Using commercial telephone directories to obtain a population-based sample for mail survey of women of reproductive age

In the United States, sampling women of reproductive age from the general population for research purposes is a challenge. Even more difficult is conducting a population-based study of couples attempting pregnancy to assess fecundity and fertility or related impairments. To address the problem of obtaining representative samples from the population in order to study such health-related issues, a commercially and readily available CD-ROM telephone directory was used and tested as a sampling framework for studies aimed at enrolling gravid women aged 18-44 years. A self-administered questionnaire (SAQ) was mailed to a stratified random sample of 10 005 (3%) households in Erie County, NY, USA. Overall, 17% of the questionnaires were undeliverable despite updating all addresses with residential software before mailing. Thirteen per cent (n = 1089) of the households returned completed questionnaires, of which 35% (n = 377) were completed by women aged 18-44 years. Using 1990 census information for zip code, respondents were more likely to be white and to have higher median household incomes than non-respondents. Of the 377 women who completed the questionnaire, 79% had been pregnant at least once, 5% reported being unable to become pregnant, and 16% reporting never trying to become pregnant. Despite the overall low response to the SAQ, the sampling framework captured a diverse group of women of reproductive age who reported various fecundity and fertility outcomes. The use of low-cost commercially available software linked to census data for selecting samples of women or couples for reproductive and perinatal research may be possible; however, oversampling of households, use of incentives and follow-up of non-respondents is needed to ensure adequate sample sizes.