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Defining a low-risk birth cohort: a cohort study comparing two perinatal data sets in Ontario, Canada

Elizabeth Kathleen Darling1,2, Olivia Marquez1, Alison L Park3

  • 1McMaster Midwifery Research Centre, 1280 Main Street West, HSC 4H24, Hamilton, ON, L8S 4K1 Canada.

International Journal of Population Data Science
|March 20, 2024
PubMed

Insights

The Better Outcomes Registry Network (BORN) database and the Canadian Institute for Health Information Discharge Abstract Database (CIHI-DAD) show high agreement for perinatal data. Both databases can identify low-risk birth cohorts, but understanding data collection is key.

Area of Science:

  • Perinatal health surveillance
  • Health data analytics
  • Reproductive health research

Background:

  • Ontario, Canada utilizes two primary perinatal data sources: the Better Outcomes Registry Network (BORN) Better Information System (BIS) and the Canadian Institute for Health Information Discharge Abstract Database (CIHI-DAD). These databases are crucial for perinatal health surveillance, research, and informing healthcare decisions.
  • Understanding the agreement and discrepancies between these vital data sources is essential for accurate population health monitoring and evidence-based healthcare policy.

Purpose of the Study:

  • To assess the agreement level between the BORN BIS and CIHI-DAD perinatal databases.
  • To identify differences in defining a low-risk birth (LRB) cohort using each data source.
  • To understand the implications of these differences on clinical outcomes and data interpretation.

Main Methods:

  • A population-based cohort study was conducted, linking births recorded in both BORN BIS and CIHI-DAD from April 1, 2012, to March 31, 2018.
  • Exclusions included out-of-hospital births, invalid health numbers, non-Ontario residents, and gestational age under 20 weeks.
  • The study compared the prevalence of low-risk births and clinical outcomes (cesarean delivery, NICU/ICU admission) between cohorts identified by each database.

Main Results:

  • Over 779,000 births were linkable between the two databases; 129,908 cases were identified in BORN BIS and 136,184 in CIHI-DAD after applying LRB exclusions.
  • High agreement was observed for most exclusion criteria.
  • Differences were noted in the prevalence of cesarean delivery (14.3% BORN BIS vs. 12.0% CIHI-DAD) and NICU admission (8.7% BORN BIS vs. 7.5% CIHI-DAD) between the identified LRB cohorts.

Conclusions:

  • High overall agreement exists between the BORN BIS and CIHI-DAD for perinatal data.
  • Either database can be utilized for identifying low-risk birth cohorts, provided users understand the nuances of data collection, coding, and outcome definitions.
  • The choice of database may depend on the specific variables critical for a given research analysis.
Abstract

Keywords:
administrative databirth registrycohort studydata accuracydatabaselinkagelow-risk birthperinatalpopulation data

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