ArticleScientific reports2022
Bias in the association between advanced maternal age and stillbirth using left truncated data.
Article in Scientific reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Racialized Economic Segregation and Disparities in the Risk of Stillbirth.Journal of racial and ethnic health disparities · 2026Article
- Healthcare access barriers and maternal healthcare service uptake in 14 sub-Saharan African countries (2017-2021): a propensity score matched analysis.BMJ public health · 2026Article
- The role of women's empowerment in the uptake of maternal health services in low- and middle-income countries: a propensity score-matched analysis.Journal of global health · 2025Article
- Prevalence and associated factors of stillbirth among women at extreme ages of reproductive life in Sub-Saharan Africa: a multilevel analysis of the recent demographic and health survey.Maternal health, neonatology and perinatology · 2025Article
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Authors and funding
4 authors.
Funding
Abstract
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.
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