# Presentation: 921120

## The National Natality Data Set

- Paul D. Sutton, Ph.D.

## The Natality Team

- Brady E. Hamilton
- Sharon Kirmeyer
- Marian F. MacDorman
- Joyce A. Martin (Team Leader)
- T. J. Mathews
- Fay Menacker
- Martha L. Munson
- Paul D. Sutton
- Stephanie J. Ventura (Branch Chief)

## Vital Statistics Cooperative Program (VSCP)

- Goals
- Standardize definitions
- Standardize measures for quality
- Standardize methods for collecting, processing and analyzing vital statistics

## 1989 U.S. Standard Certificate of Live Birth

## Confidentiality

- Public Use Data files do NOT include
- Names
- Addresses
- Geographic identifiers for cities or counties with population under 100,000
- Dates of birth for infants, mothers, fathers
- Birth certificate numbers

## Items on the 1989 Standard Birth Certificate

- Maternal demographics (i.e. Hispanic origin, race, age, education)
- Maternal and infant health characteristics

## Hispanic Origin and subgroups

- Mexican
- Puerto Rican
- Cuban
- Central or South American

## Asian of Pacific Islander (API) subgroups

- Coded prior to 1992
- Chinese
- Japanese
- Hawaiian
- Filipino
- Other API

- Expanded coding beginning with 1992*
- Vietnamese
- Asian Indian
- Korean
- Samoan
- Guamanian
- Remaining API

- *detail reported by 11 states

## Some Health Items on the 1989 Standard Birth Certificate

- Maternal medical risk factors- e.g. hypertension, diabetes
- Induction, stimulation of labor
- Cesarean rates/VBAC rates
- Preterm delivery, low birthweight
- Tobacco use
- Multiple births

## Types of Data Dissemination: National Vital Statistics Reports

## Provisional Data

- Most timely data release of counts and rates
- Short “fact sheet” released monthly on the Internet in the NVSR series
- Includes counts of births, deaths, infant deaths, marriages & divorces
- Estimates based on counts of certificates received during a one-month period, regardless of month of occurrence

## Preliminary Data

- Based on substantial sample of records – 98% of all births for 2002
- More detailed inclusive annual report
- Provides preview of data in final report
- Data track very well with those from final report
- Sample of all records received and processed by cut-off date – 4-5 months after end of data year
- Published 6-8 months after end of year

## Final Data

- Annual report – based on all US births in a given year
- Discussion and detailed data on almost all items in the data set
- Released 12-14 months after end of year

## Types of Data Dissemination: Topical Reports

- Types of Data Dissemination: Topical Reports

## Upcoming Reports

- Births to 10-14 year old mothers, 1990-2002: Trends and Health Outcomes (available early fall)
- Analysis of Rise in infant Mortality for 2002 (available late summer)

## Types of Data Dissemination: Vital Statistics of the United States

- Tabulated Data

## Types of Data Dissemination: CD-ROMs

- Unit Record Data

## Statistical Export and Tabulation System (SETS)

## Birth Data Web Pagewww.cdc.gov/nchs/births.htm

## The 2003 U.S. Standard Certificate of Live Birth

- Improved data quality
- Standardized worksheets (Tested prior to implementation)
- Standardized electronic systems
- Changes to existing items
- New items

## Standardized Worksheets

- To encourage collection from the best sources, two  worksheets have been developed and tested
- Mother’s Worksheet
- Facility Worksheet

## Mother’s Worksheet

- Data directly from _the mother_ (e.g., race, education, cigarette smoking, WIC)

- Tested on women with a recent live birth
- Slight modifications made
- Overall, mother’s worksheet worked well
- Companion brochure

## Facility Worksheet 

- Data directly from the _medical records_ (e.g., pregnancy risk factors, method of delivery)
- Tested in hospitals
- Hospital staff completed the worksheet using medical records
- Outside expert reviewed responses for accuracy
- Several items modified or deleted
- Testing generally showed that the facility worksheet could be completed efficiently and accurately

## Guide to Completing Facility Worksheet

- 	To assist hospital staff in completing the facility worksheet a comprehensive instruction manual has been developed.  It includes:

- Definitions
- Preferred sources within the records
- Key words/common abbreviations

## Detailed Specification for Electronic Systems

- 	Detailed specifications for _each data item_ on the birth certificate have been developed

- Automatic edits/cross edits
- Ability to edit and query at data entry
- Suggested screens
- On-line help
- Drop-down menus
- Test decks for vendors/States

## New Birth Certificate:Modified Items

- Cigarette smoking before and during pregnancy
- Method of delivery
- Pre-pregnancy weight, weight at delivery and height
- Congenital anomalies

## New Birth Certificate:New Items

- Fertility therapy
- WIC
- Infections during pregnancy
- Maternal morbidity
- Breast feeding
- Principal source of payment for the delivery

## Transition to the New Birth Certificate Continues...

- Expected to Implement in 2005

- Implementing in 2006 or later

- Implemented New Certificate

- DC

## Data Dissemination

- Public Use data file for 2003, will include data from new and modified items for States that have implemented the new certificate

## For more information contact a member of the Natality Team at 301-458-4111