Lydon-Rochelle Mona T, Holt Victoria L, Cárdenas Vicky, Nelson Jennifer C, Easterling Thomas R, Gardella Carolyn, Callaghan William M
Department of Family Child Nursing, School of Nursing, University of Washington, Seattle 98195-7262, USA.
Am J Obstet Gynecol. 2005 Jul;193(1):125-34. doi: 10.1016/j.ajog.2005.02.096.
The purpose of this study was to determine the accuracy of live-birth certificates and hospital discharge data that reported of pre-existing maternal medical conditions and complications of pregnancy.
We conducted a population-based validation study in 19 non-federal short-stay hospitals in Washington state with a stratified random sample of 4541 women who had live births between January 1, 2000, and December 31, 2000. True- and false-positive fractions were calculated.
Birth certificate and hospital discharge data combined had substantially higher true-positive fractions than did birth certificate data alone for cardiac disease (54% vs 29%), acute or chronic lung disease (24% vs 10%), gestational diabetes mellitus (93% vs 64%), established diabetes mellitus (97% vs 52%), active genital herpes (77% vs 38%), chronic hypertension (70% vs 47%), pregnancy-induced hypertension (74% vs 49%), renal disease (13% vs 2%), and placenta previa (70% vs 33%). For the 2 medical risk factors that are available only on birth certificates, true-positive fractions were 37% for established genital herpes and 68% for being seropositive for hepatitis B surface antigen.
In Washington, most medical conditions and complications of pregnancy that affect mothers are substantially underreported on birth certificates, but hospital discharge data are accurate in the reporting of gestational and established diabetes mellitus and placenta previa. Together, birth certificate and hospital discharge data are much superior to birth certificates alone in the reporting of gestational diabetes mellitus, active genital herpes, and chronic hypertension.
本研究旨在确定出生证明和医院出院数据中所报告的孕产妇既往疾病及妊娠并发症的准确性。
我们在华盛顿州的19家非联邦短期住院医院开展了一项基于人群的验证性研究，对2000年1月1日至2000年12月31日期间分娩的4541名妇女进行分层随机抽样。计算真阳性率和假阳性率。
对于心脏病（54%对29%）、急慢性肺病（24%对10%）、妊娠期糖尿病（93%对64%）、已确诊糖尿病（97%对52%）、活动性生殖器疱疹（77%对38%）、慢性高血压（70%对47%）、妊娠高血压（74%对49%）、肾病（13%对2%）和前置胎盘（70%对33%），出生证明和医院出院数据综合后的真阳性率显著高于单独的出生证明数据。对于仅在出生证明上出现的两种医学风险因素，已确诊生殖器疱疹的真阳性率为37%，乙肝表面抗原血清学阳性的真阳性率为68%。
在华盛顿，出生证明上对影响母亲的大多数妊娠疾病和并发症报告严重不足，但医院出院数据在报告妊娠期和已确诊糖尿病及前置胎盘方面较为准确。综合来看，出生证明和医院出院数据在报告妊娠期糖尿病、活动性生殖器疱疹和慢性高血压方面比单独的出生证明要好得多。
