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A Quality Study of a Medical Birth Registry
Abstract
A quality control study was made of the Swedish Medical Birth Registry. This registry used one mode of data collection during 1973-1981 and another from 1982 onwards. The number of errors in the register was checked by comparing register information with a sample of the original medical records, and the variability in the use of diagnoses between hospitals was studied. Different types of errors were identified and quantified and the efficiency of the two methods of data collection evaluated.
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“We based our study on the Swedish Medical Birth Register (MBR), which contains approximately 99% of all deliveries occurring in the country [28].”
From The effect of swedish snuff (snus) on offspring birthweight: a sibling analysis (2013) · cites this paper as [28]
In the citing paper
“Our analyses are based on a nationwide birth registry covering nearly 99% of the deliveries occurring in Sweden [28].”
From The effect of swedish snuff (snus) on offspring birthweight: a sibling analysis (2013) · cites this paper as [28]
Citations
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MethodMultiple malformations and maternal smoking
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Human Chorionic Gonadotropin in Pregnancy and Maternal Risk of Breast Cancer
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“Birth characteristics and different dimensions of intellectual performance in young males: a nationwide population-based study EM Lundgren1, S Cnattingius2, B Jonsson1 and T Tuvemo1 Department of Women’s and Children’s Health1, Uppsala University, Uppsala; Department of Medical Epidemiology2, Karolinska Institute, Sto…”
BackgroundInfluentialSelf-citationSocial adversity, migration and hospital admissions for childhood asthma in Sweden
Hjern, A., Haglund, B., Bremberg, S. G., & Weitoft, G. R. (1999) · Acta Paediatrica · doi:10.1080/08035259950168171 · Cited by 41
Relationship of Maternal Snuff Use and Cigarette Smoking With Neonatal Apnea
Gunnerbeck, A., Wikström, A.-K., Bonamy, A.-K. E., Wickström, R., & Cnattingius, S. (2011) · Pediatrics · doi:10.1542/peds.2010-3811 · Cited by 51
Self-citationCarlander, A., Hultstrand, J. N., Reuterwall, I., Jonsson, M., Tydén, T., & Kullinger, M. (2023) · PLoS ONE · doi:10.1371/journal.pone.0286052 · Cited by 40
Berglind, D., Willmer, M., Näslund, E. B., Tynelius, P., Sørensen, T. I. A., & Rasmussen, F. E. (2013) · Pediatric Obesity · doi:10.1111/j.2047-6310.2013.00205.x · Cited by 40
“1Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; 2Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden; 3Institute of Preventive Medicine, Bispebjerg and Frederiksberg University Hospital, Copenhagen, The Capital Region, Denmark Received 26 April…”
MethodInfluentialPredicting Risk of Spontaneous Preterm Delivery in Women with a Singleton Pregnancy
Morken, N., Källén, K., & Jacobsson, B. (2013) · Paediatric and Perinatal Epidemiology · doi:10.1111/ppe.12087 · Cited by 40
Andolf, E. G., Thorsell, M., & Källén, K. (2010) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2010.07.013 · Cited by 40
Juárez, S., & Revuelta-Eugercios, B. (2015) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-015-0157-5 · Cited by 40
“We based our study on the Swedish Medical Birth Register (MBR), which contains approximately 99 % of all deliveries in the country [24].”
Remaeus, K., Stephansson, O., Johansson, K., Granath, F. N., & Hellgren, K. E. (2019) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.15836 · Cited by 40
Løvvik, T. S., Wikström, A., Neovius, M., Stephansson, O., Roos, N., & Vanky, E. (2015) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.13339 · Cited by 41
Some neonatal risk factors for adult pulmonary arterial hypertension remain unknown
Naumburg, E., Axelsson, I., Huber, D., & Söderström, L. (2015) · Acta Paediatrica · doi:10.1111/apa.13205 · Cited by 39
Derraik, J. G. B., Ahlsson, F., Diderholm, B., & Lundgren, M. (2015) · Scientific Reports · doi:10.1038/srep16692 · Cited by 39
Bröms, G., Granath, F. N., Stephansson, O., & Kieler, H. (2016) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365521.2016.1208269 · Cited by 39
Routine ultrasound screening in the third trimester: a population‐based study
Sylvan, K., Ryding, E. L., & Rydhstroem, H. (2005) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/j.0001-6349.2005.00649.x · Cited by 39
“was performed during a period when new methods for estimation of gestational duration were not available (12).”
