Variables in Delivery Report Form (DRF) | ||||
Question# | Question | Field name | Response nature | Response options |
1 | PID number | PID | ### | ### |
2 | Child PID number | drf_A | 9### | 9### |
3 | Initials of the mother | drf _B | XX | XX |
4 | Researcher code | drf _C | ## | ## |
5 | Date
of Interview (according to English calender) |
drf _D | dd-mmm-yy | dd-mmm-yy |
6 | Date
of Birth of child (according to English calender) |
drf_1 | dd-mmm-yy | dd-mmm-yy |
7 | Place of delivery? | drf_2 | ## | 1=Study site, 2=Bhaktapur H., 3=Maternity H., 4=Patan H., 5=T. U. Teaching H., 6=Dhulikhel H., 7=Kathmandu Medical College (KMC), 8=Scheer Memorial H.Banepa, 9=Home, 10=Other |
8 | Gestational age (wks) at delivery | drf _3 | ## | |
9 | Type of Delivery | drf _4 | # | 1=Vaginal/normal, 2= Induced vaginal delivery, 3=Caesarian section, 4=Vacuums/forceps delivery, 5=Other |
10 | If other than normal delivery, specify indication of CS or instrumental delivery | drf _4 txt | TXT | NA
if drf_4=1; TEXT if drf_4ǂ1 |
11 | Any labor/ delivery complication | drf_5 | ## | 2=No, 3=Preterm labor/ delivery, 4= Premature Rupture of Membranes (PROM) 5=Abnormal position/presentation, 6= Cord prolapse, 7=Fetal Distress (Meconium Stained Liquor/Tachy/bradycardia), 8=Prolonged labor/failure to progress, 9=NA, 10=Precipitate Labor, 11=Pre-eclampsia/Eclampsia, 12=III degree/IV degree perineal tear, 13= Post-partum hemorrhage (PPH), 14=Others |
12 | Is there any more complication? | drf _5_i | ## | 2=No, 3=Preterm labor/ delivery, 4= Premature Rupture of Membranes (PROM) 5=Abnormal position/presentation, 6= Cord prolapse, 7=Fetal Distress (Meconium Stained Liquor/Tachy/bradycardia), 8=Prolonged labor/failure to progress, 9=NA, 10=Precipitate Labor, 11=Pre-eclampsia/Eclampsia, 12=III degree/IV degree perineal tear, 13= Post-partum hemorrhage (PPH), 14=Others |
13 | If other/more complication, specify | drf _5_ii | TXT | TEXT
if drf_5_i=14 NA if drf_5_iǂ14 |
14 | Was the baby alive? | drf _6 | # | 1=Yes, 2=No (still birth) |
15 | Did the baby cry just after birth? | drf_7 | # | 1=Yes, 2=No |
16 | Apgar scores (in total of 10) | |||
17 | i. at1 min | drf_8i | ## | ## |
18 | ii. at 5 min | drf_8ii | ## | ## |
19 | Sex of the baby | drf_9 | # | 1=Male, 2=Female, 3=Unknown |
20 | Any complications or medication for baby after birth? | drf _10 | # | 1=Yes, 2=No |
21 | If yes, specify | drf _10txt | TXT | TEXT
if drf_10=1 NA if drf_102 |
22 | Any congenital anomaly? | drf _11 | # | 1=Yes, 2=No |
23 | If yes, Specify | drf _11txt | TXT | TEXT
if drf_11=1 NA if drf_11=2 |
24 | Admission of baby in hospital after birth? | drf _12 | # | 1=NICU, 2=No, 3=Other ward |
25 | If admitted, specify diagnosis. | Drf_12txt | TXT | NA
if drf_12=2 TEXT if drf_12ǂ2 |
26 | Any complication with mother and medication use? | drf _13 | # | 1=Yes, 2=No |
27 | If yes, specify | drf _13txt | TXT | TEXT
if drf_13=1 NA if drf_13=2 |
28 | Did the mother need prolonged hospitalization after delivery? | drf _14 | # | 1=Yes, 2=No |
29 | If yes, specify reason | drf _14txt | TXT | TEXT
if drf_14=1 NA if drf_14=2 |
30 | Was prelacteal feeding done? If yes which food was given? | drf _15 | # | 2=No, 3=Donor milk, 4=Formula milk, 5=Glucose water, 6=Animal milk, 7=Honey, 8=Others |
31 | If others, specify | drf _15_a | TXT | TEXT
if drf_15=8 NA if drf_15ǂ 8 |
32 | Reason for prelacteal feeding? | drf _15_b | # | 1=Caesarian section, 2=Preterm/LBW 3=Illness of Baby, 4=Illness of mother, 5=No milk secretion, 6= Others |
33 | If others, specify | drf _15_c | TXT | TEXT
if drf_15_b=6 NA if drf_15_bǂ 6 |
34 | When was breastfeeding initiated after birth? | drf _16 | # | 1=within 1 hour, 2=1-2 hours, 3=2-4 hours 4=5-24 hours, 5= after 24 hours |
35 | Birth
weight of the baby (gm) (According to hospital record) |
drf _17 | #### | |
Anthropometric measurement of the neonate on the
day of interview (Measurement by field) |
||||
36 | Weight of the baby (gm) | drf _18 | #### | |
37 | Weight of the baby (gm) | drf _18_i | #### | |
38 | Length of the baby (cm) | drf_19 | ##.# | |
39 | Length of the baby (cm) | drf_19_i | ##.# | |
40 | Head circumference (cm) | drf_20 | ##.# | |
41 | Head circumference (cm) | drf_20_i | ##.# | |
42 | Remarks | TXT |