The quality of vital statistics for studying perinatal health: the Spanish case.

BACKGROUND: Birthweight and gestational age are key indicators for perinatal health obtained through the birth certificate. Knowing the validity of birth certificate data is crucial when identifying needs and evaluating birth outcomes. In Spain, vital information is reported by parents and is not checked for consistency with any hospital document. Therefore, to perform a validation study and describe the variables associated with misreporting is essential to improve the quality of birth certificates. METHODS: A database was created using birth information from hospital medical records that were individually linked with the Spanish National Institute of Statistics (INE) birth certificate files. Measures of reliability and validity were used to compare the data from the two sources. Logistic regression models were adjusted to model the odds of being misreported in birthweight and gestational age, controlling for relevant variables. RESULTS: INE overestimated the prevalence of birthweight and gestational age. The degree of agreement between the two sources was good for most gestational age groups (Kappa = 0.74), very good for the very preterm (Kappa = 0.85) and very good also for all categories of birthweight (Kappa = 0.88). Misreporting was significantly higher among immigrants, unmarried mothers and girls. Being a preterm birth increased the odds of being declared with errors in gestational age; having low birthweight and missing information on gestational age were associated with misreporting birthweight. CONCLUSIONS: The reliability of INE information could be greatly improved if hospitals included birthweight and gestational age on the document provided to parents for registering the birth.

Mortalidad perinatal en el Hospital Clínico San Carlos de Madrid / Perinatal mortality in the San Carlos Hospital of Madrid

Objetivo: Comparar las tasas de mortalidad perinatal del Hospital Clínico San Carlos entre los períodos 1995-1999 y 2000-2004.Material y métodos: Estudio retrospectivo de la mortalidad perinatal del quinquenio 2000-2004, empleando la clasificación internacional de la Federación Internacional de Ginecología y Obstetricia. Se recopiló un total de 157 casos y se estudiaron la mortalidad según el tipo de parto, así como los resultados de los estudios anatomopatológicos post mórtem realizados.Resultados: La mortalidad perinatal ampliada (MPNA) fue de 10,68/1.000 nacidos y la mortalidad perinatal estándar (MPNE) de 4,82‰, sobre un total de 14.261 partos, con 14.508 recién nacidos de500 g o más de peso. Las tasas de MPNA y MPNE corregidas fueron de 10,2 y 4,34/1.000 nacidos, respectivamente.Conclusiones: La mortalidad perinatal ha disminuido de forma drástica, de 13,6‰ nacidos en el período 1995-1999 a un 10,68‰ en el período estudiado. Los mejores resultados se obtuvieron en el año 2002 (6,63‰ nacidos vivos) (AU)

Objective: To compare perinatal mortality in San Carlos Clinic Hospital of Madrid during the period 2000-2004 with the period 1995-1999.Material and methods: We performed a retrospective study of perinatal deaths during the period 2000-2004, using the international FIGO classification. A total of 157 cases were collected. Mortality was studied by type of childbirth, and the histopathology results of the autopsies.Results: Extended perinatal mortality is 10.68 per thousand and standard perinatal mortality is 4.48%, in a total of 14,261 childbirths, with 14,508 newborns of 500 g. or more in weight. Corrected extended and standard perinatal mortality are 10.2% and 4.34%, respectively.Conclusions: Perinatal mortality is decreasing significantly, from 13.6% during 1995-1999 to 10.68% in 2000-2004. The best results were obtained in 2002 (6.63% newborns) (AU)