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Thinking outside the curve, part II: modeling fetal-infant mortality
- Source :
- BMC Pregnancy and Childbirth, Vol 10, Iss 1, p 44 (2010), BMC Pregnancy and Childbirth
- Publication Year :
- 2010
- Publisher :
- Springer Science and Business Media LLC, 2010.
-
Abstract
- Background Greater epidemiologic understanding of the relationships among fetal-infant mortality and its prognostic factors, including birthweight, could have vast public health implications. A key step toward that understanding is a realistic and tractable framework for analyzing birthweight distributions and fetal-infant mortality. The present paper is the second of a two-part series that introduces such a framework. Methods We propose estimating birthweight-specific mortality within each component of a normal mixture model representing a birthweight distribution, the number of components having been determined from the data rather than fixed a priori. Results We address a number of methodological issues related to our proposal, including the construction of confidence intervals for mortality risk at any given birthweight within a component, for odds ratios comparing mortality within two different components from the same population, and for odds ratios comparing mortality within analogous components from two different populations. As an illustration we find that, for a population of white singleton infants, the odds of mortality at 3000 g are an estimated 4.15 times as large in component 2 of a 4-component normal mixture model as in component 4 (95% confidence interval, 2.04 to 8.43). We also outline an extension of our framework through which covariates could be probabilistically related to mixture components. This extension might allow the assertion of approximate correspondences between mixture components and identifiable subpopulations. Conclusions The framework developed in this paper does not require infants from compromised pregnancies to share a common birthweight-specific mortality curve, much less assume the existence of an interval of birthweights over which all infants have the same curve. Hence, the present framework can reveal heterogeneity in mortality that is undetectable via a contaminated normal model or a 2-component normal mixture model.
- Subjects :
- Population
Risk Assessment
lcsh:Gynecology and obstetrics
White People
Odds
Pregnancy
Infant Mortality
Obstetrics and Gynaecology
Covariate
Statistics
Confidence Intervals
Birth Weight
Humans
Medicine
education
lcsh:RG1-991
education.field_of_study
business.industry
Singleton
Smoking
Infant, Newborn
Obstetrics and Gynecology
Odds ratio
Infant, Low Birth Weight
Mixture model
United States
Confidence interval
Infant mortality
Logistic Models
Technical Advance
Fetal Mortality
Female
business
Demography
Subjects
Details
- ISSN :
- 14712393
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- BMC Pregnancy and Childbirth
- Accession number :
- edsair.doi.dedup.....14d8346b2cabe3bb5e798f871c4a9759