Birth Certificate Data (birth + certificate_data)

Distribution by Scientific Domains


Selected Abstracts


United States vital statistics and the measurement of gestational age

PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2007
Joyce A. Martin
Summary Estimates of the gestational age of the newborn based on US Birth Certificate data are extensively used to monitor trends in infant and maternal health and to improve our understanding of adverse pregnancy outcome. Two measures of gestational age, the ,date of the last normal menses' (LMP) and the ,clinical estimate of gestation' (CE), have been available from birth certificate data since 1989. Reporting irregularities with the LMP-based measure are well-documented, and important questions remain regarding the derivation of the CE. Changes in perinatal medicine and in vital statistics reporting in recent years may have importantly altered gestational age data based on vital statistics. This study describes how gestational age measures are collected and edited in US national vital statistics, and examines changes in the reporting of these measures by race and Hispanic origin between 1990 and 2002. Data are drawn from the National Center for Health Statistics' restricted use US birth files for 1990,2002. Bivariable statistics are used. The percentage of records with missing LMP dates declined markedly over the study period, overall, and for each racial/Hispanic origin group studied. A marked shift in the distribution of the CE of gestational age was also observed, suggesting changes both in the true distribution of age at birth, and in the derivation of this measure. Agreement between the LMP-based and CE estimates increased over the study period, especially among preterm births. However, a high proportion of LMP dates continue to be missing or invalid and the derivation of the CE is still uncertain. In sum, although the reporting of gestational age measures in vital statistics appears to have improved between 1990 and 2002, substantial concerns with both the LMP-based and the CE persist. Efforts to identify approaches to further improve upon the quality of these data are needed. [source]


Declining Trends in Cesarean Deliveries, Ohio 1989,1996: An Analysis by Indications

BIRTH, Issue 1 2000
Siran M. Koroukian PhD
Background:Similar to trends observed nationwide, the rates of cesarean deliveries declined in Ohio during the late 1980s and the early 1990s. This study examined the trends in cesarean deliveries in Ohio from 1989 through 1996, in the presence or absence of indications, and in relation to the use of obstetric procedures. Methods:Birth certificate data for all singleton, liveborn infants in Ohio (n =1,204,859) were used to analyze temporal trends in cesarean sections. Results:The rates of primary and repeat cesarean deliveries declined, respectively, from 15.7 to 12.4 percent and from 83 to 63.3 percent during the 8-year study period. Significant declines in repeat cesarean deliveries were observed both in the presence and absence of documented medical conditions that could present a potential indication for the procedure. The rates of repeat cesareans remained comparable among women with and without documented indications for cesarean section (64% and 61%, respectively). In addition, 45 and 30 percent of repeat cesareans in 1989 and 1996, respectively, were performed in the absence of any documented indications, or on an elective basis. The declines in cesarean delivery rates during the 8-year study period occurred simultaneously with an increase in the use of electronic fetal monitoring, induction, and stimulation of labor. Conclusions:The findings suggest that a sizable proportion of repeat cesarean deliveries in 1996 may be unnecessary, even though a marked decline in the procedure has occurred between 1989 and 1996. [source]


Biological, social, and community influences on third-grade reading levels of minority Head Start children: A multilevel approach

JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 3 2003
Virginia A. Rauh
The purpose of the study was to determine the impact of individual and community level risks on school outcomes of children who attend Head Start. We studied a sample of 3,693 African American and Hispanic children who had been born in New York City, participated in Head Start, and attended New York City public schools. The outcome was the score obtained on a citywide third-grade reading test. Individual level risk factors were derived from birth certificate data. Community level risks were extracted from citywide U.S. Census data and other public-access data sets. Multilevel regression analyses indicated that at the individual level, lower reading scores were significantly associated with: male gender, low birth weight, unmarried mother, low maternal education, and inadequate interpregnancy spacing. Controlling for individual-level risk, concentrated community poverty significantly lowered reading scores, and a high percentage of immigrants in the community significantly raised scores. There was also a significant crosslevel effect: boys benefited more than girls from the immigrant community effect. The evidence suggests that we can better identify children at future educational risk and maximize the success of early intervention programs by exploring influences on school success at multiple levels, including the community. 2003 Wiley Periodicals, Inc. J Comm Psychol 31: 255,278, 2003. [source]


