A comparison of congenital anomalies on birth and death certificates

Congenital anomalies have now become the leading cause of infant mortality in the United States. Birth defects also are a leading cause of developmental disabilities. As a result, there is a need for accurate and complete data on birth defects. One possible source of data is birth certificates. Birth certificates are available for all births in the United States and data can be obtained cheaply and efficietly. However, problems exit in using birth certificate data on congenital anomalies. Birth certificates and infant death certificates from Alabama from 1988-2005 were linked to see if birth certificates indicated an anomaly when the baby died of an anomaly. In almost two thirds of the cases where the baby died of an anomaly, there was no indication of an anomaly on the birth certificates. Reporting was universally poor and did not greatly vary by the characteristics of the mother or hospital. The conclusion is that birth certificates are a poor medium for collecting information on birth defects.