Duke C Wes, Alverson C J, Correa Anolfo
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd., NE, Mailstop E-86, Atlanta, GA 30333, USA.
Public Health Rep. 2007 Sep-Oct;122(5):664-9. doi: 10.1177/003335490712200514.
We assessed fetal death certificates (FDCs) as a source of surveillance for stillbirths with birth defects by linkage with data from the Metropolitan Atlanta Congenital Defects Program (MACDP), a population-based birth defects surveillance system.
Stillbirths with defects in MACDP were identified from 1994 through 2002 and linked to FDCs. Sensitivity of FDCs for capturing stillbirths with defects was estimated, and predictors for a case being reported were assessed. Concordance for selected variables from each data source was evaluated. RESILTS: Two hundred twenty-four of 257 stillbirths with birth defects in MACDP were linked to an FDC (linkage rate = 87.2%; 95% confidence interval [CI] 82.4, 91.0). Stillbirths of non-Hispanic black and Hispanic/other mothers were more likely to be issued an FDC (odds ratio [OR] = 5.6 [95% CI 1.9, 17.0] and 14.0 [95% CI 1.7, 114.0], respectively). Cases undergoing autopsy were more likely to be issued an FDC (OR = 3.2; 95% CI 1.1, 8.7). Performance of an amniocentesis was poorly recorded on FDCs. The sensitivity and positive predictive value of FDCs for selected classes of defects ranged from 10% to 70% and 25% to 93%, respectively.
Compared to FDCs, MACDP's active case identification improves the ascertainment of stillbirths with birth defects and the quality of certain recorded data.
我们通过将来自大都市亚特兰大先天性缺陷项目（MACDP，一个基于人群的出生缺陷监测系统）的数据与之相联系，评估胎儿死亡证明（FDC）作为出生缺陷死产监测来源的情况。
从1994年至2002年在MACDP中识别出有缺陷的死产，并将其与FDC相联系。估计FDC捕获有缺陷死产的敏感性，并评估病例报告的预测因素。评估每个数据源中选定变量的一致性。结果：MACDP中257例有出生缺陷的死产中有224例与FDC相联系（联系率=87.2%；95%置信区间[CI]82.4，91.0）。非西班牙裔黑人及西班牙裔/其他母亲的死产更有可能获得FDC（优势比[OR]=5.6[95%CI 1.9，17.0]和14.0[95%CI 1.7，114.0]）。接受尸检的病例更有可能获得FDC（OR=3.2；95%CI 1.1，8.7）。FDC上羊膜穿刺术的执行情况记录不佳。FDC对选定缺陷类别的敏感性和阳性预测值分别为10%至70%和25%至93%。
与FDC相比，MACDP的主动病例识别提高了对有出生缺陷死产的确定以及某些记录数据的质量。
