Details:

Alternative Title:
Paediatr Perinat Epidemiol
Publisher's site:
http://dx.doi.org/10.1111/ppe.12083
Personal Author:
Barradas, Danielle T. ; Dietz, Patricia M. ; Pearl, Michelle ; England, Lucinda J. ; Callaghan, William M. ; ... More +
Barradas, Danielle T. ; Dietz, Patricia M. ; Pearl, Michelle ; England, Lucinda J. ; Callaghan, William M. ; Kharrazi, Martin Less -
Description:
Background

Obstetric estimate (OE) of gestational age, recently added to the standard US birth certificate, has not been validated. Using early ultrasound-based gestational age (prior to 20 weeks gestation) as the criterion standard, we estimated the prevalence of preterm delivery and the sensitivity and positive predictive value (PPV) of gestational age estimates based on OE.

Methods

We analyzed 165 148 singleton livebirth records (38% of California livebirths during the study period) with linked early ultrasound information from a statewide California prenatal screening programme. OE of gestational age estimates was obtained from birth certificates.

Results

Prevalence of preterm delivery (<37 weeks gestation) was higher based on early ultrasound (8.1%) compared with preterm delivery based on OE (7.1%). Sensitivity for preterm birth when using OE for gestational age was 74.9% (95% confidence interval [CI] [74.1, 75.6]), and PPV was 85.1% (95% CI [84.4, 85.7]). Incongruence, defined as a ≥ 14-day difference between early-ultrasound-derived gestational age and OE, was 3.4%.

Conclusions

OE reported on the birth certificate may underestimate the prevalence of preterm delivery, particularly among women of non-Hispanic non-white race and ethnicity and women with lower educational attainment, public insurance at time of delivery, and missing prepregnancy BMI. Additional validation studies in other samples of births are needed.


Subject:
[+]
Article
Birth Certificates
Delivery, Obstetric
Female
Gestational Age
Humans
Infant, Newborn
Predictive Value Of Tests
Pregnancy
Premature Birth
Sensitivity And Specificity
Ultrasonography, Prenatal

Source:
Paediatr Perinat Epidemiol. 28(1):3-10.
Pubmed ID:
24117928
Pubmed Central ID:
PMC4741369
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States ; T32 DK007734/DK/NIDDK NIH HHS/United States
CC999999/Intramural CDC HHS/United States ; T32 DK007734/DK/NIDDK NIH HHS/United States Less -
Place as Subject:
California
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:2dfb1baa8e82e67aa491d10a7f687f34b3e65c5bdd86e2bf4b54ee9039e0a064
File Type:

Supporting Files

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