Birth and fetal death records and environmental exposures: promising data elements for environmental public health tracking of reproductive outcomes.

Abstract

We inventoried and reviewed the birth and fetal death certificates of all 50 U.S. states to identify nonstandard data items that are environmentally relevant, inexpensive to collect, and might enhance environmental public health tracking. We obtained online or requested by mail or telephone the birth certificate and fetal death record forms or formats from each state. Every state data element was compared to the 2003 standards promulgated by the National Center for Health Statistics to identify any items that are not included on the standard. We then evaluated these items for their utility in environmentally related analyses. We found three data fields of potential interest. First, although every state included residence of mother at time of delivery on the birth certificate, only four states collected information on how long the mother had lived there. This item may be useful in that it could be used to assess and reduce misclassification of environmental exposures among women during pregnancy. Second, we found that father's address was listed on the birth certificates of eight states. This data field may be useful for defining paternal environmental exposures, especially in cases where the parents do not live together. Third, parental occupation was listed on the birth certificates of 15 states and may be useful for defining parental workplace exposures. Our findings were similar for fetal death records. If these data elements are accurate and well-reported, their addition to birth, fetal death, and other health records may aid in environmental public health tracking.