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Prevention of Disabilities

How Can We Determine any Conclusion about the Safety of Medications Given at Birth or Any Obstetric Practice?

Adult hand holding infant's hand

Is there a cause and affect of any obstetric practice for Autism Spectrum Disorders, Cerebral Palsy or other Developmental Disabilities?  How do we know if we don’t collect the data at birth?

This Prevention Report is a call for education and training for hospitals, doctors, nurses, and other attendants of birth to lead the call  to measure quality of care outcomes and to identify  known obstetric techniques that put children at risk of disability.

Importance of Collecting Data

After the revision in 2003 of the U.S. Standard Certificate of Live Birth, the National Center for Health Statistics (NCHS) hoped to be able to report the new statistics that had been implemented. Analyzing the integrity of the information collected, they came to several conclusions including that several items were under reported. To correct these problems, improved efforts were made to train hospital staff to record the data from birth.

Although a 2011 NCHS report states that under reporting of health conditions is considered a primary limitation of both medical and birth certificate data, they state, “There is the potential for high-quality national data for many birth certificate items that appeared under reported.” (1)

In an NCHS Data brief of 2014 it was noted that that induction of labor is under reported on the birth certificate. The sensitivity of this issue is substantial from 14% to over 50% in validity studies. (2)

How can we determine any conclusion about induction of labor or that matter any sensitive issue on the birth certificate? Hospitals and doctors must be educated in the importance of recording procedures used at birth for the research for prevention.

In their 2013 report, NCHS is confident because they reported several ways that they were implementing a plan to improve the quality of birth data. E-learning training for hospital staff, promoting universal use of the standard definitions and instructions to complete the birth certificate health information, and a joint committee was reported identifying data quality issues and promoting hospital understanding of the importance and use of birth data.

The American College of Obstetricians and Gynecologists has been developing a national standardization of obstetric clinical data definitions for electronic health records and birth certificates to be incorporated for the birth certificate. (3)

With these programs already in place and the improved automation of birth data and vital statistic records mentioned above, we can address a far more comprehensive data collection on the U.S. Certificate of Live Birth. We can collect the actual conditions of birth. New manuals of course will be required for hospitals, clinics, attendants at birth and staff to be able to update to the new standard.

If we don’t collect the data, how will we ever know if Autism Spectrum Disorders, Cerebral Palsy and other Developmental Disabilities are related to birth injury and/or medications?
What other road blocks in collecting data for research do we face to find the causes of Developmental Disabilities so we might prevent disability?

If you have information about the prevention of disability, please comment or send us an e-mail.
NHU invites you to visit our Report on the Prevention of Disabilities which focuses on the prevention of Developmental Disabilities.


References
(1) CDC, National Vital Statistics Reports, Vol. 62, No. 2, July 22, 2013 pp. 9-10.

(2) Michelle J.K. Osterman, M.H.S. and Joyce A. Martin, M.P.H. “Recent Declines in Induction of Labor by Gestational Age” – CDC, NCHS Data Brief (Number 155, June 2014) pp. 1, 7 http://www.cdc.gov/nchs/data/databriefs/db155.htm (01 September 2014).

(3) CDC, National Vital Statistics Reports, Vol. 62, No. 2, July 22, 2013 pp. 9-10.

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