ArticleDrug safety2026
Hierarchical Algorithms for Constructing Mother-Father-Infant Linkages Under Modern Privacy Constraints.
Article in Drug safety, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPost-marketing safety surveillance of medications used during pregnancy depends on accurate reconstruction of mother-father-infant triads in administrative healthcare data. However, global privacy regulations increasingly restrict the use of direct familial identifiers, and few parent-infant linkage algorithms have been validated against a reference standard.
objectiveWe aimed to develop and validate a hierarchical deterministic algorithm that constructs mother-infant and father-infant linkages from variables widely available in administrative healthcare data internationally.
methodsUsing Taiwan's National Health Insurance Research Database and Birth Certificate Application database (2012-19), we constructed mother-infant and father-infant linkages through a five-step hierarchical mother-infant procedure and a single-step father-infant match, incorporating dependent-guarantor relationships, paternal demographic proxies, and sibling history. We validated the algorithm against the historical Maternal and Child Health Database, which provided a deterministic reference standard of 1,570,007 mother-infant and 1,510,578 father-infant pairs among 1,676,503 registered infants.
resultsThe algorithm identified 1,554,179 mother-infant pairs (positive predictive value 97.01%, 95% confidence interval [CI] 96.99-97.04; sensitivity 96.03%, 95% CI 96.00-96.06) and 1,036,980 father-infant pairs (positive predictive value 93.64%, 95% CI 93.59-93.69; sensitivity 64.28%, 95% CI 64.21-64.36). Mother-infant performance remained stable across the 8-year period, whereas paternal sensitivity showed a secular drift that we characterized to support recalibration in future birth cohorts.
conclusionsThis hierarchical framework offers a reproducible, privacy regulation-compatible template for constructing parent-infant linkages to support pharmacovigilance research on parental medication exposures. Operating characteristics should be re-validated when the framework is applied in each new setting.
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