Piper J M, Mitchel E F, Snowden M, Hall C, Adams M, Taylor P
Department of Preventive Medicine, School of Medicine, Vanderbilt University, Nashville, TN.
Am J Epidemiol. 1993 Apr 1;137(7):758-68. doi: 10.1093/oxfordjournals.aje.a116736.
In 1989, the state of Tennessee adopted a new birth certificate which incorporates changes recommended by the National Center for Health Statistics in the revised US Standard Certificate of Live Birth. The data now being collected are intended to provide improved information for understanding maternal and infant health issues. To assess data quality, the authors compared information reported on the 1989 Tennessee birth certificates with the same data obtained from an ongoing case-control study in which the delivery hospital medical records of mothers and infants were reviewed by trained nurse abstractors using a structured data collection instrument. Cases (n = 1,016) were all infants born in Tennessee in 1989 with birth weights less than 1,500 g or other infants who died during the first 28 days of life. The infants were identified from linked birth-death certificate files. Control infants (n = 634) were randomly selected from the noncase population. The most reliable information obtained from birth certificates was descriptive demographic data and birth weight. The quality of information obtained from the new birth certificate checkboxes varied. Routine medical procedures were better reported on the birth certificates than relatively uncommon conditions and occurrences, even serious ones. Caution is needed in using birth certificate data for assessment of maternal medical risk factors, complications of labor and delivery, abnormal conditions of the newborn, and congenital anomalies, since sensitivity is low.
1989年，田纳西州采用了一种新的出生证明，该证明纳入了美国国家卫生统计中心在美国标准出生证明修订版中建议的变更内容。目前收集的数据旨在为理解母婴健康问题提供更完善的信息。为评估数据质量，作者将1989年田纳西州出生证明上报告的信息与从一项正在进行的病例对照研究中获得的相同数据进行了比较，在该研究中，经过培训的护士摘要员使用结构化数据收集工具对母亲和婴儿的分娩医院病历进行了审查。病例组（n = 1,016）为1989年在田纳西州出生、出生体重低于1,500克的所有婴儿或在出生后前28天内死亡的其他婴儿。这些婴儿是从链接的出生死亡证明文件中识别出来的。对照组婴儿（n = 634）是从非病例人群中随机选取的。从出生证明中获得的最可靠信息是描述性人口统计数据和出生体重。从新出生证明复选框中获得的信息质量各不相同。与相对不常见的情况和事件（即使是严重情况）相比，出生证明上对常规医疗程序的报告更好。在使用出生证明数据评估孕产妇医疗风险因素、分娩并发症、新生儿异常情况和先天性异常时需要谨慎，因为敏感性较低。
