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Objective <p>To assess the validity of NICU admission reporting on birth certificates in a large dataset.</p> Study design <p>We compared NICU admissions on birth certificates to actual NICU admissions for all potentially viable in-hospital deliveries in Pennsylvania and South Carolina from 2006 to 2018 (<i>n</i> = 2,470,917). We used data from linked birth certificate and hospital discharge records to identify actual NICU admissions and evaluated missed NICU admissions by gestational age, mother’s race and ethnicity, and other factors.</p> Results <p>38% of infants who were truly admitted to a NICU did not have a NICU admission on their birth certificates. Missed NICU admission occurred across all gestational ages. Birth certificates missed more than half of NICU admissions among term infants (37+ weeks), including among those with conditions considered to be severe.</p> Conclusions <p>NICU admission reporting on birth certificates grossly underestimates utilization of NICU care and can have serious implications for research, resource allocation, and policy.</p>

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Birth certificate data substantially misrepresent actual NICU admissions, including among most vulnerable

  • 期刊论文

  • 发表日期：

    2026年5月27日

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  • Carolyn S. Hughes,
  • Scott A. Lorch,
  • Susan Schmitt,
  • Molly Passarella,
  • Ciaran S. Phibbs

摘要

Objective

To assess the validity of NICU admission reporting on birth certificates in a large dataset.

Study design

We compared NICU admissions on birth certificates to actual NICU admissions for all potentially viable in-hospital deliveries in Pennsylvania and South Carolina from 2006 to 2018 (n = 2,470,917). We used data from linked birth certificate and hospital discharge records to identify actual NICU admissions and evaluated missed NICU admissions by gestational age, mother’s race and ethnicity, and other factors.

Results

38% of infants who were truly admitted to a NICU did not have a NICU admission on their birth certificates. Missed NICU admission occurred across all gestational ages. Birth certificates missed more than half of NICU admissions among term infants (37+ weeks), including among those with conditions considered to be severe.

Conclusions

NICU admission reporting on birth certificates grossly underestimates utilization of NICU care and can have serious implications for research, resource allocation, and policy.