General Obstetrics and Gynecology: ObstetricsThe reporting of pre-existing maternal medical conditions and complications of pregnancy on birth certificates and in hospital discharge data
Section snippets
Material and methods
Details of the study methods have been reported previously.14 Briefly, from the 65 nonfederal short-stay hospitals in Washington with at least 50 births in 2000, we identified a representative, geographically diverse sample of 22 hospitals and enrolled 19 of these hospitals (86%) in the study. The study sampling frame consisted of the 26,363 women who had live births at these hospitals during 2000. To evaluate less common diagnoses (such as placenta previa), we stratified our sampling of women
Results
Maternal and infant characteristics of the validation study sample, all births at the 19 study hospitals, and all births at Washington nonfederal short-term hospitals in 2000 are shown in Table I. The women in our study were more likely to be nonwhite or primiparous and less likely to be delivered at a high-volume hospital than were women statewide. In addition, our study cohort had a higher percentage of low birth weight (<2500 g) infants and infants with estimated gestational age of <37 weeks.
Comment
In this first statewide, population-based study to compare medical records data with data that were obtained from live-birth certificate and hospital discharge summaries for the detection of maternal medical conditions and complications of pregnancy, the combination of birth certificates and discharge data was strikingly more accurate than the birth certificate data alone. Combining data sources resulted in TPFs of at least 70% for both established and gestational diabetes mellitus, active
Acknowledgments
We thank Helen Harte, RN, MPH, MPA, Rachel Brucker, MPH, BSN, and Sandra Salinas, AS, RHIT, for their field work and abstractions of medical records, and William O'Brien, who assisted with data linkage and management.
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Supported by grant S1838-21/21 from the Association of Schools of Public Health and Centers for Disease Control and Prevention Cooperative Agreement.