Maternal and Child Health Journal

, Volume 15, Issue 7, pp 851–859 | Cite as

Reliability and Validity of Birth Certificate Prepregnancy Weight and Height Among Women Enrolled in Prenatal WIC Program: Florida, 2005

  • Sohyun Park
  • William M. Sappenfield
  • Connie Bish
  • Diana M. Bensyl
  • David Goodman
  • Jane Menges


To investigate the reliability and validity of weight, height, and body mass index (BMI) from birth certificates with directly measured values from the Women, Infants, and Children (WIC) Program. Florida birth certificate data were linked and compared with first trimester WIC data for women with a live birth during the last quarter of calendar year 2005 (n = 23,314 women). Mean differences for weight, height, and BMI were calculated by subtracting birth certificate values from WIC values. Reliability was estimated by Pearson’s correlation. Validity was measured by sensitivity and specificity using WIC data as the reference. Overall mean differences plus or minus standard error (SE) were 1.93 ± 0.04 kg for weight, −1.03 ± 0.03 cm for height, and 1.07 ± 0.02 kg/m2 for BMI. Pearson’s correlation ranged from 0.83 to 0.95, which indicates a strong positive association. Compared with other categories, women in the second weight group (56.7–65.8 kg), the highest height group (≥167.6 cm), or BMI < 18.5 had the greatest mean differences for weight (2.2 ± 0.08 kg), height (−2.4 ± 0.05 cm), and BMI (1.5 ± 0.06), respectively. Mean differences by maternal characteristics were similar, but statistically significant, likely in part from the large sample size. The sensitivity for birth certificate data was 77.3% (±1.42) for underweight (BMI < 18.5) and 76.4% (±0.51) for obesity (BMI ≥ 30). Specificity was 96.8% (±0.12) for underweight and 97.5% (±0.12) for obesity. Birth certificate data had higher underweight prevalence (6 vs. 4%) and lower obesity prevalence (24 vs. 29%), compared with WIC data. Although birth certificate data overestimated underweight and underestimated obesity prevalence, the difference was minimal and has limited impact on the reliability and validity for population-based surveillance and research purposes related to recall or reporting bias.


Reliability Validity Birth certificate Prepregnancy weight Prepregnancy height Prepregnancy BMI WIC 


