A team approach to ensuring data quality in the surveillance of maternal pre-pregnancy BMI

The inclusion of pre-pregnancy height and weight data elements on birth records allows for a cost-effective means of tracking maternal pre-pregnancy BMI and weight gain during pregnancy. These data also offer the potential to explore relationships between pre-pregnancy overweight/obesity and complications of pregnancy and birth outcomes as well as serving as a measure of preconception health among women of childbearing age.

Beginning in 2008, we began to explore the use of birth record maternal height and pre-pregnancy weight to calculate pre-pregnancy BMI as a health indicator. We found that there appeared to be some utility of these data when interpreted with caution and in context with other data sources. However, during our analysis of birth record data from 2007 through 2010, we found that a significant number of birth reports were missing one or both data elements necessary to calculate BMI. We also found that data were not missing randomly. In fact, births to Latinas, births to mothers for whom Medicaid was the delivery pay source, and births to mothers with <12 years of education were all significantly more likely to be missing height and weight data (Chi square, p < .001).

In this presentation, we will discuss our findings and subsequent experience in implementing strategies to improve the quality and completeness of selected birth record data elements, particularly maternal height and pre-pregnancy weight, in partnership with local birthing centers and perinatal care providers. We will also discuss recommendations that local health jurisdictions may find beneficial in promoting overall birth record data quality and completeness.