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PubMed1996

Client and birth record linkage: a method, biases, and lessons.

"Due to rising data collection costs and the availability of extant data files, record linkage is becoming increasingly important in evaluation research. We begin by discussing record linkage as a data-generating technique and its applicability to evaluation studies. This paper--part of a larger study assessing the perinatal outcomes of a comprehensive prenatal program for poor, urban women--describes a method for linking client records to live and stillbirth records [in Cleveland, Ohio]. Biases which can enter into the linkage process and general issues which need to be addressed early in an investigation are also discussed."

Americas↗
PubMedDate not supplied

Discrepancies between published data on racial classification and self-reported race: evidence from the 2002 North Carolina live birth records.

OBJECTIVES: We compared data on race as reported by the mother on North Carolina birth certificates with data on race in officially reported statistics. We also determined to what extent differences in the classification of race affect measures of racial disparity in maternal and child health indicators. METHODS: We examined how data on race are collected, coded, and tabulated in North Carolina via live birth certificates, death certificates, the Behavioral Risk Factor Surveillance System (BRFSS) telephone survey, and the Central Cancer Registry case records. We showed how the data on race collected through North Carolina birth and death certificates are translated into 10 fixed racial categories designated by the National Center for Health Statistics (NCHS) for use in official vital statistics. We compared race as reported by the mother on birth certificates to racial tabulations used in the official published birth statistics. We also examined to what extent differences in the determination of race affect measures of racial disparity in maternal and child health indicators. RESULTS: Out of nearly 118,000 live births in North Carolina in 2002, mothers reported more than 600 different versions of race on birth certificates. These entries were collapsed into the 10 standard racial categories outlined in federal coding rules. Approximately two-thirds of mothers of Hispanic ethnicity report their race with a label that can be categorized as "Other" race, but nearly all of these births are re-coded to "white" for the official birth statistics. Measures of racial disparity vary depending on whether self-reported or officially coded race is used. CONCLUSIONS: This study shows that, given the opportunity to report their own race, North Carolinians describe their race using a wide variety of terms and concepts. In contrast, health statistics are usually reported using a few standardized racial categories defined by federal policy. The NCHS rules for coding race should be reexamined. As the ethnic and racial diversity of the United States continues to increase, these rules will become increasingly antiquated.

Birth Certificates↗
PubMed2005

Accuracy of reporting maternal in-hospital diagnoses and intrapartum procedures in Washington State linked birth records.

While the impact of maternal morbidities and intrapartum procedures is a common topic in perinatal outcomes research, the accuracy of the reporting of these variables in the large administrative databases (birth certificates, hospital discharges) often utilised for such research is largely unknown. We conducted this study to compare maternal diagnoses and procedures listed on birth certificates, hospital discharge data, and birth certificate and hospital discharge data combined, with those documented in a stratified random sample of hospital medical records of 4541 women delivering liveborn infants in Washington State in 2000. We found that birth certificate and hospital discharge data combined had substantially higher true positive fractions (TPF, proportion of women with a positive medical record assessment who were positive using the administrative databases) than did birth certificate data alone for labour induction (86% vs. 52%), cephalopelvic disproportion (83% vs. 35%), abruptio placentae (85% vs. 68%), and forceps-assisted delivery (89% vs. 55%). For procedures available only in hospital discharge data, TPFs were generally high: episiotomy (85%) and third and fourth degree vaginal lacerations (91%). Except for repeat caesarean section without labour (TPF, 81%), delivery procedures available only in birth certificate data had low TPFs, including augmentation (34%), repeat caesarean section with labour (61%), and vaginal birth after caesarean section (62%). Our data suggest that researchers conducting perinatal epidemiological studies should not rely solely on birth certificate data to detect maternal diagnoses and intrapartum procedures accurately.

Abruptio Placentae↗
PubMed1993

Variations in the accuracy of obstetric procedures and diagnoses on birth records in Washington State, 1989.

The authors abstracted a sample of 7,536 hospital medical records to validate the accuracy of the coding of obstetric information on 1) birth certificates, 2) a statewide computerized hospital discharge abstract data system, and 3) a linked file merging birth certificates and the hospital abstract data for Washington State deliveries occurring in 1989. Measures of accuracy of coding of delivery method and obstetric procedures varied greatly among the 23 hospitals that participated in the study. Computerized hospital discharge data were generally more complete and accurate than were birth certificate data. The linked file was more likely to identify obstetric procedures than was either source alone. For example, only 84.1% of cesarean deliveries noted in the hospital charts were identified on birth certificates (range among hospitals, 37-100%). Using the linked file, the authors identified 99.8% of cesarean deliveries (range, 97-100%). Linked birth certificate-hospital abstract files may become an excellent source of data for epidemiologic and health care studies; however, further training of medical record personnel and standardization of coding are needed to improve the quality of computerized data on obstetric events.

Birth Certificates↗
PubMed1990

Pregnancy and perinatal factors associated with persistently low Apgar scores: an analysis of the birth records of infants born in South Australia.

