The Utility of Using an Existing Birth Defects Surveillance Program to Enhance Surveillance Data on Stillbirths
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The Utility of Using an Existing Birth Defects Surveillance Program to Enhance Surveillance Data on Stillbirths

Filetype[PDF-374.90 KB]

  • English

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    • Alternative Title:
      J Registry Manag
    • Description:

      Fetal death certificates (FDC) are the main source of stillbirth surveillance data in the United States yet previous studies suggest FDC have incomplete ascertainment. In 2005, Centers for Disease Control and Prevention (CDC) funded two pilot programs to determine the feasibility of expanding existing birth defects surveillance systems employing active case finding methods to conduct surveillance of stillbirths. The objectives of this analysis were to: 1) estimate the completeness of ascertainment of stillbirths identified through one of the pilot programs, the Metropolitan Atlanta Congenital Defects Program (MACDP), and 2) compare the prevalence of stillbirths obtained through active case finding (MACDP) with data available from FDC.


      Stillbirths in metropolitan Atlanta were independently ascertained by both FDC and MACDP in 2006 and 2008. Capture-recapture methods were used to estimate the total number of stillbirths in the surveillance area. The sensitivities for capturing stillbirths were estimated for FDC, MACDP, and both sources combined. Prevalence estimates for each data source and for the combined data sources were calculated using a denominator of live births plus FDC-identified stillbirths.


      An estimated 1,118 stillbirths occurred in metropolitan Atlanta. MACDP captured 863 and FDC captured 862. There were 198 stillbirths captured by MACDP and not reported by FDC, and 197 stillbirths identified in FDC were not initially captured by MACDP. The estimated sensitivities were 77.1%, 77.2%, and 94.8% for FDC, MACDP, and both sources combined, respectively. The stillbirth prevalences for 2006 and 2008 using FDC data alone were 8.2 and 7.4 per 1,000 live births plus stillbirths, respectively, and 9.9 and 9.3 per 1,000 live births plus stillbirths, respectively using both data sources combined.


      Leveraging the resources of existing birth defects surveillance programs in combination with FDC could improve population-based ascertainment of stillbirths.

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