The 130th Annual Meeting of APHA

Abstract #49742

Jane Lazar, Department of Maternal and Child Health, Boston University School of Public HEalth, 715 Albany Street, Boston, MA 02118-2526, 617-624-5589, jlazar@bu.edu, Eugene R Declercq, PhD, Maternal and Child Health Department, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, and Judy Weiss, ScD, Bureau of Family and Community Health, Massachusetts Department of Public Health, 250 Washington St. 5th Floor, Boston, MA 02108.

Purpose: Birth certificates are an important source of data on the prevalence of pregnancy complications in the population, however, the validity of this data has been questioned. Methods: Birth certificates were linked to hospital discharge data and to over 3500 cases abstracted from MassHealth (Medicaid) inpatient hospital records for fiscal years 1999 and 2000. We examine the ability of the birth certificate and hospital discharge data to correctly identify intrapartum complications and use these data to create an algorithm that approximates the MassHealth “gold standard”. Preliminary findings: Birth certificate and hospital discharge data varied widely in sensitivity and specificity when compared to the abstracted data. In relatively clear diagnoses, such as placental abruption, most cases were reported, particularly on the birth certificate (86%). For more ambiguous diagnoses, such as fetal distress and cephalopelvic disorders, less than half the cases were correctly identified. Also, false positives were common on all of the variables analyzed for both the birth certificate and hospital discharge data. Conclusions: Birth certificate or hospital discharge data used alone are poor estimates of intrapartum complications. Analyses of the linked file can result in the creation of an algorithm that will better approximate the true rates of intrapartum complications and can be used with confidence by policy-makers nationwide.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Identify problems with the reporting of intrapartum complications on birth certificate and hospital discharge data.
• Understand the methods we employed in comparing birth certificate and hospital discharge data to abstracted medical records data (the "gold standard").
• Use birth certificate and hospital discharge data to create an algorithm that approximates the true rates of intrapartum conditions.

Keywords: Data/Surveillance, MCH Epidemiology

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.