title: Accuracy of assisted reproductive technology information on birth certificates: Florida and Massachusetts, 2004-06.
abstract: BACKGROUND
  Assisted Reproductive Technology (ART) includes fertility procedures where both egg and sperm are handled in the lab. ART use has increased considerably in recent years, accounting for 47,090 livebirths in the U.S. in 2010. ART increases the probability of multiple gestation births, which are at higher risks than singletons for adverse outcomes. Additionally, ART is associated with a greater risk of complications during pregnancy, labour, and delivery, and increased risk of adverse perinatal outcomes in singleton births.
  
  
  METHODS
  We merged Florida and Massachusetts birth records from 2004-06 with the National ART Surveillance System (NASS) and using NASS as the gold standard, calculated sensitivity, specificity, and positive predictive value (PPV) of ART reporting on the birth certificates by maternal, infant, and hospital characteristics. We fit random-effects logistic regression models to evaluate simultaneously the association of ART reporting with these predictors while accounting for correlation among births occurring in the same hospital.
  
  
  RESULTS
  Sensitivity of ART reporting on the birth certificate was 28.9% in Florida and 41.4% in Massachusetts. Specificity was >99% in both states. PPV was 45.5% in Florida and 54.6% in Massachusetts. The odds of ART reporting varied by state and by several maternal and delivery characteristics including age, parity, history of fetal loss, plurality, race/Hispanic ethnicity, delivery payment source, pre-existing conditions, and complications during pregnancy or labour and delivery.
  
  
  CONCLUSIONS
  There was significant under-reporting of ART procedures on the birth certificates. Using data on ART births identified only from birth certificates yields a biased sample of the population of ART births.
authors.affiliation: Massachusetts Department of Public Health, Boston, MA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Cohen
authors.forename: Dana
authors.initials: D
authors.lastname: Bernson
authors.forename: William
authors.initials: W
authors.lastname: Sappenfield
authors.forename: Russell S
authors.initials: RS
authors.lastname: Kirby
authors.forename: Dmitry
authors.initials: D
authors.lastname: Kissin
authors.forename: Yujia
authors.initials: Y
authors.lastname: Zhang
authors.forename: Glenn
authors.initials: G
authors.lastname: Copeland
authors.forename: Zi
authors.initials: Z
authors.lastname: Zhang
authors.forename: Maurizio
authors.initials: M
authors.lastname: Macaluso
mesh_terms: D001719:Birth Certificates; D001723:Birth Rate; D005260:Female; D005431:Florida; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D033181:Information Dissemination; D008297:Male; D008404:Massachusetts; D011159:Population Surveillance / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D047928:Premature Birth; D015203:Reproducibility of Results; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects / Q000706:statistics & numerical data; D015983:Selection Bias; D012680:Sensitivity and Specificity
keywords: Assisted Reproductive Technology; birth certificates; data quality; validity