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

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

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

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

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

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

Additional file 1 of Association between treatment failure and hospitalization after receipt of neutralizing monoclonal antibody treatment for COVID-19 outpatients

Additional file 1: Figure S1. Maximum level of oxygenation support during the index hospitalization for patients who experienced treatment failure. IV: invasive mechanical ventilation; HFC: high flow nasal cannula; NIV: non-invasive ventilation

Additional file 5 of Association between treatment failure and hospitalization after receipt of neutralizing monoclonal antibody treatment for COVID-19 outpatients

Additional file 5: Table S1. Medications and conditions used to stratify Mild versus Moderate/Severe immunocompromised status

Additional file 3 of Association between treatment failure and hospitalization after receipt of neutralizing monoclonal antibody treatment for COVID-19 outpatients

Additional file 3: Figure S3. Adjusted risk difference and adjusted odds ratio (OR) for treatment failure for each risk factor from a conservative imputation model. In this model, we assumed all missing SARS-CoV-2 positive test dates were ten days prior to the mAb administration date. Risk differences were calculated via Firth's bias-reduced multiple regression logistic regression. Adjusted ORs and 95% confidence intervals (95% CI) were computed by penalized profile likelihood

Additional file 4 of Association between treatment failure and hospitalization after receipt of neutralizing monoclonal antibody treatment for COVID-19 outpatients

Additional file 4: Figure S4. Adjusted risk difference and adjusted odds ratio (OR) for treatment failure for each risk factor from a conservative imputation model. In this model, we included only patients with confirmed dates for both SARS-CoV-2 positive test and mAb administration. Risk differences were calculated via Firth's bias-reduced multiple regression logistic regression. Adjusted ORs and 95% confidence intervals (95% CI) were computed by penalized profile likelihood

Additional file 2 of Association between treatment failure and hospitalization after receipt of neutralizing monoclonal antibody treatment for COVID-19 outpatients

Additional file 2: Figure S2. Cumulative incidence of hazard for hospitalization by immunocompromised status