Bias in the association between advanced maternal age and stillbirth using left truncated data
Restriction to analysis of births that survive past a specified gestational age (typically 20 weeks gestation) leads to biased exposure-outcome associations. This bias occurs when the cause of restriction (early pregnancy loss) is influenced by both the exposure and unmeasured factors that also affe...
| Main Authors: | , , , |
|---|---|
| Format: | Journal Article |
| Language: | English |
| Published: |
NATURE PORTFOLIO
2022
|
| Subjects: | |
| Online Access: | http://purl.org/au-research/grants/nhmrc/1099655 http://hdl.handle.net/20.500.11937/93383 |
| _version_ | 1848765731743727616 |
|---|---|
| author | Dunne, Jennifer Tessema, Gizachew Gebremedhin, Amanuel Pereira, Gavin |
| author_facet | Dunne, Jennifer Tessema, Gizachew Gebremedhin, Amanuel Pereira, Gavin |
| author_sort | Dunne, Jennifer |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Restriction to analysis of births that survive past a specified gestational age (typically 20 weeks gestation) leads to biased exposure-outcome associations. This bias occurs when the cause of restriction (early pregnancy loss) is influenced by both the exposure and unmeasured factors that also affect 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-stratification 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 effects. Selection effects included the effects 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. |
| first_indexed | 2025-11-14T11:39:55Z |
| format | Journal Article |
| id | curtin-20.500.11937-93383 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:39:55Z |
| publishDate | 2022 |
| publisher | NATURE PORTFOLIO |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-933832023-10-25T01:29:44Z Bias in the association between advanced maternal age and stillbirth using left truncated data Dunne, Jennifer Tessema, Gizachew Gebremedhin, Amanuel Pereira, Gavin Science & Technology Multidisciplinary Sciences Science & Technology - Other Topics PREGNANCY SMOKING BIRTH EPIDEMIOLOGY EXPLANATION PARADOX Pregnancy Female Humans Stillbirth Maternal Age Abortion, Spontaneous Gestational Age Bias Risk Factors Humans Abortion, Spontaneous Risk Factors Maternal Age Gestational Age Pregnancy Female Stillbirth Bias Restriction to analysis of births that survive past a specified gestational age (typically 20 weeks gestation) leads to biased exposure-outcome associations. This bias occurs when the cause of restriction (early pregnancy loss) is influenced by both the exposure and unmeasured factors that also affect 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-stratification 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 effects. Selection effects included the effects 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. 2022 Journal Article http://hdl.handle.net/20.500.11937/93383 10.1038/s41598-022-23719-3 English http://purl.org/au-research/grants/nhmrc/1099655 http://purl.org/au-research/grants/nhmrc/1173991 http://purl.org/au-research/grants/nhmrc/1195716 http://creativecommons.org/licenses/by/4.0/ NATURE PORTFOLIO fulltext |
| spellingShingle | Science & Technology Multidisciplinary Sciences Science & Technology - Other Topics PREGNANCY SMOKING BIRTH EPIDEMIOLOGY EXPLANATION PARADOX Pregnancy Female Humans Stillbirth Maternal Age Abortion, Spontaneous Gestational Age Bias Risk Factors Humans Abortion, Spontaneous Risk Factors Maternal Age Gestational Age Pregnancy Female Stillbirth Bias Dunne, Jennifer Tessema, Gizachew Gebremedhin, Amanuel Pereira, Gavin Bias in the association between advanced maternal age and stillbirth using left truncated data |
| title | Bias in the association between advanced maternal age and stillbirth using left truncated data |
| title_full | Bias in the association between advanced maternal age and stillbirth using left truncated data |
| title_fullStr | Bias in the association between advanced maternal age and stillbirth using left truncated data |
| title_full_unstemmed | Bias in the association between advanced maternal age and stillbirth using left truncated data |
| title_short | Bias in the association between advanced maternal age and stillbirth using left truncated data |
| title_sort | bias in the association between advanced maternal age and stillbirth using left truncated data |
| topic | Science & Technology Multidisciplinary Sciences Science & Technology - Other Topics PREGNANCY SMOKING BIRTH EPIDEMIOLOGY EXPLANATION PARADOX Pregnancy Female Humans Stillbirth Maternal Age Abortion, Spontaneous Gestational Age Bias Risk Factors Humans Abortion, Spontaneous Risk Factors Maternal Age Gestational Age Pregnancy Female Stillbirth Bias |
| url | http://purl.org/au-research/grants/nhmrc/1099655 http://purl.org/au-research/grants/nhmrc/1099655 http://purl.org/au-research/grants/nhmrc/1099655 http://hdl.handle.net/20.500.11937/93383 |