The reliability and validity of birth certificates.

OBJECTIVES: To summarize the reliability and validity of birth certificate variables and encourage nurses to spearhead data improvement. DATA SOURCES: A Medline key word search of reliability and validity of birth certificate, and a reference review of more than 60 articles were done. STUDY SELECTION: Twenty-four primary research studies of U.S. birth certificates that involved validity or reliability assessment. DATA EXTRACTION: Studies were reviewed, critiqued, and organized as either a reliability or a validity study and then grouped by birth certificate variable. DATA SYNTHESIS: The reliability and validity of birth certificate data vary considerably by item. Insurance, birthweight, Apgar score, and delivery method are more reliable than prenatal visits, care, and maternal complications. Tobacco and alcohol use, obstetric procedures, and delivery events are unreliable. Birth certificates are not valid sources of information on tobacco and alcohol use, prenatal care, maternal risk, pregnancy complications, labor, and delivery.
CONCLUSIONS: Birth certificates are a key data source for identifying causes of increasing U.S. infant mortality but have serious reliability and validity problems. Nurses are with mothers and infants at birth, so they are in a unique position to improve data quality and spread the word about the importance of reliable and valid data. Recommendations to improve data are presented.