BackgroundMethodInfluentialÅberg, A., Rydhström, H., Källén, B. A. J., & Källén, K. (1997) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/j.1600-0412.1997.tb07847.x · Cited by 39
Self-citationThe Effects of Twins, Parity and Age at First Birth on Cancer Risk in Swedish Women
Neale, R. Ε., Darlington, S., Murphy, M. F., Silcocks, P., Purdie, D. M., & Talbäck, M. (2005) · Twin Research and Human Genetics · doi:10.1375/1832427053738809 · Cited by 39
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“The Swedish Medical Birth Registry collects standardized information on nearly all pregnancies in Sweden that culminate in delivery (15).”
BackgroundVitamin D Status at Birth and Future Risk of Attention Deficit/Hyperactivity Disorder (ADHD)
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“Demographic and obstetric information on the mothers and the infants was obtained from the SMBR by using their personal identification numbers.”
InfluentialSurgically Induced Interpregnancy Weight Loss and Prevalence of Overweight and Obesity in Offspring
Willmer, M., Berglind, D., Sørensen, T. I. A., Näslund, E. B., Tynelius, P., & Rasmussen, F. E. (2013) · PLoS ONE · doi:10.1371/journal.pone.0082247 · Cited by 38
“A database was created using record-linkage between the Swedish Medical Birth Register, which covers 99% of all births in Sweden [23], the Hospital Discharge Register, which contains information about all bariatric operations performed in Sweden, the Cause of Death Register (in order to exclude those women who had die…”
MethodInfluentialFrid, C., Drott, P., Olausson, P. O., Sundelin, C., & Annerén, G. (2004) · Acta Paediatrica · doi:10.1111/j.1651-2227.2004.tb00683.x · Cited by 38
“Limitations of the present study to be recognized were the deficiencies inherent in the Medical Birth Register concerning the reported medical diagnoses (10).”
BackgroundMethodViktorin, A., Lichtenstein, P., Lundholm, C., Almqvist, C., D'Onofrio, B. M., Larsson, H., Landén, M., & Magnusson, P. K. E. (2016) · International Journal of Epidemiology · doi:10.1093/ije/dyv351 · Cited by 38
Kuja‐Halkola, R., Juto, K. L., Skoglund, C. B., Rück, C., Mataix‐Cols, D., Pérez-Vigil, A., Larsson, J. K., Hellner, C., Långström, N., Petrović, P., et al. (2018) · Molecular Psychiatry · doi:10.1038/s41380-018-0248-5 · Cited by 41
“The Medical Birth Register [24] provided sex and birth date; we included everyone born between 1 January 1979 and 31 December 2001 (2,319,694 individuals).”
Mid‐trimester ultrasound prediction of gestational age: advantages and systematic errors
Källén, K. (2002) · Ultrasound in Obstetrics and Gynecology · doi:10.1046/j.1469-0705.2002.00855.x · Cited by 38
Czeizel, A. E. (2009) · Expert Opinion on Drug Safety · doi:10.1517/14740330902916459 · Cited by 38
“At the first visit to the antenatal care clinic (usually during gestation weeks 10 – 12), the pregnant women is interviewed by a midwife for about 1 h including questions regarding drug use during the first trimester [88].”
MethodLundgren, E. M., Cnattingius, H. M. S., Jonsson, G. B., & Tuvemo, T. (2001) · Journal of Hypertension · doi:10.1097/00004872-200109000-00003 · Cited by 38
Chronic hypertension as a risk factor for offspring to be born small for gestational age
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“In Sweden a population-based birth weight standard, where the growth curves are based on ultrasonically estimated intrauterine weights (18), is used.”
MethodInfluentialMortality in infants of obese mothers: is risk modified by mode of delivery?
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“The Swedish Medical Birth Register was established in 1973 and includes more than 99% of all births in Sweden (21).”
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“The Swedish Medical Birth Registry provides data on 98–99% of Swedish births (8).”
BackgroundSkalkidou, A., Kieler, H., Stephansson, O., Roos, N., Cnattingius, S., & Haglund, B. (2010) · Epidemiology · doi:10.1097/ede.0b013e3181f3a660 · Cited by 37
“Among the strengths of this study is the use of a registry with highly reliable data.(28) The study was population-based, and included more than 1 million births (n 1,194,266), and controlled for possible confounding factors such as level of hospital, maternal age, and parity.”
