Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; the Department of Pediatrics, Children's Hospital of Philadelphia, and the Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania; the Health Economics Resource Center, Veterans Affairs Palo Alto Healthcare System, Menlo Park, and the Department of Pediatrics and the Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California; and the Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota.
Obstet Gynecol. 2024 Mar 1;143(3):459-462. doi: 10.1097/AOG.0000000000005497. Epub 2024 Jan 4.
A growing number of studies are using birth certificate data, despite data-quality concerns, to study maternal morbidity and associated disparities. We examined whether conclusions about the incidence of maternal morbidity, including Black-White disparities, differ between birth certificate data and hospitalization data. Using linked birth certificate and hospitalization data from California and Michigan for 2018 (N=543,469), we found that maternal morbidity measures using birth certificate data alone are substantially underreported and have poor validity. Furthermore, the degree of underreporting in birth certificate data differs between Black and White individuals and results in erroneous inferences about disparities. Overall, Black-White disparities were more modest in the birth certificate data compared with the hospitalization data. Birth certificate data alone are inadequate for studies of maternal morbidity and associated racial disparities.
越来越多的研究尽管存在数据质量问题，但仍在使用出生证明数据来研究产妇发病率和相关差异。我们研究了使用出生证明数据（包括黑人-白人差异）来研究产妇发病率的结论是否与住院数据有所不同。我们使用加利福尼亚州和密歇根州 2018 年的链接出生证明和住院数据（N=543469），发现仅使用出生证明数据的产妇发病率衡量标准严重报告不足，并且有效性较差。此外，出生证明数据中黑人报告不足的程度与白人不同，导致对差异的错误推断。总体而言，与住院数据相比，出生证明数据中的黑人和白人之间的差异较小。仅使用出生证明数据不足以研究产妇发病率和相关的种族差异。
