Live birth and infant death record linkage: methodological and policy issues

Area of Science:

• Public Health
• Epidemiology
• Vital Statistics

Background:

• Accurate linkage of birth and death records is essential for understanding infant mortality.
• Late-registered and unregistered births can introduce bias into vital statistics research.
• Previous studies may have overlooked unregistered births, potentially skewing findings on birth outcomes.

Purpose of the Study:

• To describe a method for linking live birth and infant death certificates.
• To address challenges posed by late-registered and unregistered births in vital statistics.
• To investigate the characteristics of infants with unregistered births and their impact on mortality data.

Main Methods:

• Utilized Ohio annual vital statistics tapes for a study population in Cleveland and East Cleveland (1985-87).
• Developed and applied a method for linking live birth and infant death certificates.
• Analyzed differences between timely registered, late-registered, and unregistered births among deceased infants.

Main Results:

• Deceased infants with late-registered births were similar to those with timely registered births.
• Approximately 4.6% of decedents had unregistered births.
• Unregistered births were associated with very premature infants from socially disadvantaged backgrounds who died shortly after delivery, including homicides.

Conclusions:

• Failing to link infant deaths with unregistered births can significantly bias studies of birth outcomes.
• The findings highlight the importance of including unregistered births in vital statistics analyses.
• Policy implications suggest a need for improved birth registration completeness to ensure accurate public health surveillance.