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Olsson, D., Ekström, M., & Forsberg, B. (2012) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph9010272 · Cited by 37
“The Medical Birth Registry has existed in Sweden since 1973, is almost complete (99%) and of very high quality [23].”
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Self-citationFetal growth and systolic blood pressure in young adulthood: the Swedish Young Male Twins Study
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“Since 1973, all children born in Sweden have been recorded in the national Medical Birth Register together with birth characteristics of the children and mothers (37).”
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“The Medical Birth Register contains prospectively collected information on more than 99% of all births in Sweden since 1973 [12].”
BackgroundSørbye, L. M., Cnattingius, S., Skjærven, R., Klungsøyr, K., Wikström, A., Kvalvik, L. G., & Morken, N. (2020) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.16364 · Cited by 37
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Self-citationWomen who gave birth to girls with Turner syndrome: maternal and neonatal characteristics
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Tanghöj, G., Odermarsky, M., Naumburg, E., & Liuba, P. (2016) · Pediatric Cardiology · doi:10.1007/s00246-016-1507-3 · Cited by 35
“Cardiovascular malformations affect approximately 800 children per year in Sweden [1, 2].”
MethodInfluentialThe influence of maternal childhood and adulthood social class on the health of the infant
Gisselmann, M. (2006) · Social Science & Medicine · doi:10.1016/j.socscimed.2006.03.015 · Cited by 35
Ladfors, L., Mattsson, L.-Å., Eriksson, M., & Milsom, I. (2000) · Journal of Perinatal Medicine · doi:10.1515/jpm.2000.066 · Cited by 35
“[2] Cnattingius S, A Ericson, J Gunnarskog, B Kallen:”
BackgroundMethodNeonatal mortality in the Czech Republic during the transition
Koupilová, I., McKee, M., & Holčı́k, J. (1998) · Health Policy · doi:10.1016/s0168-8510(98)00048-7 · Cited by 35
Pregnancy Outcome and Infant Mortality in Diabetic Patients in Sweden
Cnattingius, S., Berne, C., & Nordström, M. (1994) · Diabetic Medicine · doi:10.1111/j.1464-5491.1994.tb00335.x · Cited by 35
Self-citationThe changing panorama of late fetal death in Sweden between 1984 and 1991
Ahlenius, I., & Thomassen, P. A. B. (1999) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1034/j.1600-0412.1999.780512.x · Cited by 35
“The Register now includes more than 99% of all births in Sweden (7).”
BackgroundInfluentialBirth outcomes among women exposed to neuraminidase inhibitors during pregnancy
Svensson, T., Granath, F. N., Stephansson, O., & Kieler, H. (2011) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.2194 · Cited by 34
“The accordance between Swedish register diagnoses and review of medical records is high.(14) We used the MBR to identify all women giving birth to singletons between 1 July 2005 and 31 December 2007.”
MethodGestational age differences in health and development among young Swedish men born at term
Yang, S., Bergvall, N., Cnattingius, S., & Kramer, M. S. (2010) · International Journal of Epidemiology · doi:10.1093/ije/dyq070 · Cited by 34
Self-citationChen, Q., Kuja-Halkola, R., Sjölander, A., Serlachius, E., Cortese, S., Faraone, S., Almqvist, C., & Larsson, H. (2017) · Journal of Child Psychology and Psychiatry and Allied Disciplines · doi:10.1111/jcpp.12686 · Cited by 39
“The Swedish Medical Birth Register provides information on approximately 98% of all births in Sweden since 1973 (Cnattingius et al., 1990).”
