[The quality of registration of causes of death in perinatal and neonatal deaths].

The quality of registration of the causes of death in 273 perinatal and neonatal deaths was assessed. The present authors classified the causes of death according to WHO classification of disease. The authors classification was compared with the Danish Health Department's original classification of deaths and a classification undertaken by one of the staff of the Danish Health Department, the coding of which was based exclusively on information from the original death certificates (death certificate classification). Agreement between the respective forms of classification was assessed by the observed agreement for positive diagnosis and the kappa coefficients calculated by the three-figure level in the ICD diagnosis for categories and between categories of causes of perinatal and neonatal death, respectively. The investigation revealed that the deaths were classified with great accuracy by coding by the staff member when the death certificates were correctly completed. Comparison between the "authors classification" and the "Danish Health Department's original classification" and the "death certificate classification", respectively revealed that the observed agreement for positive diagnoses were 52% and 50% and that the kappa coefficients were between 0.80-0.07 and 0.81-0.04, respectively, on comparison with the three-figure levels in the ICD diagnoses and 0.93-0.32 and 0.85 and 0.32 on comparing the categories in between. It is concluded that considerable improvement in registration of perinatal and neonatal deaths may be obtained if the Danish Health Departments states precisely what information is required on the death certificate in connection with perinatal and neonatal deaths. Correspondingly, local efforts should be made to complete death certificates more correctly.