title: Infant Mortality, Cause of Death, and Vital Records Reporting in Ohio, United States.
abstract: Introduction Infant mortality rate is a sensitive metric for population health and well-being. Challenges in achieving accurate reporting of these data can lead to inaccurate targeting of public health interventions. We analyzed a cohort from a pediatric tertiary care referral medical center to evaluate concordance between autopsy cause of death (COD) and death certificate documentation for infants <1 year of age. We predicted that infant COD as documented through vital records would not correspond to that as determined by autopsy. Methods We conducted a retrospective review comparing causes of infant death reported through Ohio Department of Health documents to those on Cincinnati Children's Hospital Medical Center autopsy reports over an 8-year period from January 1, 2006 through December 31, 2013. Results We analyzed 276 total cases of which 167 (61.5 %) represented infants born preterm. Autopsy reports identified 55 % of cases had a congenital anomaly. Additionally, 34 % of all cases had primary or contributing COD related to infection and 14.5 % of all cases indicated chorioamnionitis. We identified 156 (56.5 %) death certificates discordant with autopsy COD of which 52 (33.3 %) involved infection and 24 (15.4 %) involved congenital anomalies. Discussion There are opportunities to improve COD reporting through training for providers, and improvement of established state certification systems. Future strategies to reduce infant mortality will be better informed through enhancements in vital records COD reporting.
authors.affiliation: Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, ML 7009, Cincinnati, OH, 45229, USA. Laura.seske@gmail.com.|Perinatal Institute, Center for Prevention of Preterm Birth, Cincinnati, OH, 45229, USA. Laura.seske@gmail.com.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Seske
authors.affiliation: Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, ML 7009, Cincinnati, OH, 45229, USA.|Perinatal Institute, Center for Prevention of Preterm Birth, Cincinnati, OH, 45229, USA.|Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA.
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Muglia
authors.affiliation: Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, ML 7009, Cincinnati, OH, 45229, USA.|Perinatal Institute, Center for Prevention of Preterm Birth, Cincinnati, OH, 45229, USA.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Hall
authors.affiliation: Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA.|Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA.
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Bove
authors.affiliation: Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, ML 7009, Cincinnati, OH, 45229, USA.|Perinatal Institute, Center for Prevention of Preterm Birth, Cincinnati, OH, 45229, USA.|Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Greenberg
mesh_terms: D001344:Autopsy / Q000592:standards*; D002423:Cause of Death; D003644:Death Certificates; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D004282:Documentation / Q000592:standards*; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D009820:Ohio; D012189:Retrospective Studies
keywords: Autopsy; Cause of death; Death certificate; Infant mortality; Vital records