乌兰巴托妊娠与空气污染研究中活产偏倚的敏感性分析。

IF 3.3 Q2 ENVIRONMENTAL SCIENCES
Lawrence C McCandless, Enkhjargal Gombojav, Ryan W Allen
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引用次数: 0

摘要

乌兰巴托妊娠和空气污染研究(UGAAR)研究是一项随机对照试验,旨在研究怀孕期间使用便携式高效微粒空气(HEPA)过滤器空气净化器对胎儿生长和儿童健康结果的影响。这项研究的一个挑战是,在没有活产的情况下,无法衡量结果变量。因此,妊娠丢失是结果变量的竞争事件,可以模糊干预-结果关系。这种现象在流行病学文献中被称为“活产偏差”,这是由于调整受先前暴露影响的变量而导致的选择偏差的一个例子。方法:在本研究中,我们重新分析了UGAAR研究的数据,并检查了干预对三个健康结局的影响:早产(PTB),出生体重,以及儿童四岁时用韦氏学前和初级智力量表III测量的全面智商(FSIQ),同时考虑了活产偏差。具体来说,我们使用了一种新颖的多重归算方法来模拟怀孕流产而不是活产并经历一系列健康结果的情景。结果:在考虑活产偏差后,干预与PTB之间的相关性减弱。此外,干预对出生体重和FSIQ的影响程度增加。FSIQ对活产偏倚的敏感性低于出生体重。结论:我们引入了一种新的分析方法来研究活产偏倚的作用,研究结果将有助于出生队列的环境流行病学研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Sensitivity analysis for live birth bias in the Ulaanbaatar Gestation and Air Pollution Research study.

Sensitivity analysis for live birth bias in the Ulaanbaatar Gestation and Air Pollution Research study.

Sensitivity analysis for live birth bias in the Ulaanbaatar Gestation and Air Pollution Research study.

Sensitivity analysis for live birth bias in the Ulaanbaatar Gestation and Air Pollution Research study.

The Ulaanbaatar Gestation and Air Pollution Research (UGAAR) study is a randomized controlled trial of the effects of portable high efficiency particulate air (HEPA) filter air cleaner use during pregnancy on fetal growth and child health outcomes. A challenge with the study is that the outcome variables cannot be measured in the absence of a live birth. Thus pregnancy loss is a competing event for the outcome variables that can obscure the intervention-outcome relationship. This phenomenon is called "live birth bias" in the epidemiological literature, and it is an example of selection bias due to adjustment for variables affected by previous exposure.

Methods: In this investigation, we reanalyzed data from the UGAAR study and examined the impacts of the intervention on three health outcomes: preterm birth (PTB), birth weight, and full-scale IQ (FSIQ) measured with the Wechsler Preschool and Primary Scale of Intelligence III when children were four years old, while accounting for live birth bias. Specifically, we used a novel multiple imputation approach to simulate scenarios in which pregnancy losses had instead been born alive and experienced a range of health outcomes.

Results: After accounting for live birth bias, the association between the intervention and PTB diminished. Additionally, the magnitude of intervention effect on birth weight and FSIQ increased. FSIQ was less sensitive to live birth bias than birth weight.

Conclusion: We introduced a novel analysis approach to examine the role of live birth bias, and the findings will be useful in environmental epidemiology studies of birth cohorts.

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来源期刊
Environmental Epidemiology
Environmental Epidemiology Medicine-Public Health, Environmental and Occupational Health
CiteScore
5.70
自引率
2.80%
发文量
71
审稿时长
25 weeks
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