Completeness and reliability of the National Mortality Information System for perinatal deaths in Brazil, 2011-2012: a descriptive study

Rodrigues, Patricia Lima; Gama, Silvana Granado Nogueira da; Mattos, Inês Echenique

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Epidemiologia e Serviços de Saúde

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 28 (1) • 2019 • https://doi.org/10.5123/S1679-49742019000100007 copy

Completeness and reliability of the National Mortality Information System for perinatal deaths in Brazil, 2011-2012: a descriptive study^* * This article is derived from the Doctoral thesis entitled 'Evaluation of the quality of the Mortality Information System and factors associated with perinatal mortality in Brazil', defended by Patricia Lima Rodrigues at the Postgraduate Program on Public Health Epidemiology, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, on 12 April 2017. This research was funded with resources as provided for by Call for Proposals MCT/CNPq/CT-Saúde/MS/SCTID/DECIT No. 057/2009, under the coordination of the 'Women’s, Child and Adolescent Health - Social determinants, Epidemiology and Policy Evaluation, Programs and Services' research group, National Council for Scientific and Technological Development (CNPq)/Ministry of Science, Technology, Innovation and Communication (MCTIC).

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to analyze the completeness and reliability of data on perinatal deaths held on Brazil’s Mortality Information System (SIM) in 2011-2012.

Methods:

this was a study evaluating the quality of completeness of data on perinatal deaths reported on SIM compared to data from the ‘Birth in Brazil’ survey for the same period; to evaluate reliability, we used the Kappa coefficient, the intraclass correlation coefficient (ICC) and the Bland-Altman plot method.

Results:

completeness was greater than 80%, and agreement was 0.61 for 10 of the 12 evaluated fields; aggregated gestation length (Kappa coefficient=0.542) and continuous gestation length (ICC=0.448) for early neonatal deaths and fetal deaths, respectively, had regular agreement; graphical evaluation of gestation length showed that the fetal death metric was underestimated and that early neonatal deaths were overestimated by between 25 and 35 weeks of gestation.

Conclusion:

the information analyzed available on SIM for perinatal deaths is complete and reliable for the period analyzed.

Keywords:
Date Accuracy; Vital Statistics; Perinatal Mortality; Information Systems; Death Certificates

Variables	Perinatal death	Fetal death	Early neonatal death	p -value^a
Variables	n (%)	n (%)	n (%)	p -value^a
Maternal age	377 (88.0)	190 (86.8)	147 (89.6)	0.392
Maternal schooling	292 (76.2)	162 (74.0)	130 (79.3)	0.228
Number of live births	314 (82.0)	175 (79.9)	139 (84.8)	0.222
Number of fetal losses	297 (77.5)	128 (78.0)	169 (77.2)	0.838
Gestation length	334 (87.2)	192 (87.7)	142 (86.6)	0.753
Type of pregnancy	360 (94.0)	208 (95.0)	152 (92.7)	0.350
Type of delivery	356 (93.0)	205 (93.6)	151 (92.1)	0.562
Childbirth-related death	348 (90.9)	200 (91.3)	148 (90.2)	0.717
Sex	374 (97.7)	212 (96.8)	162 (98.8)	0.311^b
Ethnicity/skin color	137 (83.5)	<20^c	137 (83.5)	<20^c
Birth weight	352 (91.9)	202 (92.2)	150 (91.5)	0.783
Underlying cause of death	382 (99.7)	218 (99.5)	164 (100.0)	1.000^b

Variables	Perinatal Death (N=210)	Fetal Death (N=102)	Early neonatal death (N=108)
Variables	(95% CI)	(95% CI)	(95% CI)
Categorical and discrete variables	Kappa Coefficient
Maternal schooling^a,h	0.687 (0.596;0.778)	0.649 (0.543;0.814)	0.678 (0.548;0.808)
Number of children born alive^b,h	0.704 (0.619;0.789)	0.881 (0.765;0.996)	0.542 (0.429;0.996)
Number of fetal losses/miscarriages^c,h	0.483 (0.342;0.624)	0.348 (0.169;0.527)	0.633 (0.444;0.822)
Type of pregnancy^d	0.942 (0.867;1.000)	1.000 (1.000;1.000)	0.931 (0.842;1.000)
Type of delivery	0.979 (0.950;1.000)	1.000 (1.000;1.000)	0.960 (0.905;1.000)
Gestation length^f,h	0.704 (0.619;0.789)	0.881 (0.765;0.996)	0.542 (0.429;0.655)
Sex	0.947 (0.900;0.993)	0.932 (0.857;1.000)	0.959 (0.903;1.000)
Continuous variables	Intraclass correlation coefficient
Maternal ageⁱ	0.999 (0.999;0.999)	0,998 (0,997-;0,999)	0,999 (0,999;1,000)
Birth weight	0.972 (0.989;0.989)	0.990 (0.985;0.994)	0.978 (0.967;0.985)
Gestation length^l	0.673 (0.540;0.768)	0.448 (0.098;0.667)	0.925 (0.881;0.953)

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
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[1] Correspondence: Patricia Lima Rodrigues - Universidade Federal do Rio de Janeiro, Rua Bruno Lobo, No. 50, Cidade Universitária, Rio de Janeiro, RJ, Brazil. Postcode: 21941-912 E-mail: patylimarodrigues@yahoo.com.br