The Reliability and Validity of Birth Certificates

JOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 1 2006
Sally Northam
Objectives:, To summarize the reliability and validity of birth certificate variables and encourage nurses to spearhead data improvement. Data sources:, A Medline key word search of reliability and validity of birth certificate, and a reference review of more than 60 articles were done. Study selection:, Twenty-four primary research studies of U.S. birth certificates that involved validity or reliability assessment. Data extraction:, Studies were reviewed, critiqued, and organized as either a reliability or a validity study and then grouped by birth certificate variable. Data synthesis:, The reliability and validity of birth certificate data vary considerably by item. Insurance, birthweight, Apgar score, and delivery method are more reliable than prenatal visits, care, and maternal complications. Tobacco and alcohol use, obstetric procedures, and delivery events are unreliable. Birth certificates are not valid sources of information on tobacco and alcohol use, prenatal care, maternal risk, pregnancy complications, labor, and delivery. Conclusions:, Birth certificates are a key data source for identifying causes of increasing U.S. infant mortality but have serious reliability and validity problems. Nurses are with mothers and infants at birth, so they are in a unique position to improve data quality and spread the word about the importance of reliable and valid data. Recommendations to improve data are presented. JOGNN, 35, 3-12; 2006. DOI: 10.1111/J.1552-6909.2006.00016.x [source]


United States vital statistics and the measurement of gestational age

PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 2007
Joyce A. Martin
Summary Estimates of the gestational age of the newborn based on US Birth Certificate data are extensively used to monitor trends in infant and maternal health and to improve our understanding of adverse pregnancy outcome. Two measures of gestational age, the ,date of the last normal menses' (LMP) and the ,clinical estimate of gestation' (CE), have been available from birth certificate data since 1989. Reporting irregularities with the LMP-based measure are well-documented, and important questions remain regarding the derivation of the CE. Changes in perinatal medicine and in vital statistics reporting in recent years may have importantly altered gestational age data based on vital statistics. This study describes how gestational age measures are collected and edited in US national vital statistics, and examines changes in the reporting of these measures by race and Hispanic origin between 1990 and 2002. Data are drawn from the National Center for Health Statistics' restricted use US birth files for 1990,2002. Bivariable statistics are used. The percentage of records with missing LMP dates declined markedly over the study period, overall, and for each racial/Hispanic origin group studied. A marked shift in the distribution of the CE of gestational age was also observed, suggesting changes both in the true distribution of age at birth, and in the derivation of this measure. Agreement between the LMP-based and CE estimates increased over the study period, especially among preterm births. However, a high proportion of LMP dates continue to be missing or invalid and the derivation of the CE is still uncertain. In sum, although the reporting of gestational age measures in vital statistics appears to have improved between 1990 and 2002, substantial concerns with both the LMP-based and the CE persist. Efforts to identify approaches to further improve upon the quality of these data are needed. [source]


Relationships between air pollution and preterm birth in California

PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 6 2006
Mary Huynh
Summary Air pollution from vehicular emissions and other combustion sources is related to cardiovascular and respiratory outcomes. However, few studies have investigated the relationship between air pollution and preterm birth, a primary cause of infant mortality and morbidity. This analysis examined the effect of fine particulate matter (PM2.5) and carbon monoxide (CO) on preterm birth in a matched case,control study. PM2.5 and CO monitoring data from the California Air Resources Board were linked to California birth certificate data for singletons born in 1999,2000. Each birth was mapped to the closest PM monitor within 5 miles of the home address. County-level CO measures were utilised to increase sample size and maintain a representative population. After exclusion of implausible birthweight,gestation combinations, preterm birth was defined as birth occurring between 24 and 36 weeks' gestation. Each of the 10 673 preterm cases was matched to three controls of term (39,44 weeks) gestation with a similar date of last menstrual period. Based on the case's gestational age, CO and PM2.5 exposures were calculated for total pregnancy, first month of pregnancy, and last 2 weeks of pregnancy. Exposures were divided into quartiles; the lowest quartile was the reference. Because of the matched design, conditional logistic regression was used to adjust for maternal race/ethnicity, age, parity, marital status and education. High total pregnancy PM2.5 exposure was associated with a small effect on preterm birth, after adjustment for maternal factors (adjusted odds ratio [AOR] = 1.15, [95% CI 1.07, 1.24]). The odds ratio did not change after adjustment for CO. Results were similar for PM2.5 exposure during the first month of pregnancy (AOR = 1.21, 95% CI [1.12, 1.30]) and the last 2 weeks of pregnancy (AOR = 1.17, 95% CI [1.09, 1.27]). Conversely, CO exposure at any time during pregnancy was not associated with preterm birth (AORs from 0.95 to 1.00). Maternal exposure to PM2.5, but not CO, is associated with preterm birth. This analysis did not show differences by timing of exposure, although more detailed examination may be needed. [source]


