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Related Experiment Video

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Breakfast Habits among Schoolchildren in the City of Uruguaiana, Brazil
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Validating linkage of multiple population-based administrative databases in Brazil.

Enny S Paixão1, Oona M R Campbell1, Laura C Rodrigues1

  • 1London School of Hygiene and Tropical Medicine, Bloomsbury, London, United Kingdom.

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Summary

This study linked maternal death records with birth outcomes in Brazil, achieving 72% sensitivity and 88% specificity. Linkage accuracy varied by social-demographic factors, not dengue status.

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Area of Science:

  • Public Health
  • Epidemiology
  • Biostatistics

Background:

  • Linking routinely collected data enables assessment of prenatal exposures on maternal and infant outcomes.
  • Accurate data linkage is crucial for reliable results, especially in mother-baby studies.
  • Challenges exist in linking maternal deaths to birth outcomes and disease notifications.

Purpose of the Study:

  • To estimate the accuracy of linkage between maternal deaths and birth outcomes with dengue notifications in Brazil.
  • To identify potential biases in assessing maternal death risk from dengue during pregnancy.

Main Methods:

  • Utilized population-based administrative databases from Brazil (2007-2012).
  • Linked dengue-infected pregnant women (from prior dataset) to maternal death records probabilistically.
  • Examined linkage accuracy, false matches, and missed matches to detect bias.

Main Results:

  • Successfully linked 6717 out of 10,259 maternal deaths.
  • Achieved an estimated sensitivity of 72%, specificity of 88%, and positive predictive value of 98%.
  • Linkage errors were associated with maternal education and race, but not dengue status.

Conclusions:

  • Demonstrated high linkage standards comparable to literature, despite lacking unique identifiers.
  • Acknowledged that linkage errors disproportionately affected certain social-demographic groups.
  • Emphasized the need to consider linkage biases in future analyses of maternal mortality and dengue in pregnancy.