Invited Commentary: Using Vital Statistics Databases for Perinatal Epidemiology: Does the Quality Go In Before the Name Goes On?

Abstract

Most epidemiologic research using birth certificate records utilizes cross-sectional or case-control study designs. These records are typically made available to qualified researchers as computerized files of vital events for a state or the entire United States by year of occurrence, either for events occurring within the state or to residents of the state. This structure clearly lends itself to the cross-sectional approach. Occasionally, researchers step outside the box and conduct studies utilizing prospective study designs, generally with one of two approaches: 1) intergenerational studies based on record linkage between the birth certificate for the index case and the birth certificate for the mother of the index case (1–3) or 2) maternally linked pregnancy outcomes based on record linkage of the birth certificate for a firstborn infant of the index mother and her subsequent birth outcomes (4). The intergenerational approach is somewhat limited due to the smaller number of statistical data fields collected on birth certificates in the past (5). Datasets with maternally linked pregnancy outcomes can be used to study birth outcomes within sibships, especially for conditions in which a prior adverse outcome (for example, low birth weight or fetal death) may be associated with an adverse outcome in a subsequent pregnancy (6).