Abstract
Objectives: Birth certificates are a major source of population-based data on maternal and perinatal health, but their value depends on the accuracy of the data. This study assesses the validity of information recorded on the birth certificates for women in Washington State who were considered to be low risk at entry into care. Methods: Birth certificates were matched to data abstracted from prenatal and intrapartum clinic and hospital records of a sample of 1937 Washington State obstetrical patients who were considered to be low risk at the beginning of their pregnancies. Accuracy of a variety of pregnancy characteristics (e.g., complications, procedures) on the birth certificate was analyzed using percentage agreement and sensitivity with record abstracts as the “gold standard.” Next, we weighted the data from each source to produce estimates of pregnancy characteristics in the population. We compared these estimates from the two data sources to see whether they provide similar pictures of this subpopulation. Results: Missing data for specific items on the birth certificates ranged from 0% to 24%. The birth certificate accurately captured gravidity and parity, but was less likely to report prenatal and intrapartum complications. The population estimates of the two data sources were significantly different. Conclusions: Because birth certificates significantly underestimated the complications of pregnancies, number of interventions, number of procedures, and prenatal visits, use of these data for health policy development or resource allocation should be tempered with caution.
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REFERENCES
Tolson GC, Barnes JM, Gay GA, Kowaleski JL. The 1989 Revision of the U.S. Standard Certificates and Reports. Hyattsville, MD: National Center for Health Statistics, 1991. (Vital and health statistics (4), no. 28)
Woolbright LA, Harshbarger DS. The revised standard certificate of live birth: Analysis of medical risk factor data from birth certificates in Alabama, 1988–92. Pub Health Rep 1995;110:59–62.
Centers for Disease Control. Pregnancy risks determined from birth certificate data—United States, 1989. JAMA 1992;268:1831–2.
Lilienfield AM, Parkhurst E, Patton R, Schlesinger ER. Accuracy of supplemental medical information on birth certificates. Pub Health Rep 1951;66:191–8.
Green HG, Nelson CJ, Gaylor DW, Holson JF. Accuracy of birth certificate data for detecting facial cleft defects in Arkansas children. Cleft Palate J 1979;16:167–70.
David R. The quality and competeness of birthweight and gestational age data in computerized birth files. Am J Pub Health 1980;70:964–73.
Frost F, Starzyk P, George S, McLaughlin JF. Birth complication reporting: The effect of birth certificate design. Am J Pub Health 1984;74:505–6.
Ethen MK, Selwyn BJ, Borders SB. Hospital reporting practices and their impact on Texas birth certificate data quality. In: Department of Health and Human Services, ed. Proceedings of 25th Public Health Conference on Records and Statistics. 1995:405–10. (DHHS publication no. (PHS) 96–1214).
Buescher PA, Taylor KP, Davis MH, Dowling JM. The quality of the new birth certificate data: A validation study in North Carolina. Am J Pub Health 1993;83:1163–5.
Piper JM, Mitchell EF, Snowden M, Hall C, Adams M, Taylor P. Validation of the 1989 Tennessee birth certificates using maternal and newborn hospital records. Am J Epidemiol 1993;137:758–68.
Parrish KM, Holt VM, Connell FA, Williams B, LoGerfo P. Variations in the accuracy of obstetric procedures and diagnoses in birth records in Washington State. Am J Epidemiol 1993;138:119–27.
Hexter AC, Harris JA, Roeper P, Croen LA, Krueger P, Gant D. Evaluation of the hospital discharge diagnoses index and the birth certificate as sources of information on birth defects. Pub Health Rep 1990;105:296–307.
Snell LM, Little BB, Knoll KA, Johnston WL, Rosenfeld CR, Gant NF. Reliability of birth certificate reporting of congenital anomalies. Am J Perinatol 1992;9:219–22.
Watkins ML, Edmonds L, McClearn A, Mullins L, Mulinare J, Khoury M. The surveillance of birth defects: The usefulness of the revised U.S. standard birth certificate. Am J Pub Health 1996;86:731–4.
Fingerhut LA, Kleinman JC. Comparability of reporting between the birth certificates and the 1980 National Natality Survey. Hyattsville, MD: National Center for Health Statistics, 1985. (Data Evaluation and Methods Research (2), No. 99)
Schoendorf KC, Parker JD, Kiely JL. Vital and Health Statistics: Comparability of the Birth Certificate and 1988 Maternal and Infant Health Survey. Hyattsville, MD: National Center for Health Statistics, 1993. (Data Evaluation and Methods Research (2), No. 116)
Calle EE, Khoury MJ. Completeness of the discharge diagnoses as a measure of birth defects recorded in the hospital birth record. Am J Epidemiol 1991;134:69–77.
Clark K, Fu CM, Burnett C. Accuracy of birth certificate data regarding the amount, timing, and adequacy of prenatal care using clinic medical records as referents. Am J Epidemiol 1997;145:68–71.
Baldwin L-M, Raine T, Jenkins LD, Hart LG, Rosenblatt RA. Do providers adhere to ACOG standards? The case of prenatal care. Obstet Gynecol 1994;84:549–56.
Kosekoff J, Kanouse DE, Rogers WH, McCloskey L, Winslow CM, Brook RH. Effects of the NIH Consensus Development Program on physician practice. JAMA 1987;258:2708–13.
Dobie SA, Hart LG, Fordyce M, Rosenblatt RA. Do women choose their obstetric providers based on risks at entry into prenatal care? A study of women in Washington State. Obstet Gynecol 1994;84:557–64.
Fleiss JL. Statistical Methods for Rates and Proportions. 2nd edition. New York: John Wiley & Sons, 1981.
Lantz CA, Nebenzahl E. Behavior and interpretation of the k statistic: Resolution of the two paradoxes. J Clin Epidemiol 1996;49:431–4.
Guggenmoose-Holzmann I. The meaning of kappa: Probablistic concepts of reliability and validity revisited. J Clin Epidemiol 1996;49:775–82.
Shah BV, Folsom RE, LaVange LM, Wheeless SC, Boyle KE, Williams RL. Statistical methods and mathematical algorithms used in SUDAAN. Research Triangle Park, NC: Research Triangle Institute, 1993.
Kessner DM, Singer J, Kalk CE, Schlesinger ER. Chapter 2. In: Institute of Medicine, National Academy of Sciences, ed. Infant Death: An Analysis by Maternal Risk and Health Care. Washington, DC: Institute of Medicine and National Academy of Sciences, 1973.
Kotelchuck M. An evaluation of the Kessner adequacy of prenatal care index and a proposed adequacy of prenatal care utilization index. Am J Public Health 1994;84:1414–20.
Hart LG, Dobie SA, Baldwin L-M, Pirani MJ, Fordyce M, Rosenblatt RA. Rural and urban differences in physician resource use for low-risk obstetrics. Health Serv Res 1996;31:429–52.
Rosenblatt RA, Dobie SA, Hart LG, Schneeweiss R, Gould D, Raine RT, Benedetti TJ, Pirani MJ, Perrin EB. Interspecialty differences in the obstetric care of low-risk women. Am J Pub Health 1997;87:344–51.
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Dobie, S.A., Baldwin, LM., Rosenblatt, R.A. et al. How Well Do Birth Certificates Describe the Pregnancies They Report? The Washington State Experience with Low-Risk Pregnancies. Matern Child Health J 2, 145–154 (1998). https://doi.org/10.1023/A:1021875026135
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DOI: https://doi.org/10.1023/A:1021875026135