Bias in the association between advanced maternal age and stillbirth using left truncated data

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dc.contributor.authorDunne, J.
dc.contributor.authorTessema, G.A.
dc.contributor.authorGebremedhin, A.T.
dc.contributor.authorPereira, G.
dc.date.issued2022
dc.description.abstractRestriction to analysis of births that survive past a specifed gestational age (typically 20 weeks gestation) leads to biased exposure-outcome associations. This bias occurs when the cause of restriction (early pregnancy loss) is infuenced by both the exposure and unmeasured factors that also afect the outcome. The aim of this study is to estimate the magnitude of bias resulting from left truncated data in the association between advanced maternal age and stillbirth. We simulated data for the causal pathway under a collider-stratifcation mechanism. Simulation parameters were based on an observed birth cohort from Western Australia and a range of plausible values for the prevalence of early pregnancy loss, unmeasured factor U and the odds ratios for the selection efects. Selection efects included the efects of maternal age on early pregnancy loss, U on early pregnancy loss, and U on stillbirth. We compared the simulation scenarios to the observed birth cohort that was truncated to pregnancies that survived beyond 20 gestational weeks. We found evidence of marginal downward bias, which was most prominent for women aged 40+ years. Overall, we conclude that the magnitude of bias due to left truncation is minimal in the association between advanced maternal age and stillbirth.
dc.description.statementofresponsibilityJennifer Dunne, Gizachew A.Tessema, Amanuel T.Gebremedhin, Gavin Pereira
dc.identifier.citationScientific Reports, 2022; 12(1):1-9
dc.identifier.doi10.1038/s41598-022-23719-3
dc.identifier.issn2045-2322
dc.identifier.issn2045-2322
dc.identifier.orcidTessema, G.A. [0000-0002-4784-8151]
dc.identifier.urihttps://hdl.handle.net/2440/136923
dc.language.isoen
dc.publisherNature Publishing Group
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1099655
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1173991
dc.rights© The Author(s) 2022. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Te images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
dc.source.urihttps://doi.org/10.1038/s41598-022-23719-3
dc.subjectHumans
dc.subjectAbortion, Spontaneous
dc.subjectRisk Factors
dc.subjectMaternal Age
dc.subjectGestational Age
dc.subjectPregnancy
dc.subjectFemale
dc.subjectStillbirth
dc.subjectBias
dc.subject.meshHumans
dc.subject.meshAbortion, Spontaneous
dc.subject.meshRisk Factors
dc.subject.meshMaternal Age
dc.subject.meshGestational Age
dc.subject.meshPregnancy
dc.subject.meshFemale
dc.subject.meshStillbirth
dc.subject.meshBias
dc.titleBias in the association between advanced maternal age and stillbirth using left truncated data
dc.typeJournal article
pubs.publication-statusPublished

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