Chinese medicine syndrome differentiation-kidney deficiency syndrome (KDS) for women during pregnancy: Delphi expert consensus on a self-reported KDS symptoms scale followed by psychometric properties evaluation.

OBJECTIVE: To develop an expert consensus on kidney deficiency syndrome (KDS) in pregnant women and construct a validated self-reported KDS Patient-Reported Measures Pregnancy Scale (KDS-PRMs-Pregnancy Scale) for early identification and management. METHODS: The study was conducted in three phases. First, a comprehensive review of Traditional Chinese Medicine (TCM) literature and diagnostic criteria was performed, generating initial KDS symptoms for pregnancy. Second, a two-round Delphi survey, involving 21 experts from TCM, obstetrics, and gynaecology, assessed importance, relevance, and appropriateness of the items. Third, a psychometric evaluation was conducted, including exploratory factor analysis and internal consistency assessment. RESULTS: In the first Delphi round, 19 items were flagged for revision or removal due to expert variability, with 12 items deemed irrelevant. In the second round, consensus was reached, resulting in a 25-item scale. After psychometric evaluation, seven items were removed due to poor factor loadings, leaving an 18-item scale. Three factors-physiological discomfort, fatigue & weakness, and excretion abnormalities-accounted for 78.4% of the variance. The final scale demonstrated excellent internal consistency (Cronbach's alpha = 0.959). CONCLUSION: The validated 18-item KDS-PRMs-Pregnancy Scale is a reliable tool for assessing KDS in pregnant women. Future research should focus on validation in diverse populations and exploring its predictive validity for pregnancy outcomes.