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about live birth data

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  • For each data source, information about data collection and analytical methods, limitations, the citation and additional resources can be found on the Data Sources and Methods page.

SOURCE

Original source: Ontario Office of the Registrar General (ORG)

Cite as: Ontario Live Birth Database 1986-2011, IntelliHEALTH Ontario, Ministry of Health and Long-Term Care

METHODS

Data Collection Methods

  • Information on live births is collected by the Office of the Registrar General (ORG) using the birth registration form completed by parents and the Physician Notice of Birth or Stillbirth form (PNOB).
  • Live birth registration is required by law.

Data Analysis Methods

  • Data are based on geographic place of residence of the infant and not location of live birth.
  • Rates and proportions based on counts less than five (5) are suppressed.
  • Births to out-of-province mothers have been excluded from analyses and may affect areas bordering Quebec and Manitoba.
  • Rates are calculated based on the current APHEO core indicator recommendations:
    • The denominator for rates may be: all live births, all live births among a specific age group, all births (including live births and stillbirths) or all pregnancies (including live births, stillbirths and therapeutic abortions). The denominator will depend on the indicator being examined.
    • Due to changes in registration practices of births at the borderline of viability, both crude rates and birth weight-specific rates should be considered.
  • Include live births with birth weight less than 500 grams. It is recognized that there has been an observed increase in the number of registered live births with a birth weight of less than 500 grams across Canada.
  • Region of birth of mother is defined based on the mother's country of birth. Countries included in each of the categories are as follows:
Region of Birth Countries included
Canada All provinces and territories
South Asia BANGLADESH, INDIA, PAKISTAN, SRI LANKA, BHUTAN, NEPAL
East Asia BRUNEI DARUSSALAM, CAMBODIA, CHINA, HONG KONG, INDONESIA, JAPAN, KOREA NORTH, KOREA SOUTH, LAOS, MACAU, MALAYSIA, MYANMAR, PHILIPPINES, SINGAPORE, TAIWAN, THAILAND, VIET NAM
Caribbean ANTIGUA AND BARBUDA, BAHAMAS, BARBADOS, BERMUDA, CAYMAN ISLANDS, CUBA, DOMINICA, DOMINICAN REPUBLIC, GRENADA, HAITI, JAMAICA, MONTSERRAT, NETHERLANDS ANTILLES, PUERTO RICO, SAINT KITTS AND NEVIS, SAINT LUCIA, SAINT VINCENT AND THE GRENADINES, TRINIDAD AND TOBAGO, TURKS AND CAICOS ISLANDS, VIRGIN ISLANDS, BRITISH WEST INDIES / CARIBBEAN (STC CODE)
Africa AFRICA (STC CODE), ANGOLA, BENIN, BOTSWANA, BURKINA FASO, BURUNDI, CAMEROON, CAPE VERDE, CENTRAL AFRICAN REPUBLIC, CHAD, CONGO, CONGO (THE DEMOCRATIC REPUBLIC OF), COTE DIVOIRE, DJIBOUTI, EQUATORIAL GUINEA, ERITREA, ETHIOPIA, GABON, GAMBIA, GHANA, GUINEA, KENYA, LIBERIA, LESOTHO, MADAGASCAR, MALAWI, MALI, MAURITANIA, MAURITIUS, MOZAMBIQUE, NAMIBIA, NIGER, NIGERIA, RWANDA, REUNION, SENEGAL, SEYCHELLES, SIERRA LEONE, SOMALIA, SOUTH AFRICA, SWAZILAND, TANZANIA (UNITED REPUBLIC OF), TOGO, UGANDA, ZAMBIA, ZIMBABWE
Other All others not listed above

LIMITATIONS

  • The information within the Vital Statistics dataset is provided by both the parents (birth registration form) and the Physician Notice of Live Birth or Stillbirth form (PNOB). Both forms must be received by the ORG for the birth to be registered. Although live birth registration is required by law, changes in registration practices and the institution of registration fees decreased the proportion of births which were registered in the period 1991 through 1997, when approximately 1% of live births were unregistered. Unregistered births were more likely within urban populations and among younger mothers and lower birth weight births.
  • The number of births registered in some areas changed dramatically starting in 1991 when the Office of the Registrar General moved from Toronto to Thunder Bay. In addition, registration fees initiated in some areas in 1996 may have reduced the number of infants registered, especially for low income and/or adolescent parents. Municipal fees have now been eliminated so that this is no longer an issue with more recent data.
  • Data using the parent registration form may be subject to some recall bias.
  • There are possible errors in the birth data file related to assignment of municipality of residence/census subdivision of mother.
  • The duration of pregnancy field has also had some problems. Up until 1990 the ORG used the Physician Notification of Birth form as a gold standard for entering gestation age when the two forms disagreed. However, in 1990 the ORG stopped using the PNOB as the gold standard and switched to using the parent's form. As of June 1998 the ORG has switched back to using the PNOB as the gold standard. For the data from 1990 to 1998, ORG undertook a project to review gestation age data for those births with an age of 36 weeks or less entered. If the age on the forms disagreed they re-entered the age using the PNOB. Prior to these corrections the provincial rate of pre-term births for the time period between 1990 and June 1998 averaged approximately 9%. Preliminary results from the re-entry project indicate that as a result of the corrections the rate in the same time period averaged between 5.9% and 6.2%. Currently accessible data do not contain this 'corrected' variable and therefore calculation of pre-term births will likely result in overestimates.
  • Through their work linking birth and death records, the Perinatal Infant Mortality Study Group has identified a number of data quality problems with the Ontario birth file. The magnitude of these problems has not been documented. They are presented here for information:
    • In attempting to link live birth and infant death records it appeared that there was a underreporting of live births,
    • There appeared to be an underreporting of stillbirths in 1990,
    • Fluctuations in proportions of infants with birth weight < 500 grams suggests underreporting or misclassification of borderline viable infants,
    • In multiple births, not all infants were accounted for,
    • Duplicate and late registrations of births,
    • Missing analytical variables, and
    • No copy of the original information to verify and/or correct these errors.
  • Missing entry of infants from multiple births.

REFERENCES AND RESOURCES

  1. Ennis SL, Woodward GL, Ardal S. Low Birth Weight: Troubling Trend or Misguided Measure (Extended Mix): A CEHIP Discussion Paper. Central East Health Information Partnership, May 2000.
  2. Woodward GL, Ardal S. Data Quality Report: Effect of Residence Code Errors on Fertility Rates. Central East Health Information Partnership, July 2000.
  3. Health Canada. Perinatal Health Indicators for Canada: A Resource Manual. Ottawa: Minister of Public Works and Government Services Canada, 2000.
  4. Joseph KS, Kramer MS. Recent trends in Canadian infant mortality rates: the effect of changes in registration of live newborns weighing less than 500g. Can Med Assoc J 1996; 155:1047-52.


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