The National Natality Data Set

1. The National Natality Data Set Paul D. Sutton, Ph.D.

2. 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)

3. Vital Statistics Cooperative Program (VSCP) • Goals • Standardize definitions • Standardize measures for quality • Standardize methods for collecting, processing and analyzing vital statistics

4. 1989 U.S. Standard Certificate of Live Birth

5. 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

6. Items on the 1989 Standard Birth Certificate • Maternal demographics (i.e. Hispanic origin, race, age, education) • Maternal and infant health characteristics

7. Hispanic Origin and subgroups • Mexican • Puerto Rican • Cuban • Central or South American

8. Coded prior to 1992 Chinese Japanese Hawaiian Filipino Other API Expanded coding beginning with 1992* Vietnamese Asian Indian Korean Samoan Guamanian Remaining API Asian of Pacific Islander (API) subgroups *detail reported by 11 states

9. 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

10. Types of Data Dissemination: National Vital Statistics Reports

11. 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

12. 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

13. 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

14. Types of Data Dissemination:Topical Reports

15. 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)

16. Types of Data Dissemination:Vital Statistics of the United States Tabulated Data

17. Types of Data Dissemination: CD-ROMs Unit Record Data

18. Statistical Export and Tabulation System (SETS)

19. Birth Data Web Pagewww.cdc.gov/nchs/births.htm

20. 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

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

22. 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 Mother’s Worksheet

23. 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

24. 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 Guide to Completing Facility Worksheet

25. 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 Detailed Specification for Electronic Systems

26. New Birth Certificate:Modified Items • Cigarette smoking before and during pregnancy • Method of delivery • Pre-pregnancy weight, weight at delivery and height • Congenital anomalies

27. New Birth Certificate:New Items • Fertility therapy • WIC • Infections during pregnancy • Maternal morbidity • Breast feeding • Principal source of payment for the delivery

28. WA ME MT ND MN VT OR NH MA ID WI NY SD CT WY MI RI PA IA NJ NE NV OH DE IN IL UT MD CO WV VA KS MO CA KY NC TN OK AZ AR SC NM GA AL MS TX LA FL AK HI Transition to the New Birth Certificate Continues… DC Implemented New Certificate Expected to Implement in 2005 Implementing in 2006 or later

29. Data Dissemination • Public Use data file for 2003, will include data from new and modified items for States that have implemented the new certificate

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