Online Program

Accuracy of cause-of-death data recorded on death certificates for pregnancy-associated deaths — Ohio, 2008–2011

Tuesday, November 3, 2015

Carolyn (Lullo) McCarty, PhD, Ohio Department of Health, Centers for Disease Control and Prevention, Columbus, OH
Elizabeth Conrey, PhD, RD, CDC Assigned to the Ohio Department of Health, Columbus, OH
Sierra Mullen, MPH, Ohio Department of Health, Columbus, OH
John Paulson, Office of Vital Statistics, Ohio Department of Health, Columbus, OH
Devon Priddle, Office of Vital Statistics, Ohio Department of Health, Columbus, OH
Cynthia Shellhaas, MD, MPH, Ohio Department of Health, Columbus, OH
Rachel Toukan, Ohio Department of Health, Columbus, OH
Background: Pregnancy-associated deaths, defined as death of a woman from any cause during or ≤1 year after pregnancy, substantially affect families. Targeting prevention efforts requires understanding the cause of death (COD). The accuracy of COD information recorded on death certificates, the primary data source, is not well-understood; therefore, we examined COD accuracy for pregnancy-associated deaths.

Methods: Pregnancy-associated deaths were identified using the death certificate pregnancy checkbox, COD code, and/or linkage of maternal death to fetal death or child birth certificates. We obtained death certificates and medical, coroner, and other records for pregnancy-associated deaths occurring in Ohio among residents during 2008–2011. A multidisciplinary expert committee reviewed each case’s records to determine if they agreed with death certificate immediate and underlying literal CODs. We used chi square to analyze differences in percentage agreement by age, race/ethnicity, certifier title, and county type, location, and manner of death.

Results: Of 234 identified pregnancy-associated deaths, the committee has reviewed 180 to-date and agreed with death certificate CODs for 152 (84.4% of reviewed deaths). Percentage agreement for reviewed deaths differed only by location of death (hospital, 77.8% agreement of 108 deaths; other/unknown, 92.9% of 28; home, 94.9% of 39; hospice/long-term care, 100% of 5; P = .03) and manner of death (natural, 75% agreement of 96 deaths; accident, 94.3% of 53; suicide/homicide, 100% of 26; P < .01; 5 cases did not include manner).

Conclusion: Efforts to improve death certificate COD reporting for pregnancy-associated deaths should focus on natural deaths and deaths in hospitals.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice

Learning Objectives:
Describe the accuracy of cause of death reporting for pregnancy-associated deaths occurring in Ohio to Ohio residents during 2008-2011. Identify opportunities for improving cause of death reporting.

Keyword(s): MCH Epidemiology, Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Centers for Disease Control and Prevention Epidemic Intelligence Service Officer assigned to the state of Ohio. My projects have focused on maternal mortality surveillance and the evaluation of Vital Statistics data on pregnancy-associated death. My work is supervised by the State Maternal and Child Health Epidemiologist.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4382.0: Data & Epi Poster Session