRF: Prenatal and Perinatal History

Displaying 1 - 18 of 18
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (Question Text) Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
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. 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

No references available Adult;Pediatric Exploratory 3.00 2013-07-25 08:54:08.2 Prenatal and Perinatal History General Health History Participant History and Family History

Single Pre-Defined Value Selected

2738533
C11083 Delivery extraction type DeliveryExtractionTyp Type of extraction used to assist with the delivery of the participant/subject Type of extraction used to assist with the delivery of the participant/subject Instruments 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. Only answered if "History of instruments being used to assist with the delivery of the participant/subject?" is answered Yes.

No references available Adult;Pediatric Exploratory 3.00 2013-07-25 08:54:08.2 Prenatal and Perinatal History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C11062 Maternal delivery age value MatrnlDelvryAgeVal Mother's age at the time she gave birth to the participant/subject Mother's age at the time she gave birth to the participant/subject Mother's age at the time she gave birth to the participant/subject Numeric Values

Answer should be recorded in years

No references available Adult;Pediatric Exploratory 3.00 2013-07-24 21:00:23.88 Prenatal and Perinatal History General Health History Participant History and Family History

Free-Form Entry

0 99 year
C17490 Birth delivery history indicator BirthDeliveryHistInd Indicator of pregnancy/delivery risk factors Indicator of pregnancy/delivery risk factors Is there a history of the following? Yes;No;Unknown Yes;No;Unknown Alphanumeric No references available Adult;Pediatric Exploratory 3.00 2013-07-15 16:08:48.687 Prenatal and Perinatal History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C11063 Parity maternal value ParityMaternalVal Number of live born children the participant's/subject's mother has delivered Number of live born children the participant's/subject's mother has delivered Number of live born children the participant's/subject's mother has delivered Numeric Values

Answer should be recorded as a whole integer

No references available Adult;Pediatric Exploratory 3.00 2013-07-10 11:37:29.993 Prenatal and Perinatal History General Health History Participant History and Family History

Free-Form Entry

0 99
C17491 Birth delivery history type BirthDeliveryHistoryTyp Type of pregnancy complication the participant's/subject's mother may have experienced in her lifetime Type of pregnancy complication the participant's/subject's mother may have experienced in her lifetime Is there a history of the following? Resuscitation of the participant/subject at delivery;Intravascular catheter placed in newborn period;Placenta sent for pathology;Placental abnormalities;Cord abnormalities;Fetal heart rate abnormality;Decreased fetal movement;Chorioamnionitis;Other pregnancy/delivery risk factors Resuscitation of the participant/subject at delivery;Intravascular catheter placed in newborn period;Placenta sent for pathology;Placental abnormalities;Cord abnormalities;Fetal heart rate abnormality;Decreased fetal movement;Chorioamnionitis;Other pregnancy/delivery risk factors Alphanumeric No references available Adult;Pediatric Exploratory 3.00 2013-07-15 16:08:48.687 Prenatal and Perinatal History General Health History Participant History and Family History

Multiple Pre-Defined Values 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 Total number of times the participant's/subject's mother has been pregnant, regardless of whether these pregnancies were carried to term Total number of times the participant/subject?s mother has been pregnant, regardless of whether these pregnancies were carried to term Numeric Values

Answer should be recorded as a whole integer. A current pregnancy, if any, is included in this count

No references available Adult;Pediatric Exploratory 3.00 2013-07-25 08:54:08.2 Prenatal and Perinatal History General Health History Participant History and Family History

Free-Form Entry

1 99
C22800 Pregnancy or delivery risk factor other indicator PregDelvRskFactrOthInd Indicate whether there are other pregnancy/delivery risk factors. Indicate whether there are other pregnancy/delivery risk factors. Other pregnancy/delivery risk factors? Yes;No;Unknown Yes;No;Unknown Alphanumeric Adult;Pediatric Exploratory 1.00 2016-11-04 15:33:57.0 Prenatal and Perinatal History General Health History Participant History and Family History

Single Pre-Defined Value Selected

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 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 Does the participant/subject's mother have a history of Previous pregnancy loss;Preeclampsia during pregnancy of the participant/subject;Another hypertensive disorder during pregnancy of the participant/subject;Oligohydramnios;Gestational onset diabetes during pregnancy of the participant/subject;Fever during delivery of participant/subject;Prolonged rupture of membranes (i.e., > 24 hours) during delivery of participant/subject;Second stage of labor more than two hours;Meconium staining of the amniotic fluid Previous pregnancy loss;Preeclampsia during pregnancy of the participant/subject;Another hypertensive disorder during pregnancy of the participant/subject;Oligohydramnios;Gestational onset diabetes during pregnancy of the participant/subject;Fever during delivery of participant/subject;Prolonged rupture of membranes (i.e., > 24 hours) during delivery of participant/subject;Second stage of labor more than two hours;Meconium staining of the amniotic fluid Alphanumeric

For each pregnancy condition record whether the mother experienced it using the element "Pregnancy condition maternal indicator".