BackgroundPreterm Birth is Associated With Increased Blood Pressure in Young Adult Women
Skudder‐Hill, L., Ahlsson, F., Lundgren, M., Cutfield, W. S., & Derraik, J. G. B. (2019) · Journal of the American Heart Association · doi:10.1161/jaha.119.012274 · Cited by 33
“Data from the conscript register were subsequently linked to the Swedish Birth Register, which records information on >99% of all births in Sweden with a low error rate for key parameters.(10) Gestational age at birth was estimated from the date of the last menstrual period for the majority of participants, otherwise…”
MethodNorrman, E., Petzold, M., Clausen, T. D., Henningsen, A. K. A., Opdahl, S., Pinborg, A. B., Rosengren, A., Bergh, C., & Wennerholm, U. (2019) · Human Reproduction · doi:10.1093/humrep/dez227 · Cited by 35
Polycystic ovary syndrome and extremely preterm birth: A nationwide register-based study
Valgeirsdottir, H., Poromaa, I. S., Kallak, T. K., Vanky, E., Akhter, T., Roos, N., Stephansson, O., & Wikström, A. (2021) · PLoS ONE · doi:10.1371/journal.pone.0246743 · Cited by 34
The validity of the diabetes mellitus diagnosis in the Medical Birth Registry of Norway
Stene, L. C., Eidem, I., Vangen, S., Joner, G., Irgens, L. M., & Moe, N. (2009) · Norsk Epidemiologi · doi:10.5324/nje.v17i2.158 · Cited by 34
Julihn, A., Ekbom, A., & Modéer, T. (2009) · European Journal of Epidemiology · doi:10.1007/s10654-009-9399-7 · Cited by 34
“The register’s quality has been evaluated three times: in 1976, in 1988, and in 2001 [30, 31].”
BackgroundShoulder dystocia and brachial plexus injury: a case-control study
Christoffersson, M., Kannisto, P., Rydhstroem, H., Stale, H., & Walles, B. (2003) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1034/j.1600-0412.2003.00079.x · Cited by 34
Space–time clustering of childhood lymphatic leukaemias and non-Hodgkin's lymphomas in Sweden
Gustafsson, B. M., & Carstensen, J. M. (2000) · European Journal of Epidemiology · doi:10.1023/a:1010953713048 · Cited by 34
Hogberg, L., Lundholm, C., Cnattingius, S., Öberg, A. S., & Iliadou, A. N. (2012) · Human Reproduction · doi:10.1093/humrep/des380 · Cited by 33
“This information was obtained from the Medical Birth Register (1973– 2009), which holds information 98% of all births in Sweden (Cnattingius et al., 1990).”
MethodInfluentialSelf-citationFetal and perinatal risk factors for inflammatory bowel disease
Aspberg, S., Dahlquist, G. G., Kahan, T., & Källén, B. A. J. (2006) · Acta Paediatrica · doi:10.1080/08035250600573151 · Cited by 33
“The Swedish Medical Birth Register contains information on the pregnancy and the perinatal period for nearly all infants born in Sweden since 1973 [15,16].”
BackgroundSelf-citationDo foreign-born women in Sweden have an increased risk of non-normal childbirth?
Robertson, E. K., Malmström, M., & Johansson, S. (2005) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/j.0001-6349.2005.00686.x · Cited by 33
“This register contains data on more than 99% of all births in Sweden from 1973 onward, with information from all Swedish antenatal care clinics and delivery units (17).”
BackgroundMethodWikström, A., Gunnarsdóttir, J., & Cnattingius, S. (2012) · BMJ Open · doi:10.1136/bmjopen-2012-001178 · Cited by 33
“MATERIAL AND METHOD The Swedish Medical Birth Register, held by the Swedish National Board of Health and Welfare, contains data on more than 98% of all births in Sweden since 1973, including demographic data, information on reproductive history and complications during pregnancy, delivery and the neonatal period.(19)…”
MethodSelf-citationGraner, S., Svensson, T., Beau, A., Damase‐Michel, C., Engeland, A., Furu, K., Hviid, A. P., Håberg, S. E., Mølgaard‐Nielsen, D., Pasternak, B., et al. (2017) · BMJ · doi:10.1136/bmj.j629 · Cited by 33
Gisselmann, M. (2004) · Scandinavian Journal of Public Health · doi:10.1080/14034940410028352 · Cited by 33
“The quality of the data sources is generally considered to be very good [14,15].”
BackgroundInfectious and inflammatory mechanisms in preterm birth and cerebral palsy
Jacobsson, B. (2004) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2003.11.014 · Cited by 32
Weight‐for‐length model in newborn Swedish infants
Niklasson, A., & Karlberg, P. (1993) · Acta Paediatrica · doi:10.1111/j.1651-2227.1993.tb12691.x · Cited by 33
Temporal trends in incidence and outcome of hydatidiform mole: a retrospective cohort study
Joneborg, U., Folkvaljon, Y., Papadogiannakis, N., Lambe, M. P., & Marions, L. (2018) · Acta Oncologica · doi:10.1080/0284186x.2018.1438653 · Cited by 32
“during pregnancy, delivery and the neonatal period [27].”
