Deletion of Data Items from the Birth and Fetal Death National Files

The National Association for Public Health Statistics and Information Systems and the National Center for Health Statistics (NAPHSIS/NCHS) Good-to-Great Committee has worked collaboratively to improve the timeliness and quality of the National Vital Statistics System.  The Birth Data Quality Workgroup (BDQWG) was tasked with reviewing items on the 2003 national standard birth and fetal death data files and determining which, if any, should be cut from the files due to poor data quality and lack of potential for improvement. After careful deliberation, in June 2014, the Work Group recommended that several items be dropped from the national files. The Good-to-Great Committee firmly endorsed these recommendations, which were presented at the NAPHSIS Annual Meeting in Seattle, Washington in June 2014.

The BDQWG continued its review over the past year and recommends that additional items be dropped from the national files.  These recommendations were also endorsed by the Good-to-Great Committee and presented at the NAPHSIS Annual Meeting in Pittsburgh in June 2015. This email serves as official notification of these changes to all jurisdictions.  

 

Items dropped from the national birth file:  

• Mother ever married (not standard marital status item or on standard birth certificate but part of national file)
• Date of last prenatal care visit*
• Premature rupture of the membranes >=12 hours (Onset of labor**)
• Precipitous labor <3 hours (Onset of labor**)
• Prolonged labor => 20 hours(Onset of labor**)
• Tocolysis (Obstetric procedure)
• Cervical cerclage (Obstetric procedure)
• Unplanned operating room procedures (Maternal morbidity)
• Significant birth injury (Abnormal condition of the Newborn)
• Other previous poor pregnancy outcomes (Risk Factors in this Pregnancy)*
• Moderate/heavy meconium staining of the amniotic fluid  (Characteristics of Labor and Delivery) *
• Fetal intolerance of labor (Characteristics of Labor and Delivery)* 

 

Items dropped from the national fetal death file:  

• Mother ever married (not standard marital status item or on standard fetal report but part of national file)
• Mother married? (At delivery, conception or anytime between)
• Total number of prenatal visits for this pregnancy
  • Edit flag - Total number of prenatal visits for this pregnancy
• Date of last prenatal care visit*
• Mother’s weight at delivery
  • Edit flag – Mother’s weight at delivery
• Number of other pregnancy outcomes
• Date of last other pregnancy outcome
• Mother/patient transferred for maternal medical or fetal indications for delivery?
• Previous preterm birth (Risk factors for this pregnancy)
• Other previous poor pregnancy outcomes (Risk factors for this pregnancy)*
• Gonorrhea (Infections present and/or treated during this pregnancy**)
• Syphilis (Infections present and/or treated during this pregnancy**)
• Chlamydia (Infections present and/or treated during this pregnancy**)
• Listeria (Infections present and/or treated during this pregnancy**)
• Group B strep (Infections present and/or treated during this pregnancy**)
• Cytomegalovirus (Infections present and/or treated during this pregnancy**)
• Parvovirus (Infections present and/or treated during this pregnancy**)
• Toxoplasmosis (Infections present and/or treated during this pregnancy**)
• Other (Specify)  (Infections present and/or treated during this pregnancy**)
• Hysterotomy/hysterectomy (Method of delivery)
• Maternal transfusion (Maternal morbidity)
• Third or fourth degree perineal laceration (Maternal morbidity)
• Unplanned hysterectomy (Maternal morbidity)
• Unplanned operating room procedure (Maternal morbidity)
• Anencephaly (Congenital anomalies of the fetus**)
• Meningomyelocele/Spina bifida (Congenital anomalies of the fetus**)
• Cyanotic congenital heart disease (Congenital anomalies of the fetus**)
• Congenital diaphragmatic hernia (Congenital anomalies of the fetus**)
• Omphalocele (Congenital anomalies of the fetus**)
• Gastroschisis (Congenital anomalies of the fetus**)
• Limb reduction defect (Congenital anomalies of the fetus**)
• Cleft Lip with or without Cleft Palate (Congenital anomalies of the fetus**)
• Cleft palate alone (Congenital anomalies of the fetus**)
• Down syndrome- karyotype confirmed/pending (Congenital anomalies of the fetus**)
• Suspected Chromosomal disorder - karyotype confirmed/pending (Congenital anomalies of the fetus**)
• Hypospadias (Congenital anomalies of the fetus**)

*Item previously announced as dropped from the national birth file.

**All checkboxes on the national standard under this category have been dropped.

 

When will the changes be implemented?

Effective immediately, for data year 2014/2015 and beyond, NCHS no longer requires data be sent for these items. NCHS is in the process of disabling validations and verifications for the dropped items and will no longer follow-up with the jurisdictions on data issues with these items.  It is entirely at the discretion of each of the individual jurisdictions whether or not to continue to collect these data items.

NCHS will make changes to the NCHS file layouts, U.S. Standard Facility Worksheets and to the Guide to Completing the Facility Worksheets for the Certificate of Live Birth and Report of Fetal Death as soon as possible.

 

How will the changes be implemented? 

No changes are necessary on the part of the jurisdictions; NCHS will continue to accept data for these items exactly as it has in the past. When you make changes in your systems in the future, you can drop those items in your system at that point in time. However, the option to continue to collect these data items is completely yours.  

These items will NOT be included in 2014 and later year NCHS public data files. 

 

Will there be additional items dropped?

The BDQWG has completed its review of items based on the data quality information currently available.  No further reviews are planned.  This Group is working hard to improve the quality of birth data via improved engagements with birthing hospitals and the development of effective e-learning training for hospital staff among other efforts. 

 

Items previously dropped from the national files

Please remember that an earlier review had resulted in the dropping of three other items from the national birth and/or national fetal death files effective with the 2011 data.  They were

• Non-vertex presentation (Characteristics of Labor and Delivery)
• Was delivery with forceps attempted by unsuccessful? (Method of Delivery) (Also dropped for fetal deaths.)
• Was delivery with vacuum attempted by unsuccessful? (Method of Delivery) (Also dropped for fetal deaths.)

If there are any questions about the dropping of data items, please feel free to contact Joyce Martin (jcm9@cdc.gov), David Justice (dwj2@cdc.gov), or Delton Atkinson (dxa9@cdc.gov)