Accuracy of reporting maternal in-hospital diagnoses and intrapartum procedures in Washington State linked birth records
Accuracy of reporting maternal in-hospital diagnoses and intrapartum procedures in Washington State linked birth records
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DOI：
10.1111/j.1365-3016.2005.00682.x
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发表时间：
2005-11-01
影响因子：
2.8
通讯作者：
Callaghan, WM
中科院分区：
文献类型：
--
作者：
Lydon-Rochelle, MT;Holt, VL;Callaghan, WM
虽然产妇发病率和产时程序的影响是围产期结局研究中的一个常见话题，但经常用于此类研究的大型行政数据库（出生证明，出院）中报告这些变量的准确性在很大程度上是未知的。我们进行了这项研究，以比较母亲的诊断和程序列出的出生证明，出院数据，出生证明和出院数据相结合，与那些在分层随机抽样的医院医疗记录的4541名妇女在华盛顿州在2000年交付活产婴儿。我们发现，出生证明和出院数据相结合，有实质上更高的真阳性分数（TPF，具有积极医疗记录评估的妇女在使用行政数据库时为积极的比例）比仅出生证数据用于引产（86% vs. 52%）、头盆不称（83% vs. 35%）、胎盘早剥（85% vs. 68%）和产钳辅助分娩（89% vs. 55%）。对于仅在出院数据中可用的手术，TPF通常较高：会阴切开术（85%）和三度和四度阴道撕裂伤（91%）。除了无分娩的重复剖腹产（TPF，81%）外，仅在出生证明数据中提供的分娩程序具有较低的TPF，包括隆乳（34%），重复剖腹产（61%）和剖腹产后阴道分娩（62%）。我们的数据表明，进行围产期流行病学研究的研究人员不应该仅仅依靠出生证明数据来准确地检测母亲的诊断和产时程序。
While the impact of maternal morbidities and intrapartum procedures is a common topic in perinatal outcomes research, the accuracy of the reporting of these variables in the large administrative databases (birth certificates, hospital discharges) often utilised for such research is largely unknown. We conducted this study to compare maternal diagnoses and procedures listed on birth certificates, hospital discharge data, and birth certificate and hospital discharge data combined, with those documented in a stratified random sample of hospital medical records of 4541 women delivering liveborn infants in Washington State in 2000. We found that birth certificate and hospital discharge data combined had substantially higher true positive fractions (TPF, proportion of women with a positive medical record assessment who were positive using the administrative databases) than did birth certificate data alone for labour induction (86% vs. 52%), cephalopelvic disproportion (83% vs. 35%), abruptio placentae (85% vs. 68%), and forceps-assisted delivery (89% vs. 55%). For procedures available only in hospital discharge data, TPFs were generally high: episiotomy (85%) and third and fourth degree vaginal lacerations (91%). Except for repeat caesarean section without labour (TPF, 81%), delivery procedures available only in birth certificate data had low TPFs, including augmentation (34%), repeat caesarean section with labour (61%), and vaginal birth after caesarean section (62%). Our data suggest that researchers conducting perinatal epidemiological studies should not rely solely on birth certificate data to detect maternal diagnoses and intrapartum procedures accurately.