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Mark McLaughlin1, Judith Weiss, ScD1, Milton Kotelchuck, MPH, PhD, MA1, and Stephen Evans, MPH2. (1) Department of Maternal and Child Health, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, (617) 624-5502, firstname.lastname@example.org, (2) Data Coordinating Center, Boston University School of Public Health, 580 Harrison Ave., Boston, MA 02118
Purpose: To demonstrate the added advantage of using birth and fetal death certificates linked to hospital discharge data to identify successive deliveries to unique women.
Methods: A three-step process was developed to link successive deliveries using 1998-2003 Massachusetts birth and fetal death certificates (Vitals) linked to Hospital Discharge (HD) delivery records. First, deliveries within each data source were linked independently. Second, we compared the longitudinal maternal links in Vitals to those in HD to find maternal links not found in the Vitals data alone. Third, we checked the accuracy of the matches. Potential biases were assessed.
Results: A total of 384,781 women were identified in the Vitals data alone, of whom 93,298 had >1 delivery. Using both data sources, the number of unique women declined to 381,924 and the number with >1 delivery increased to 95,837, 3% more women than found in Vitals data alone. Additional deliveries were also found for women already identified as having >1 delivery. Women whose reproductive histories were augmented with the addition of HD data were more likely to be Hispanic or Black (28.5% vs. 9.1% and 10.5% vs. 5.7%, respectively), have a public payer at delivery (46.3% vs. 21.2%), and be 16-25 years old (38.8% vs. 26.8%%).
Conclusions: When linking successive deliveries, the inclusion of hospital discharge records provides a more complete accounting of women's reproductive histories, thus improving the accuracy of MCH studies relying on such data. These improvements are seen especially in younger minority women, and those with a public payer source.
Presenting author's disclosure statement:
Any relevant financial relationships? No
The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA