摘要：Objectives . This study assessed the relationship between incomplete birth certificates and infant mortality. Methods . Birth certificates from California (n = 538 945) were assessed in regard to underreporting of 13 predictors of perinatal outcomes and mortality. Results . Of the birth certificates studied, 7.25% were incomplete. Underreporting was most common in the case of women at high risk for poor perinatal outcomes and infants dying within the first day. Increasing numbers of unreported items were shown to be associated with corresponding increases in neonatal and postneonatal mortality rates. Conclusions . Incomplete birth certificates provide an important marker for identifying high-risk women and vulnerable infants. Because data “cleaning” will result in the removal of mothers and infants at highest risk, birth certificate analyses should include incomplete records. Over the last several decades, vital records have become an increasingly important resource for identifying factors associated with suboptimal perinatal outcomes. 1– 6 Although several studies have assessed the validity of birth certificate items, 7– 13 there have been, to our knowledge, no analyses of the relationship between underreporting of birth certificate items and risk of infant death. Because missing birth certificate data tend to be associated with those groups at highest risk for perinatal problems, 14 we hypothesized a strong relationship between underreporting of birth certificate data and infant death.
