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Table 2 Individual-level validation of register measurement for stillbirth, EN-BIRTH study (n = 23,072)

From: Stillbirths including intrapartum timing: EN-BIRTH multi-country validation study

 

Bangladesh

Bangladesh

Nepal

Tanzania

Tanzania

All sites

Azimpur Tertiary

Kushtia District

Pokhara Regional

Temeke Regional

Muhimbili National

Pooled (random effects)

A) All modes of birth

 Observed stillbirth rate (per 1000 total births, 95%CI)

3.8 (2.0,7.0)

31.1 (24.6,39.1)

17.3 (14.5,20.6)

22.5 (19.2,26.4)

50.3 (43.6,58)

22.3 (10.8,37.9)

 Register recorded stillbirth rate (per 1000 total births, 95%CI)

2.7 (1.1,6.2)

25 (18.9,32.9)

15.6 (12.8,18.9)

19.2 (16.1,22.9)

43 (36.7,50.2)

18.8 (9.2,31.8)

 No birth outcome recorded %

0.04 (0,0.29)

9.04 (7.86,10.38)

1.11 (0.88,1.39)

0.26 (0.16,0.42)

1.56 (1.19,2.03)

1.49 (0.22,3.86)

 Register birth outcome not readable %

0.04 (0,0.29)

0 (0,0.23)

0.01 (0,0.09)

0.02 (0,0.10)

0.05 (0.01,0.22)

0.03 (0.01,0.06)

 Sensitivity % (95% CI)

*

83.3 (71.5,91.7)

86.1 (78.4,91.8)

77.6 (69.9,84)

77.7 (70.8,83.5)

80.3 (76.5,83.8)

 Specificity % (95% CI)

*

99.9 (99.6100)

99.9 (99.8,99.9)

99.8 (99.7,99.9)

99.5 (99.2,99.7)

99.8 (99.7,99.9)

 Percent agreement

99.9

99.4

99.7

99.3

98.4

99.4 (98.9,99.8)

B) Vaginal births

 Observed stillbirth rate (per 1000 total births, 95%CI)

13 (6.6,24.6)

36.7 (27.7,48.4)

17.8 (14.7,21.5)

21.3 (17.9,25.2)

73.5 (61.4,87.7)

29.7 (16.3,47.0)

 Register recorded stillbirth rate (per 1000 total births, 95%CI)

8.9 (3.3,21.8)

30.6 (21.9,42.3)

17.1 (14.1,20.8)

18.5 (15.4,22.3)

65.1 (53.7,78.7)

25.7 (13.9,41.0)

 No birth outcome recorded %

0 (0,0.84)

6.19 (4.93,7.74)

0.28 (0.17,0.46)

0.23 (0.13,0.4)

0.76 (0.41,1.36)

0.86 (0.11,2.29)

 Register birth outcome not readable %

0 (0,0.84)

0 (0,0.39)

0 (0,0.08)

0.02 (0,0.11)

0 (0,0.3)

0.01 (0.00,0.04)

 Sensitivity % (95% CI)

*

89.7 (75.8,97.1)

88.8 (81.2,94.1)

79.2 (71.2,85.8)

83.2 (75,89.6)

84.6 (79.8,88.9)

 Specificity % (95% CI)

*

99.8 (99.4100)

99.9 (99.7,99.9)

99.8 (99.7,99.9)

99.4 (98.8,99.7)

99.8 (99.6,99.9)

 Percent agreement

100

99.5

99.7

99.4

98.2

99.4 (99.0,99.8)

C) Caesarean births

 Observed stillbirth rate (per 1000 total births, 95%CI)

0.5 (0,3)

23.1 (15.1,35.1)

12.2 (6.8,21.4)

35.1 (21.2,56.8)

28.7 (22.1,37)

16.8 (4.2,37.5)

 Register recorded stillbirth rate (per 1000 total births, 95%CI)

0.6 (0,3.9)

17.3 (10.1,29)

4.6 (1.5,12.7)

28 (15.6,48.7)

24.7 (18.6,32.6)

12.5 (2.9,28.5)

 No birth outcome recorded %

0.06 (0,0.39)

13.02 (10.89,15.48)

6.83 (5.28,8.77)

0.65 (0.17,2.04)

2.18 (1.61,2.93)

3.20 (0.39,8.55)

 Register birth outcome not readable %

0.06 (0,0.39)

0 (0,0.55)

0.12 (0.01,0.75)

0 (0,1.02)

0.1 (0.02,0.39)

0.09 (0.02,0.18)

 Sensitivity % (95% CI)

*

71.4 (47.8,88.7)

*

73.3 (44.9,92.2)

73.7 (60.3,84.5)

71.3 (62.1,79.7)

 Specificity % (95% CI)

*

100 (99.6,100)

*

99.6 (98.4,99.9)

99.6 (99.2,99.8)

99.8 (99.6,100.0)

 Percent agreement

99.9

99.3

99.8

98.7

98.8

99.4 (98.8,99.8)

  1. *Validity statistics not shown where < 10 count in either column of two-by-two table
  2. Observed: all modes of birth n = 23,072, vaginal births n = 16,284, caesarean birth n = 6769; Register: all modes of birth n = 21,401, vaginal births n = 15,458, and caesarean births n = 5926