Center for Health Policy and Research (CHPR) Publications


Accuracy of assisted reproductive technology information on the Massachusetts birth certificate, 1997-2000

UMMS Affiliation

Center for Health Policy and Rsearch

Publication Date


Document Type



Adult; *Birth Certificates; Female; Humans; Infant, Newborn; Logistic Models; Massachusetts; Medical Records; Middle Aged; Pregnancy; Reproducibility of Results; Reproductive Techniques, Assisted; Retrospective Studies; Selection Bias; Sensitivity and Specificity; Young Adult


Health Services Administration | Health Services Research | Public Health


OBJECTIVE: To evaluate the accuracy of assisted reproductive technology (ART) reporting on the Massachusetts birth certificate and to explore the individual and hospital-level characteristics associated with ART reporting.

DESIGN: Validity analysis of population-based data.

SETTING: Live-birth deliveries by Massachusetts-resident mothers during 1997-2000.

PATIENT(S): Live births and delivery mothers.

INTERVENTION(S): The ART data maintained by the Centers for Disease Control and Prevention were linked with the live birth-infant death records in Massachusetts. Successfully linked records were used as the gold standard for ART-related deliveries in evaluating the validity of the ART information reported on the Massachusetts birth certificate.

MAIN OUTCOME MEASURE(S): Sensitivity and specificity.

RESULT(S): The sensitivity of ART reporting on the birth certificate was 27% and the specificity >99%. Sensitivity of ART reporting was higher among women with multiple deliveries (twins: 32%; triplets+: 43%) and preterm deliveries (36%).

CONCLUSION(S): During the period evaluated, reporting of ART information on the birth certificate was incomplete, and ART births identified through the birth certificate were a biased sample of the population of ART births. Using delivery hospital data as the sole source of ART information for the standard birth certificate may yield inaccurate information.

DOI of Published Version



Fertil Steril. 2010 Oct;94(5):1657-61. Epub 2009 Dec 11. Link to article on publisher's site

Journal/Book/Conference Title

Fertility and sterility

Related Resources

Link to Article in PubMed