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J Registry Manag. 2010 Fall;37(3):112-20.

Validity and reliability of the Brazilian birth certificate for reporting birth defects.

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Post-graduation Program Environment and Public Health National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.



We sought to assess data validity and coding reliability of birth defects among Brazilian birth certificates (BC).


From a population of 27,945 live births delivered at 8 hospitals in 7 cities of Brazil during 2004, we compared 677 cases of birth defects identified through BC to 1,110 cases identified through a hospital-based birth defect registry.


Birth defects prevalence according to BC varied by hospital from 0.5% to 5.3%. Birth certificate sensitivity of birth defects reporting varied by hospital, from 11.4% to 66.5%. Specificity and positive and negative predictive values were above 80%. For reported cases, concordance of diagnosis was over 90% for all hospitals combined. Birth defects coding reliability, determined by kappa statistics, varied from 0.61 to 1.00 for 3-digit ICD-10 codes and 0.41 to 0.78 for 4-digit codes.


Birth certificate data underestimated birth defects prevalence among live births. Although concordance of diagnosis was high, the data should be used cautiously because of high underreporting and moderate coding reliability.

[Indexed for MEDLINE]

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