This study included all newborns with Apgar scores below seven at one minute after birth who were born in 1986 and whose births were notified to the South Australian Perinatal Statistics Collection. Univariate comparisons were made of the demographic, obstetric and pregnancy outcome characteristics of the 301 newborns whose Apgar scores remained below seven at five minutes and the 3165 whose scores recovered to seven or more. The results provide a general risk profile of the 301 newborn infants who perform poorly at birth, as indicated by a low Apgar score at both one and five minutes. Adverse risk factors identified in this study were similar to those for intellectual disability (mental retardation) and cerebral palsy in South Australia. It is suggested that persisting low Apgar scores, when combined with the other risk factors demonstrated in this and previous studies, would provide more reliable prognostic information than would Apgar scores alone. The study also shows that the majority of infants with low Apgar scores at one minute scored seven or better at five minutes. This demonstrates, that although a low one minute Apgar score has value in identifying newborns in need of immediate attention, it must be supplemented by the five minute score's stronger association with perinatal morbidity.

Apgar Score↗
PubMed2002

[Population analysis of pregnant women in the Czech Republic at the end of the millennium. I. Trends of selected demographic indicators and data from birth records from 1997 to 2000].

OBJECTIVE: To evaluate whether social-economic changes in the Czech Republic in 90's influenced selected demographic indications in population of mothers. DESIGN: Retrospective comparative epidemiological study. SETTING: Institute for the Care of Mother and Child, Praha 4-Podolí, Office of Health Information and Statistics, Praha. METHODS: Comparative analysis of selected demographic data and pregnancy history data collected according to the WHO recommendations on the innovated "Report on mother" of the Office of Health Information and Statistics database in 1997-2000. RESULTS: Nation-wide return rate of 99.89% of "Report on mother" forms confirms the representativeness of analyzed data. During the 4-year-period we demonstrated increase of maternal age, level of education, and proportion of single mothers. We observed decrease in proportion of mothers with second baby and mothers with induced abortion in history. The proportion of mothers with drug abuse during pregnancy was increasing and their age was decreasing. Characteristics of these changes suggest possible association with social and economic changes in the Czech Republic in 1990's. CONCLUSIONS: In second-half of 90's we observed increase of maternal age, educational level, proportion of single mothers and decrease of proportion of mothers delivering for the second time and mothers with history of induced abortion. Drug abuse during pregnancy is most frequent among youngest mothers.

Adult↗
PubMed2006

Birth characteristics and the risk of childhood leukaemias and lymphomas in New Zealand: a case-control study.

BACKGROUND: Some studies have found that lower parity and higher or lower social class (depending on the study) are associated with increased risks of childhood acute lymphoblastic leukaemia (ALL). Such findings have led to suggestions that infection could play a role in the causation of this disease. An earlier New Zealand study found a protective effect of parental marriage on the risk of childhood ALL, and studies elsewhere have reported increased risks in relation to older parental ages. This study aimed to assess whether lower parity, lower social class, unmarried status and older parental ages increase the risk of childhood ALL (primarily). These variables were also assessed in relation to the risks of childhood acute non-lymphoblastic leukaemia, non-Hodgkin's lymphomas and Hodgkin's disease. METHODS: A case control study was conducted. The cases were 585 children diagnosed with leukaemias or lymphomas throughout New Zealand over a 12 year period. The 585 age and sex matched controls were selected at random from birth records. Birth records from cases (via cancer registration record linkage) and from controls provided accurate data on maternal parity, social class derived from paternal occupation, maternal marital status, ages of both parents, and urban status based on the address on the birth certificate. Analysis was by conditional logistic regression. RESULTS: There were no statistically significant associations overall between childhood ALL and parity of the mother, social class, unmarried maternal status, increasing parental ages (continuous analysis), or urban status. We also found no statistically significant associations between the risks of childhood acute non-lymphoblastic leukaemia, non-Hodgkin lymphomas, or Hodgkin's disease and the variables studied. CONCLUSION: This study showed no positive results though of reasonable size, and its record linkage design minimised bias. Descriptive studies (eg of time trends of ALL) show that environmental factors must be important for some diagnoses. Work has been done on the risk of ALL in relation to chemicals (eg pesticides) and drugs, dietary factors (eg vitamins), electromagnetic fields and infectious hypotheses (to name some); but whether these or other unknown factors are truly important remains to be seen.

Journal Article↗
PubMed1995

Perinatal characteristics and adult mammographic patterns.

We retrieved breast mammograms for 370 women 40 to 74 years old with no history of breast cancer, for whom birth weight, birth length, placental weight and other birth characteristics were indicated in their standard birth records at the Uppsala University Hospital. Blind evaluation of the mammograms allowed these to be classified according to Wolfe's pattern. Logistic regression analysis was applied using as independent variables the recorded birth characteristics and as outcome variable, high risk (P2 and DY) versus low risk (N1 and P1) mammographic parenchymal pattern. After controlling for all the recorded variables, the odds ratio for a high-risk pattern (P2 or DY) increased consistently and significantly (P for trend 0.02) with the weight of the placenta, i.e. the main estrogen-producing organ during pregnancy. There were weak and non-significant positive associations with increasing birth weight (P for trend 0.53) and birth length (P for trend 0.52). These results are compatible with hypotheses suggesting that pregnancy estrogens or other perinatal characteristics may play a risk-modulating role influencing breast cancer in the offspring.

Adult↗