  1. 1.
    Reichman, N. E., & Hade, E. M. (2001). Validation of birth certificate data. A study of women in New Jersey’s HealthStart program. Annals of Epidemiology, 11, 186–193.PubMedCrossRefGoogle Scholar
  2. 2.
    Roohan, P. J., Josberger, R. E., Acar, J., Dabir, P., Feder, H. M., & Gagliano, P. J. (2003). Validation of birth certificate data in New York State. Journal of Community Health, 28, 335–346.PubMedCrossRefGoogle Scholar
  3. 3.
    Zollinger, T. W., Przybylski, M. J., & Gamache, R. E. (2006). Reliability of Indiana birth certificate data compared to medical records. Annals of Epidemiology, 16, 1–10.PubMedCrossRefGoogle Scholar
  4. 4.
    DiGiuseppe, D. L., Aron, D. C., Ranbom, L., Harper, D. L., & Rosenthal, G. E. (2002). Reliability of birth certificate data: A multi-hospital comparison to medical records information. Maternal and Child Health Journal, 6, 169–179.PubMedCrossRefGoogle Scholar
  5. 5.
    Northam, S., Polancich, S., & Restrepo, E. (2003). Birth certificate methods in five hospitals. Public Health Nursing, 20, 318–327.PubMedCrossRefGoogle Scholar
  6. 6.
    Chu, S. Y., Kim, S. Y., & Bish, C. L. (2009). Prepregnancy obesity prevalence in the United States, 2004–2005. Maternal and Child Health Journal, 13(5), 614–620.PubMedCrossRefGoogle Scholar
  7. 7.
    Ramachenderan, J., Bradford, J., & McLean, M. (2008). Maternal obesity and pregnancy complications: A review. Australian and New Zealand Journal of Obstetrics and Gynaecology, 48, 228–235.PubMedCrossRefGoogle Scholar
  8. 8.
    Chu, S. Y., Bachman, D. J., Callaghan, W. M., et al. (2008). Association between obesity during pregnancy and increased use of health care. New England Journal of Medicine, 358, 1444–1453.PubMedCrossRefGoogle Scholar
  9. 9.
    Morin, K. H., & Reilly, L. (2007). Caring for obese pregnant women. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 36, 482–489.PubMedCrossRefGoogle Scholar
  10. 10.
    Thompson, D. R., Clark, C. L., Wood, B., & Zeni, M. B. (2008). Maternal obesity and risk of infant death based on Florida birth records for 2004. Public Health Reports, 123, 487–493.PubMedGoogle Scholar
  11. 11.
    Kiel, D. W., Dodson, E. A., Artal, R., Boehmer, T. K., & Leet, T. L. (2007). Gestational weight gain and pregnancy outcomes in obese women: How much is enough? Obstetrics and Gynecology, 110, 752–758.PubMedCrossRefGoogle Scholar
  12. 12.
    Cedergren, M. I. (2007). Optimal gestational weight gain for body mass index categories. Obstetrics and Gynecology, 110, 759–764.PubMedCrossRefGoogle Scholar
  13. 13.
    Institute of Medicine. (1990). Nutrition during pregnancy: Part I: Weight gain, Part II: Nutrient supplements. Washington DC: National Academies Press.Google Scholar
  14. 14.
    National Center for Health Statistics. (2003). 2003 revisions of the US standard certificates of live birth and death and the fetal death report [online]. Available at: Accessed 6 October 2009.
  15. 15.
    Spencer, E. A., Appleby, P. N., Davey, G. K., & Key, T. J. (2002). Validity of self-reported height and weight in 4808 EPICOxford participants. Public Health Nutrition, 5, 561–565.PubMedCrossRefGoogle Scholar
  16. 16.
    Kuczmarski, M. F., Kuczmarski, R. J., & Najjar, M. (2001). Effects of age on validity of self-reported height, weight, and body mass index: Findings from the Third National Health and Nutrition Examination Survey, 1988–1994. Journal of the American Dietetic Association, 101, 28–34.PubMedCrossRefGoogle Scholar
  17. 17.
    Nawaz, H., Chan, W., Abdulrahman, M., Larson, D., & Katz, D. L. (2001). Self-reported weight and height implications for obesity research. American Journal of Preventive Medicine, 20, 294–298.PubMedCrossRefGoogle Scholar
  18. 18.
    Villanueva E. V. (2001). The validity of self-reported weight in US adults: A population based cross-sectional study. BMC Public Health 1:11. Available at: Accessed October 6, 2009.
  19. 19.
    Niedhammer, I., Bugel, I., Bonenfant, S., Goldberg, M., & Leclerc, A. (2000). Validity of self-reported weight and height in the French GAZEL cohort. International Journal of Obesity and Related Metabolic Disorders, 24, 1111–1118.PubMedCrossRefGoogle Scholar
  20. 20.
    Brunnerhuber, L. R. (2007). Validity of self-reported height and weight in women of reproductive age. Maternal and Child Health Journal, 11, 137–144.CrossRefGoogle Scholar
  21. 21.
    Florida Department of Health. (2008). State of Florida vital records. Available at: Accessed October 6, 2009.
  22. 22.
    Florida Department of Health. (2009). Office of vital statistics. Vital records registration handbook November 2008 Revision. Available at: Accessed October 6, 2009.
  23. 23.
    Florida Department of Health. (2009). Bureau of WIC and nutrition. Florida WIC Good Nutrition for Women, Infants & Children. Accessed October 9, 2009.
  24. 24.
    Neufeld, L. M., Haas, J. D., Grajéda, R., & Martorell, R. (2004). Changes in maternal weight from the first to second trimester of pregnancy are associated with fetal growth and infant length at birth. American Journal of Clinical Nutrition, 79, 646–652.PubMedGoogle Scholar
  25. 25.
    Larciprete, G., Valensise, H., Vasapollo, B., et al. (2003). Body composition during normal pregnancy: Reference ranges. Acta Diabetologica, 40(Suppl 1), S225–S232.PubMedCrossRefGoogle Scholar
  26. 26.
    National Heart, Lung, and Blood Institute. (1998). Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: The evidence report. Rockville, MD: National Institutes of Health. Available at: Accessed October 6, 2009.
  27. 27.
    Nyholm, M., Gullberg, B., Merlo, J., Lundqvist-Persson, C., Råstam, L., & Lindblad, U. (2007). The validity of obesity based on self-reported weight and height: Implications for population studies. Obesity, 15, 197–208.PubMedCrossRefGoogle Scholar
  28. 28.
    Craig, B. M., & Adams, A. K. (2009). Accuracy of body mass index categories based on self-reported height and weight among women in the United States. Maternal and Child Health Journal, 13(4), 489–496.PubMedCrossRefGoogle Scholar
  29. 29.
    John, U., Hanke, M., Grothues, J., & Thyrian, J. R. (2006). Validity of overweight and obesity in a nation based on self-report versus measurement device data. European Journal of Clinical Nutrition, 60, 372–377.PubMedCrossRefGoogle Scholar
  30. 30.
    Dietz, P. M., Adams, M. M., Spitz, A. M., Morris, L., & Johnson, C. H. (1999). Live births resulting from unintended pregnancies: Is there variation among states? The PRAMS Working Group. Family Planning Perspectives, 31(3), 132–136.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Sohyun Park
    • 1
  • William M. Sappenfield
    • 2
  • Connie Bish
    • 3
  • Diana M. Bensyl
    • 4
  • David Goodman
    • 3
  • Jane Menges
    • 2
  1. 1.Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP)Centers for Disease Control and PreventionAtlantaUSA
  2. 2.Division of Family Health ServicesFlorida Department of HealthTallahasseeUSA
  3. 3.Division of Reproductive Health, NCCDPHPCenters for Disease Control and PreventionAtlantaUSA
  4. 4.Epidemic Intelligence Service (EIS) Field Assignments Branch, CDD/OWCD/ODCenters for Disease Control and PreventionAtlantaUSA

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