The reliability and validity of birth certificates.
OBJECTIVE
To summarize the reliability and validity of birth certificate variables and encourage nurses to spearhead data improvement.


METHODS
A Medline key word search of reliability and validity of birth certificate, and a reference review of more than 60 articles were done.


METHODS
Twenty-four primary research studies of U.S. birth certificates that involved validity or reliability assessment.


METHODS
Studies were reviewed, critiqued, and organized as either a reliability or a validity study and then grouped by birth certificate variable.


RESULTS
The reliability and validity of birth certificate data vary considerably by item. Insurance, birthweight, Apgar score, and delivery method are more reliable than prenatal visits, care, and maternal complications. Tobacco and alcohol use, obstetric procedures, and delivery events are unreliable. Birth certificates are not valid sources of information on tobacco and alcohol use, prenatal care, maternal risk, pregnancy complications, labor, and delivery.


CONCLUSIONS
Birth certificates are a key data source for identifying causes of increasing U.S. infant mortality but have serious reliability and validity problems. Nurses are with mothers and infants at birth, so they are in a unique position to improve data quality and spread the word about the importance of reliable and valid data. Recommendations to improve data are presented.
Northam
Sally
S
TWU College of Nursing, Texas Woman's University, Denton, TX 76204-5498, USA. snortham@mail.twu.edu
Knapp
Thomas R
TR
D000428:Alcohol Drinking / Q000453:epidemiology; D001034:Apgar Score; D015982:Bias; D001719:Birth Certificates; D001724:Birth Weight; D015984:Causality; D003627:Data Interpretation, Statistical; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007348:Insurance, Health / Q000706:statistics & numerical data; D009309:National Center for Health Statistics, U.S.; D024802:Nurse's Role; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011295:Prenatal Care / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012107:Research Design; D012907:Smoking / Q000453:epidemiology; D014481:United States / Q000453:epidemiology