Luquetti Daniela Varela, Koifman Rosalina Jorge
Craniofacial Division, University of Washington, Seattle, WA 98105, USA.
Cad Saude Publica. 2010 Sep;26(9):1756-65. doi: 10.1590/s0102-311x2010000900009.
This study compared the validity of birth defect cases reported in the Brazilian Information System on Live Births in 2004 and 2007 in seven municipalities, out of a total of 27,945 live births in 2004 and 25,905 in 2007. The study also describes quality improvement measures in this area. The Latin American Collaborative Study on Congenital Malformations was used as the gold standard for analyzing the validity of birth defect diagnoses. In 2004, at least 40% of birth defects went unreported, and this situation persisted in 2007. Only one hospital showed a significant increase in reporting sensitivity, from 56.9% to 96.8%. Sensitivity decreased significantly in two hospitals (from 62.7% to 41.75% and from 66.5% to 32.2%, respectively). The positive and negative predictive values and specificity remained above 80%. Only two municipal health departments and four hospitals implemented measures to improve reporting of birth defects. The results indicate the need for investments in the quality of birth defect information on birth certificates.
本研究比较了巴西七个城市2004年和2007年在《活产信息系统》中报告的出生缺陷病例的有效性，2004年共有27,945例活产，2007年有25,905例。该研究还描述了这一领域的质量改进措施。拉丁美洲先天性畸形合作研究被用作分析出生缺陷诊断有效性的金标准。2004年，至少40%的出生缺陷未被报告，这种情况在2007年依然存在。只有一家医院的报告敏感性显著提高，从56.9%提高到96.8%。两家医院的敏感性显著下降（分别从62.7%降至41.75%和从66.5%降至32.2%）。阳性和阴性预测值以及特异性仍高于80%。只有两个市卫生部门和四家医院实施了改进出生缺陷报告的措施。结果表明需要对出生证明上出生缺陷信息的质量进行投资。
