THE SURVEILLANCE OF BIRTH-DEFECTS - THE USEFULNESS OF THE REVISED US STANDARD BIRTH CERTIFICATE

To assess the sensitivity and positive predictive value of birth defec ts reported on the 1989 revision of the US Standard Birth Certificate, a population of 76 862 Atlanta-area births during 1989 and 1990 was u sed as the basis for comparing 771 birth certificates that reported bi rth defects with 2428 live-born infant records in a birth defects regi stry that uses multiple sources of case ascertainment. Only 14% of bir th defects in the registry records were reported on birth certificates . After the analysis was restricted to defects recognizable at birth, the sensitivity and positive predictive value of the birth certificate s were 28% and 77%, respectively. Birth certificates underestimate bir th defect rates and should be used cautiously for birth defect surveil lance and epidemiological studies.