title: Validity of health plan and birth certificate data for pregnancy research.
abstract: OBJECTIVE
  To evaluate the validity of health plan and birth certificate data for pregnancy research.
  
  
  METHODS
  A retrospective study was conducted using administrative and claims data from 11 U.S. health plans and corresponding birth certificate data from state health departments. Diagnoses, drug dispensings, and procedure codes were used to identify infant outcomes (cardiac defects, anencephaly, preterm birth, and neonatal intensive care unit [NICU] admission) and maternal diagnoses (asthma and systemic lupus erythematosus [SLE]) recorded in the health plan data for live born deliveries between January 2001 and December 2007. A random sample of medical charts (n = 802) was abstracted for infants and mothers identified with the specified outcomes. Information on newborn, maternal, and paternal characteristics (gestational age at birth, birth weight, previous pregnancies and live births, race/ethnicity) was also abstracted and compared to birth certificate data. Positive predictive values (PPVs) were calculated with documentation in the medical chart serving as the gold standard.
  
  
  RESULTS
  PPVs were 71% for cardiac defects, 37% for anencephaly, 87% for preterm birth, and 92% for NICU admission. PPVs for algorithms to identify maternal diagnoses of asthma and SLE were ≥ 93%. Our findings indicated considerable agreement (PPVs > 90%) between birth certificate and medical record data for measures related to birth weight, gestational age, prior obstetrical history, and race/ethnicity.
  
  
  CONCLUSIONS
  Health plan and birth certificate data can be useful to accurately identify some infant outcomes, maternal diagnoses, and newborn, maternal, and paternal characteristics. Other outcomes and variables may require medical record review for validation.
authors: Meyers Primary Care Institute and University of Massachusetts Medical School, Worcester, MA, USA. sandrade@meyersprimary.org
authors: Susan E
authors: SE
authors: Andrade
authors: Pamela E
authors: PE
authors: Scott
authors: Robert L
authors: RL
authors: Davis
authors: De-Kun
authors: DK
authors: Li
authors: Darios
authors: D
authors: Getahun
authors: T Craig
authors: TC
authors: Cheetham
authors: Marsha A
authors: MA
authors: Raebel
authors: Sengwee
authors: S
authors: Toh
authors: Sascha
authors: S
authors: Dublin
authors: Pamala A
authors: PA
authors: Pawloski
authors: Tarek A
authors: TA
authors: Hammad
authors: Sarah J
authors: SJ
authors: Beaton
authors: David H
authors: DH
authors: Smith
authors: Inna
authors: I
authors: Dashevsky
authors: Katherine
authors: K
authors: Haffenreffer
authors: William O
authors: WO
authors: Cooper
mesh_terms: D035843:Biomedical Research / Q000379:methods*; D001719:Birth Certificates; D016208:Databases, Factual / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014481:United States