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Ann Epidemiol. 2010 Jan;20(1):23-31. doi: 10.1016/j.annepidem.2009.09.003.

U.S. Maternally linked birth records may be biased for Hispanics and other population groups.

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  • 1Center for Health Research, Constella Group, Durham, NC, USA.



We sought to advance understanding of linkage error in U.S. maternally linked datasets and how the error might affect results of studies based on the linked data.


North Carolina birth and fetal death records for 1988-1997 were maternally linked (n=1,030,029). The maternal set probability, defined as the probability that all records assigned to the same maternal set do in fact represent events to the same woman, was used to assess differential maternal linkage error across race/ethnic groups.


Maternal set probabilities were lower for records specifying Asian or Hispanic race/ethnicity, suggesting greater maternal linkage error for these sets. The lower probabilities for Hispanics were concentrated in women of Mexican origin who were not born in the United States.


Differential linkage error may be a source of bias in studies that use U.S. maternally linked datasets to make comparisons between Hispanics and other groups or among Hispanic subgroups. Methods to quantify and adjust for this potential bias are needed.

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