American Journal of Epidemiology Vol. 148, No. 11: 1048-1054
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Completeness of Ascertainment of Prenatal Smoking using Birth Certificates and Confidential Questionnaires
Variations by Maternal Attributes and Infant Birth Weight
1Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention Atlanta, GA
2Office of Perinatal Epidemiology, Division of Public Health, Georgia Department of Health and Human Services Atlanta, GA
Birth certificate data frequently are used to monitor the prevalence of smoking during pregnancy. The authors used a two-sample capture-recapture method to estimate the completeness of ascertainment of prenatal smoking on birth certificates and on confidential questionnaires in six US states. Completeness of ascertainment was also examined according to maternal attributes and infant birth weight. The samples included white women who delivered a live infant between 1993 and 1995 in one of six states (Alabama, Alaska, Georgia, Maine, South Carolina, or West Virginia) and who responded to a questionnaire mailed to them 2–6 months postpartum as part of the Pregnancy Risk Assessment Monitoring System. State-specific sample sizes ranged from 2, 647 to 4, 795. The completeness of ascertainment ranged from 70.6% to 82.0% using birth certificates and from 86.2% to 90.3% using confidential questionnaires. In all six states, the birth certificates‘ completeness of ascertainment varied by maternal education and infant birth weight, and the questionnaires’ completeness varied by maternal age. Both birth certificates and questionnaires underestimated the true extent of smoking during pregnancy among these white women. Differential reporting by birth weights recorded on birth certificates would result in an overestimated association between low birth weight and prenatal smoking. Am J Epidemiol 1998; 148: 1048-54.
bias (epidemiology); birth certificates; data collection; methods; pregnancy; pregnancy outcome; smoking; vital statistics
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