Journal of Obstetric, Gynecologic & Neonatal Nursing
IN REVIEWThe Reliability and Validity of Birth Certificates
Section snippets
A brief history and description of the birth certificate
The 1st U.S. Standard Certificate of Live Birth was developed in 1900 (Gould, 1999), and birth certificates have included data on maternal and infant variables for all live births in the United States and its territories since 1939 (Lilienfeld, Parkhurst, Patton, & Schlesinger, 1951). Twelve revisions of the certificate have been developed since its inception, but the 2003 revision will not be used in all states until each state can earmark funds for training and for computer program changes.
Methods
A simple word search of Medline (using EBSCO) in February 2004 for “birth certificates, reliability, and validity” retrieved only one document. When just “birth certificate and reliability” were used as search terms, seven records were identified but only two were actual research studies evaluating the reliability of birth certificate data. Usage of “birth certificate and validity” as search terms yielded 10 records; seven were identified as research studies, three were in a foreign language,
Reliability
Reliability pertains to consistency of measurement (29, 30, 45). The primary type of reliability involved in the majority of birth certificate studies has been equivalence, whereby two measurement methods are compared for consistency. Terms used as synonyms for reliability by various authors include “concordance” (Alexander, Tompkins, Peterson, Hulsey, & Mor, 1995; 9, 20, 34, 42), “concurrence” (Gore et al., 2002), “agreement” (5, 8, 12, 13, 14, 46, 49), “disagreement” (Penrod & Lantz, 2000),
Discussion
The reliability and validity of birth certificate data vary considerably from item to item. Insurance, birthweight, Apgar score, and delivery method are more reliable than prenatal visits, care, and maternal complications. Tobacco and alcohol use, obstetric procedures, and delivery events are unreliable. Birth certificate are not valid sources of information on tobacco and alcohol use, prenatal care, maternal risk, pregnancy complications, labor, and delivery. The confusing array of terms other
Conclusion
Birth certificate data with low accuracy is not better than nothing. Rather, the use of such data may lead to incorrect conclusions such as a decline in smoking and alcohol use during pregnancy. Insight into maternal and infant health is best achieved with valid and reliable birth data. Varied reliability and validity of birth certificate variables undermine insight and rational public health strategies to improve maternal and infant health.
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