Population-based retrieval of newborn dried blood spots for researching paediatric cancer susceptibility genes

PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 5 2006
Judith Klotz
Summary We have demonstrated the feasibility of linking newborn blood spots, population-based cancer incidence data and birth certificate data. Incident cases of acute lymphocytic leukaemia and population-based controls were ascertained. We retrieved dried blood spot specimens, isolated and amplified DNA, and assayed the cancer susceptibility genes GSTT1 and GSTM1. The double null genotype was over-represented in the cases, consistent with previous reports based on other epidemiological methods. The design avoids issues of participation bias by cases and controls and can be used to investigate interactions of susceptibility genes and xenobiotics in semi-ecological studies. It can be useful for generating or testing hypotheses on associations of other paediatric illness and environmental contaminants. [source]


Cesarean Delivery in Native American Women: Are Low Rates Explained by Practices Common to the Indian Health Service?

BIRTH, Issue 3 2005
Sheila F. Mahoney CNM
ABSTRACT:,Background: Studying populations with low cesarean delivery rates can identify strategies for reducing unnecessary cesareans in other patient populations. Native American women have among the lowest cesarean delivery rates of all United States populations, yet few studies have focused on Native Americans. The study purpose was to determine the rate and risk factors for cesarean delivery in a Native American population. Methods: We used a case-control design nested within a cohort of Native American live births, , 35 weeks of gestation (n = 789), occurring at an Indian Health Service hospital during 1996,1999. Data were abstracted from the labor and delivery logbook, the hospital's primary source of birth certificate data. Univariate and multivariate analyses examined demographic, prenatal, obstetric, intrapartum, and fetal factors associated with cesarean versus vaginal delivery. Results: The total cesarean rate was 9.6 percent (95% CI 7.2,12.0). Nulliparity, a medical diagnosis, malpresentation, induction, labor length > 12.1 hours, arrested labor, fetal distress, meconium, and gestations < 37 weeks were each significantly associated with cesarean delivery in unadjusted analyses. The final multivariate model included a significant interaction between induction and arrested labor (p < 0.001); the effect of arrested labor was far greater among induced (OR 161.9) than noninduced (OR 6.0) labors. Other factors significantly associated with cesarean delivery in the final logistic model were an obstetrician labor attendant (OR 2.4; p = 0.02) and presence of meconium (OR 2.3; p = 0.03). Conclusions: Despite a higher prevalence of medical risk factors for cesarean delivery, the rate at this hospital was well below New Mexico (16.4%, all races) and national (21.2%, all races) cesarean rates for 1998. Medical and practice-related factors were the only observed independent correlates of cesarean delivery. Implementation of institutional and practitioner policies common to the Indian Health Service may reduce cesarean deliveries in other populations. [source]


Prenatal diagnosis, pregnancy terminations and prevalence of Down syndrome in Atlanta,