BackgroundAdverse pregnancy outcomes and risk of later allergic rhinitis—Nationwide Swedish cohort study
Mitselou, N., Hallberg, J., Stephansson, O., Almqvist, C., Melén, E., & Ludvigsson, J. F. (2020) · Pediatric Allergy and Immunology · doi:10.1111/pai.13230 · Cited by 32
Refining the Apgar score cut-off point for newborns at risk
Chong, D., & KARLBERG, J. P. E. (2004) · Acta Paediatrica · doi:10.1080/08035250310007295 · Cited by 32
Use of an Automated Database to Evaluate Markers for Early Detection of Pregnancy
Manson, J. M. (2001) · American Journal of Epidemiology · doi:10.1093/aje/154.2.180 · Cited by 32
Noncardiac Malformations at Major Congenital Heart Defects
Pradat, P. (1997) · Pediatric Cardiology · doi:10.1007/s002469900101 · Cited by 32
“tions. A classification based on 26 groups was devised and is presented in Table 1. The Swedish Medical Birth Registry [ 5 ] was used in a special study of all infants born during the period 1981‐1990 with an upper-limb reduction defect and a cardiac anomaly.”
MethodBerg, P., & Lindelöf, B. (2002) · Pediatric Dermatology · doi:10.1046/j.1525-1470.2002.00086.x · Cited by 32
“Since thediagnosis CNN is given at birth and registered in the SMBR (25), there should be no question of the congenital nature of the lesions.”
BackgroundInfluentialJuárez, S. P., Small, R. E., Hjern, A., & Schytt, E. (2017) · Paediatric and Perinatal Epidemiology · doi:10.1111/ppe.12399 · Cited by 31
Ankarcrona, V., Zhao, H., Jacobsson, B., & Wendel, S. B. (2021) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.16663 · Cited by 31
Indremo, M., White, R. A., Frisell, T., Cnattingius, S., Skalkidou, A., Isaksson, J., & Papadopoulos, F. C. (2021) · Scientific Reports · doi:10.1038/s41598-021-95421-9 · Cited by 31
Self-citationReduced birthweight in short or primiparous mothers: physiological or pathological?
Zhang, X., Mumford, S. L., Cnattingius, S., Schisterman, E. F., & Ms, K. (2010) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2010.02642.x · Cited by 31
Self-citationImpact of maternal characteristics on fetal growth in the third trimester: a population‐based study
Lindell, G., Maršál, K., & Källén, K. (2012) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.11125 · Cited by 31
Eriksson, S. L., Olausson, P. O., & Olofsson, C. (2005) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2005.10.030 · Cited by 31
“The Swedish medical birth register held at the National Board of Health and Welfare, covers 99% of all births in Sweden [8,9].”
BackgroundMann, V., Stavola, B. L. D., & Leon, D. A. (2004) · Statistics in Medicine · doi:10.1002/sim.1853 · Cited by 31
“Data on birth weight, gestational age and parity of the mother of all children who satis ed these entry criteria were obtained from the Swedish Medical Birth Registry [8].”
A case-control study of major congenital heart defects in Sweden ? 1981?1986
Pradat, P. (1992) · European Journal of Epidemiology · doi:10.1007/bf00145321 · Cited by 31
Metadata
- Authors
- Cnattingius, S., Ericson, A., Gunnarskog, J., & Källén, B.
- Affiliations
- National Board of Health and Welfare (SE)
- Lund University (SE)
- Venue
- Scandinavian Journal of Social Medicine
- Publisher
- SAGE Publications
- Published
- 1990-06
- Volume
- 18
- Issue
- 2
- Pages
- 143-148
- ISSN
- 0300-8037 (ISSN-L)
- OpenAlex
- W2035263233
- Cited by
- 972
- References
- 14
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 27 · 2023: 27 · 2022: 26 · 2021: 32 · 2020: 46 · 2019: 31 · 2018: 26 · 2017: 34 · 2016: 36 · 2015: 39 · 2014: 38 · 2013: 45 · 2012: 44
- FWCI
- 31.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Scandinavian Journal of Social Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Physical Sciences › Computer Science › Information Systems › Data Quality and Management
- Keywords
- medical birth registry, data quality, data errors, medical records, hospital diagnoses, interhospital variation, data collection methods, quality control
- MeSH terms
- Birth Certificates, Diagnosis, Humans, Infant, Newborn, Medical Records, Quality Control, Registries, Sweden
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