Mediation analysis of gestational age, congenital heart defects, and infant birth-weight

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  • Wogu, Adane F
    • Affiliation: Gillings School of Global Public Health, Department of Biostatistics
  • Loffredo, Christopher A
    • Other Affiliation: Departments of Oncology and of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, USA
  • Bebu, Ionut
    • Other Affiliation: Department of Epidemiology and Biostatistics, The Biostatistics Center, The George Washington University, Rockville, USA
  • Luta, George
    • Other Affiliation: Departments of Oncology and of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, USA
Abstract
  • Abstract Background In this study we assessed the mediation role of the gestational age on the effect of the infant’s congenital heart defects (CHD) on birth-weight. Methods We used secondary data from the Baltimore-Washington Infant Study (1981–1989). Mediation analysis was employed to investigate whether gestational age acted as a mediator of the association between CHD and reduced birth-weight. We estimated the mediated effect, the mediation proportion, and their corresponding 95% confidence intervals (CI) using several methods. Results There were 3362 CHD cases and 3564 controls in the dataset with mean birth-weight of 3071 (SD = 729) and 3353 (SD = 603) grams, respectively; the mean gestational age was 38.9 (SD = 2.7) and 39.6 (SD = 2.2) weeks, respectively. After adjusting for covariates, the estimated mediated effect by gestational age was 113.5 grams (95% CI, 92.4–134.2) and the mediation proportion was 40.7% (95% CI, 34.7%–46.6%), using the bootstrap approach. Conclusions Gestational age may account for about 41% of the overall effect of heart defects on reduced infant birth-weight. Improved prenatal care and other public health efforts that promote full term delivery, particularly targeting high-risk families and mothers known to be carrying a fetus with CHD, may therefore be expected to improve the birth-weight of these infants and their long term health.
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  • Article
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  • In Copyright
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  • Wogu et al.; licensee BioMed Central.
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  • English
Bibliographic citation
  • BMC Research Notes. 2014 Dec 17;7(1):926
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  • BioMed Central

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