BIRTH DEFECTS RESEARCH, Issue 9 2004
Csaba Siffel
Abstract BACKGROUND The impact of prenatal diagnosis on the live birth prevalence of Down syndrome (trisomy 21) has been described. This study examines the prevalence of Down syndrome before (1990,1993) and after inclusion of prenatally diagnosed cases (1994,1999) in a population-based registry of birth defects in metropolitan Atlanta. METHODS We identified infants and spontaneous fetal deaths with Down syndrome (n = 387), and pregnancies electively terminated after a prenatal diagnosis of Down syndrome (n = 139) from 1990 to 1999 among residents of metropolitan Atlanta from a population-based registry of birth defects, the Metropolitan Atlanta Congenital Defects Program (MACDP). Only diagnoses of full trisomy 21 were included. Denominator information on live births was derived from State of Georgia birth certificate data. We compared the prevalence of Down syndrome by calendar period (1990,1993, 1994,1999), maternal age (<35 years, 35+ years), and race/ethnicity (White, Black, other), using chi-square and Fisher's exact tests. RESULTS During the period when case ascertainment was based only on hospitals (1990,1993), the prevalence of Down syndrome was 8.4 per 10,000 live births when pregnancy terminations were excluded and 8.8 per 10,000 when terminations were included. When case ascertainment also included perinatal offices (1994,1999), the prevalence of Down syndrome was 10.1 per 10,000 when terminations were excluded and 15.3 when terminations were included. During 1990,1993, the prevalence of Down syndrome was 24.7 per 10,000 among offspring to women 35+ years of age compared to 6.8 per 10,000 among offspring to women <35 years of age (rate ratio [RR] = 3.65, 95% confidence interval [CI] = 2.53,5.28). During 1994,1999, the prevalence of Down syndrome was 55.3 per 10,000 among offspring to women 35+ years compared to 8.5 per 10,000 among offspring to women <35 years (RR = 6.55, 95% CI = 5.36,7.99). There was no statistically significant variation in the prevalence of Down syndrome by race/ethnicity within maternal age and period of birth strata. During 1994,1999, the proportion of cases that were electively terminated was greater for women 35+ years compared to women <35 years (RR = 5.10, 95% CI = 3.14,8.28), and lower for Blacks compared to Whites among women 35+ years of age (RR = 0.33, 95% CI = 0.16,0.66). CONCLUSIONS In recent years, perinatal offices have become an important source of cases of Down syndrome for MACDP, contributing at least 34% of cases among pregnancies in women 35+ years of age. Variation in the prevalence of Down syndrome by race/ethnicity, before or after inclusion of cases ascertained from perinatal offices, was not statistically significant. Among Down syndrome pregnancies in mothers 35+ years we found a lower proportion of elective termination among Black women compared to White women. We suggest that future reports on the prevalence of Down syndrome by race/ethnicity take into account possible variations in the frequency of prenatal diagnosis or elective termination by race/ethnicity. Birth Defects Research (Part A) 70565,571, 2004. Published 2004 Wiley-Liss, Inc. [source]


Maternal age and non-chromosomal birth defects, Atlanta,1968,2000: Teenager or thirty-something, who is at risk?,

BIRTH DEFECTS RESEARCH, Issue 9 2004
Jennita Reefhuis
Abstract OBJECTIVE This investigation explored the association between maternal age and non-chromosomal birth defects to assess any increased risk associated with maternal age. METHODS Birth defect cases were ascertained by the Metropolitan Atlanta Congenital Defects Program (MACDP), denominator information was obtained using birth certificate data. Infants with any chromosomal diagnosis were excluded. Effect estimates were calculated using 5-year maternal age categories with 25,29 years as the referent. Multiple logistic regression was used to adjust for maternal race, parity, infant sex, and birth year. RESULTS A total of 1,050,616 singleton infants, born after ,20 weeks gestation in the five counties of metropolitan Atlanta from 1968 through 2000 who did not have a chromosomal abnormality and whose mother was 14 to 40 years old, were included in the analyses, 32,816 of them were identified with birth defects by the MACDP. Young maternal age (14,19 years) was associated with anencephaly (OR = 1.81, 95% CI = 1.30,2.52), hydrocephaly without neural tube defect (OR = 1.56, 95% CI = 1.23,1.96), all ear defects (OR = 1.28, 95% CI = 1.10,1.49), cleft lip (OR = 1.88, 95% CI = 1.30,2.73), female genital defects (OR = 1.57, 95% CI = 1.12,2.19), hydronephrosis (OR = 1.42, 95% CI = 1.11,1.82), polydactyly (OR = 1.29, 95% CI = 1.09,1.52), omphalocele (OR = 2.08, 95% CI = 1.39,3.12), and gastroschisis (OR = 7.18, 95% CI = 4.39,11.75). Advanced maternal age (35,40 years) was associated with all heart defects (OR = 1.12, 95% CI = 1.03,1.22), tricuspid atresia (OR = 1.24, 95% CI = 1.02,1.50), right outflow tract defects (OR = 1.28, 95% CI = 1.10,1.49), hypospadias 2nd degree or higher (OR = 1.85, 95% CI = 1.33,2.58), male genital defects excluding hypospadias (OR = 1.25, 95% CI = 1.08,1.45) and craniosynostosis (OR = 1.65, 95% CI = 1.18,2.30). CONCLUSIONS Young and advanced maternal ages are associated with different types of birth defects. Underlying causes for these associations are not clear. Birth Defects Research (Part A) 70:572,579, 2004. Published 2004 Wiley-Liss, Inc. [source]