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The completeness of reporting of selected birth complications and congenital malformations on the Washington State birth certificate was estimated by comparing the total occurrences reported on birth certificates to the totals reported in hospital records. Two time periods were studied (1977-78 and 1980-81 before and after changes in birth certificate design). The design change (inclusion of a series of check boxes for conditions) was found to provide more complete reporting of birth complications.

Birth complication reporting: the effect of birth certificate design.