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Validation of the Danish Birth Registration
J Kristensen1, J Langhoff-Roos, L T Skovgaard
1Department of Obstetrics and Gynecology, Rigshospitalet, University of Copenhagen, Denmark.
Journal of Clinical Epidemiology
|August 1, 1996
Summary
Danish birth registers show good agreement for pregnancy complications but understate their occurrence. Gestational age data agreement was poor, revealing significantly more preterm births than previously reported.
Area of Science:
- Reproductive Health
- Medical Informatics
- Public Health Surveillance
Background:
- National health registers are crucial for epidemiological research and public health.
- Accurate data on pregnancy complications and gestational age are vital for maternal and infant health monitoring.
- Previous studies have highlighted potential data quality issues in health registers.
Purpose of the Study:
- To assess the validity and reliability of data on serious pregnancy complications and gestational age in two Danish national registers.
- To compare register data with medical records for accuracy.
- To identify potential biases and errors in birth register data.
Main Methods:
- A cohort of Danish women giving birth to their first and second singleton infants between 1982-1987 was studied.
- A sample of 1662 medical records was reviewed and compared with data from the Medical Birth Register (MBR) and National Register of Hospital Discharges (NRHD).
- Statistical measures, including kappa statistics, were used to assess agreement between registers and medical records.
Main Results:
- Good agreement (kappa > 0.6) was found for the registration of most pregnancy complications between registers and medical records.
- A tendency toward understatement of three out of four pregnancy complications was observed due to low sensitivity.
- Agreement for length of gestation was poor (43%), indicating significant underestimation of singleton preterm deliveries (estimated 52% more than previously reported).
Conclusions:
- While Danish birth registers demonstrate reasonable validity for certain pregnancy complications, improvements are needed for gestational age accuracy.
- Underreporting of complications and inaccuracies in gestational age suggest a need for enhanced data collection protocols.
- Recommendations include explicit data definitions, increased use of raw data, and professional, motivated data collection by birth attendants to improve register validity.