Quality report of the OSF publication series

Medical birth register

Relevance of statistical data

The Medical Birth Register was established in 1987. It contains data on all mothers who have given birth in Finland and on all newborn infants up to the age of seven days. The purpose of the register is to collect statistical data for the research, development and provision of maternity care, obstetrics services and the care of newborn infants.

The three different Statistical Reports concerning the Medical Birth Register present nationwide information on parturients, deliveries and newborns in the form of absolute figures and percentages.
In addition, data on deliveries are provided by age group, by hospital district per 1000 women of the same age, and by hospital and type of hospital. Data on newborn children are given by length of gestation and birth weight. Data on perinatal mortality are given by number of foetuses, sex, weight, gestational age and hospital district.

The Statistical Reports aim to provide information to health care professionals, administrators, planning officials and researchers working in the area of reproductive health. They need statistical up-to-date and detailed data on deliveries and newborns.

The report text describes the concepts used in the Register.

The collection of data is based on the Act on the National Institute for Health and Welfare (668/2008), on the Act on the Statistical Service of the National Research and Development Centre for Welfare and Health (409/2001), and on the Act on the National Personal Records Kept under the Health Care System (556/1989) and the subsequent Decree (774/1989).

Description of methods used in statistical research

The Medical Birth Register includes data on all live births, and on stillbirths of foetuses with a birth weight of at least 500 g or with a gestational age of at least 22+0 weeks. For each infant, a form has to be completed by the hospital no later than seven days after delivery. The form is sent in paper form or electronically to the Register, which is maintained by the National Institute for Health and Welfare (THL). With regard to deliveries taking place at home, the form is to be completed by the midwife or the physician who has assisted in the delivery. Additionally, more detailed information has been gathered on small premature infants since 2005. Small premature infants refer to live births with a weight at birth of less than 1500 g or with a gestational age at birth of less than 32+0 weeks. A changed definition has been applied since 2008, also including live births with a birth weight of exactly 1500 g.

Correctness and accuracy of data

The data are correct in so far as they have been reported correctly. The data submitted to THL by hospitals are checked, and any data that are missing or inferred to be incorrect are confirmed by contacting the treating hospitals, and then corrected in the database.

Some birth data are missing in the Medical Birth Register. The Register is therefore supplemented with data compiled by the Population Register Centre on live births and with data compiled by Statistics Finland on stillbirths and deaths during the first week of life. After these additions, the statistics in practice have a coverage of 100 per cent.

In 1990 and 1996, the data content of the Register was changed in order to improve its reliability. The form was again updated in 2004. The purpose of the reform was to bring the form more in line with current care practices. Previous data contents are available in paper format and as electronically stored forms and manuals.

Timeliness and promptness of published data

The Statistical Report Perinatal statistics: parturients, deliveries and newborns (previously Births and Newborns) is produced by THL annually. The aim is to publish preliminary data in June-July and the Statistical Report itself in September-October. The preliminary data only include statistical data in the form of a time series table. The biennial Statistical Reports Newborns and Delivery Procedures in Finland by Hospital are published in alternate years. The latter reports are published after the primary report on perinatal statistics, but in the same year nonetheless. The two biennial reports take a closer look at the statistics on their respective topics. Each hospital is given its own data to check for the Statistical Report Delivery Procedures in Finland by Hospital. Tables are corrected using the corrected data supplied by the hospitals. As a consequence, figures may differ slightly from figures given in the Statistical Report Perinatal statistics: parturients, deliveries and newborns published earlier the same year. THL does not publish the annual data for each hospital without the hospitals' consent.

The statistics contained in the Statistical Reports are based on data concerning deliveries during the preceding calendar year. However, in order to reduce random variation, some of the tables have been compiled across two-year periods. Hospitals submit their data to the Medical Birth register at the latest by the end of March of the year following the child's year of birth. The statistics are completed at the latest by the autumn following the calendar year, after data on causes of death compiled by the Population Register Centre and Statistics Finland have been combined.

Availability and transparency/clarity of data

The Statistical Reports are sent electronically to all maternity hospitals and published on THL's website at http://www.thl.fi/en/statistics/parturients. Data in the Medical Birth Register are also submitted to international statistical organisations (OECD, NOMESCO, WHO and perinatal statistics in the Nordic countries).

Comparability of statistical data

The reforms made to the Medical Birth Register in 1990, 1996 and 2004 were aimed at improving its reliability. The definitions of the variables and concepts used in the form have been specified on several occasions. With the 2004 reform, the instructions were revised and improved based on feedback from hospitals so as to ensure the greatest possible consistency in the definitions used in the hospitals. Previous years' data are also corrected, if necessary.

Beginning from 1987, the annual statistical data presented in the Statistical Reports are mutually comparable. However, the data for 2004, 2005 and 2006 are not fully comparable between hospitals, since a few hospitals failed to submit that year's data in accordance with the new form.

The preliminary data do not include the data obtained by combining the Population Register Centre's register data on live births and Statistics Finland's register data on causes of death. However, there are no major differences in data between the preliminary data and the final figures published in the Report. The preliminary data on parturients, deliveries and births consist of nationwide absolute figures and percentages only.

Clarity and consistency

The definitions and concepts related to pregnancy and neonatality are based on the STAKES publication Ohjeita ja luokituksia 1999:2 Tautiluokitus ICD-10. The Statistical Reports also use established international concepts and classifications.