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Validity and reliability of the Brazilian birth certificate for reporting birth defects
Daniela Varela Luquetti1, Rosalina Jorge Koifman
1Post-graduation Program Environment and Public Health National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil. luquetti@uw.edu
Objectives:
We sought to assess data validity and coding reliability of birth defects among Brazilian birth certificates (BC).
Methods:
From a population of 27,945 live births delivered at 8 hospitals in 7 cities of Brazil during 2004, we compared 677 cases of birth defects identified through BC to 1,110 cases identified through a hospital-based birth defect registry.
Results:
Birth defects prevalence according to BC varied by hospital from 0.5% to 5.3%. Birth certificate sensitivity of birth defects reporting varied by hospital, from 11.4% to 66.5%. Specificity and positive and negative predictive values were above 80%. For reported cases, concordance of diagnosis was over 90% for all hospitals combined. Birth defects coding reliability, determined by kappa statistics, varied from 0.61 to 1.00 for 3-digit ICD-10 codes and 0.41 to 0.78 for 4-digit codes.
Conclusions:
Birth certificate data underestimated birth defects prevalence among live births. Although concordance of diagnosis was high, the data should be used cautiously because of high underreporting and moderate coding reliability.
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