Validating the Use of ICD-9-CM Codes to Evaluate Gestational Age and Birth Weight.

摘要

The objective of this study was to determine the accuracy of International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) derived gestational age and birth weight data in the Department of Defense (DoD) Birth and Infant Health Registry (Registry). We compared Registry data and1858 randomly selected birth records from 17 DoD hospitals (gold standard), with oversampling for infants with birth defects. We performed extraction of record information and matching subject data to Registry data to assess birth outcome agreement. Of the 1858 reviewed infant records, 1700 met inclusion criteria, with 1669 records successfully matched to the Registry for analyses. Despite small differences in parental demographics, our investigation revealed exceptional agreement for our primary outcomes: kappa of 0.83 for preterm and 0.87 for low weight births. Subgroup analyses revealed no significant differences in birth outcome agreement based on the presence of a birth defect, or military parent rank, race/ethnicity, and branch of military service. This study demonstrates that ICD-9-CM codes provide an accurate assessment of preterm and low weight birth outcomes captured in this large birth and infant health registry. These results strengthen data integrity evidence for investigators examining parental occupational exposures and birth outcomes among service member families.