No references available Adult;Pediatric Exploratory 3.00 2013-07-25 08:54:08.2 Prenatal and Perinatal History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

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 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 Does the participant's/subject's mother have a history of Yes;No;Unknown Yes;No;Unknown Alphanumeric

Choose one for each condition (see "Pregnancy condition maternal type" CDE)

No references available Adult;Pediatric Exploratory 3.00 2013-07-25 08:54:08.2 Prenatal and Perinatal History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C11078 Delivery mode type DeliveryModeTyp Type of delivery mode of the neonate Type of delivery mode of the neonate Mode of delivery of the neonate Spontaneous;Induced;Unknown Spontaneous;Induced;Unknown Alphanumeric

Choose one

No references available Adult;Pediatric Exploratory 3.00 2013-07-25 08:54:08.2 Prenatal and Perinatal History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C11079 Neonate delivery route type NeonateDelivRteTyp Route of delivery of the neonate Route of delivery of the neonate Route of delivery of the neonate Vaginal;Caesarean Vaginal;Caesarean Alphanumeric

Choose one

No references available Adult;Pediatric Exploratory 3.00 2013-07-25 08:54:08.2 Prenatal and Perinatal History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C00001 Gestational age value GestatnlAgeVal Time elapsed in weeks between the first day of the last normal menstrual period and the day of delivery of the participant/subject. 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 at birth Numeric Values

Answer should be recorded in weeks

No references available Adult;Pediatric Exploratory 3.00 2013-07-25 08:54:08.2 Prenatal and Perinatal History General Health History Participant History and Family History

Free-Form Entry

0 52 week 3192017
C11080 Delivery modality type DeliveryModltyTyp Type of modality of the participant/subject's intrauterine orientation at delivery 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 Exploratory 3.00 2013-07-25 08:54:08.2 Prenatal and Perinatal History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C00311 Birth weight value BirthWgtVal Birth weight according to the participant's/subject's medical report or reported by the parent or legal guardian Birth weight according to the participant's/subject's medical report or reported by the parent or legal guardian Birth weight Numeric Values

Pounds and ounces or grams

No references available Adult;Pediatric Exploratory 3.00 2013-07-24 21:00:23.88 Prenatal and Perinatal History General Health History Participant History and Family History

Free-Form Entry

0 9000 gram 3201400;2179689
C11081 Delivery caesarean timing status DeliveryCaesareanTimingStatus Status of the caesarean delivery Status of the caesarean delivery If Caesarean, timing of the procedure? Emergency;Elective;Unknown Emergency;Elective;Unknown Alphanumeric

Choose one. Element is only applicable if "Delivery route" is answered as "Caesarean".

No references available Adult;Pediatric Exploratory 3.00 2013-07-16 14:01:43.01 Prenatal and Perinatal History General Health History Participant History and Family History

Single Pre-Defined Value Selected

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. 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

Record the APGAR score (0 - 10 points, inclusive) assessed at 10 minutes

No references available Adult;Pediatric Exploratory 3.00 2013-07-25 08:54:08.2 Prenatal and Perinatal History General Health History Participant History and Family History

Single Pre-Defined Value Selected

3181701
C11082 Delivery extraction indicator BirthDeliveryExtractionInd Indicator as to whether or not the participant's/subject's birth was assisted with an extraction method Indicator as to whether or not the participant's/subject's birth was assisted with an extraction method Instruments used to assist with the delivery of the participant/subject Yes;No;Unknown History reported and/or confirmed in medical record;History NOT reported and NOT confirmed in medical record;History reported as unknown or could not be collected Alphanumeric

If "No," skip "Birth delivery extraction type."

No references available Adult;Pediatric Exploratory 3.00 2013-07-11 15:03:49.2 Prenatal and Perinatal History General Health History Participant History and Family History

Single Pre-Defined Value Selected

CSV