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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