ahmedelfatmaoui
commented
5 months ago -
[x] 1) infant death,
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[x] 2) low birth weight (weight <2500grams)
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[ ] 3) We cannot use preterm variable for having too many missing observations, but I think it correlates well with low birth variable
prams_df$MORB_LAB %>% summary Min. 1st Qu. Median Mean 3rd Qu. Max. NA's 1.000 1.000 1.000 1.232 1.000 2.000 28889
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[x] Instead of preterm, we have DEFECT: BC: BIRTH DEFECT BABY? tiny fraction as expected answered yes for birth defect (expected!):
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Asian == CHINESE, JAPANESE, FILIPINO or OTH ASIAN
RJaggad
jzhao2jzhao2jzhao2
Reproducing the document from Dr. Zhao's email on March 29:
Teenage pregnancy, maternal immunization, and infant mortality among Native Americans and other minorities
Research question:
How does teenage pregnancy impact maternal immunization and infant mortality across Native Americans and other US racial and ethnic minorities?
Variables:
To examine the differential effects of teenage pregnancy versus adult pregnancy on maternal immunization and infant health outcomes. The x variable is a binary variable of the teenage age threshold <=19 years old. The two y variables at the mother level are 1) mother’s Tdap vaccination status, 2) mother’s flu vaccination status. Furthermore, the three y variables at the infant level are 1) infant death, 2) low birth weight, 3) preterm birth (or premature birth).
Study population:
The main study population is Native Americans, variable name “American Indians or Alaska Natives” (NA). Additional populations include all racial and ethnic groups, such as Native Hawaiians, White, Black, Hispanic, Chinese, Filipinos, and Japanese.
Hypotheses:
Within the NA racial group, compared to adult mothers, teenage mothers have lower vaccination rates (including both Tdap, and flu), through which their infants have worse health outcomes.
Between the NA and Native Hawaiian groups, compared to Native Hawaiian teenage mothers, NA teenage mothers have equal vaccination rates (including both Tdap, and flu), through which their infants might have equal health outcomes.
Across all racial groups, NA teenage mothers have the lowest vaccination rates (including both Tdap, and flu), through which their infants have the worst health outcomes.
Motivation:
This study is motivated by four facts: 1) NA teenage pregnancy (measured as teenage birth rate) at 29.2% is the highest among all US racial and ethnic groups (e.g., non-Hispanic Blacks 25.8%, Hispanics 25.3%, non-Hispanic White 11.4%); 2) Low birth weight is the top second leading cause of infant death in the US among all racial and ethnic groups, and is the top third leading cause among the NA group; 3) NAs are a historically racially disadvantaged population in urgent need of policy intervention; 4) Mothers’ acquired immunity through Tdap and flu vaccinations affect unborn fetus and born infant immunity (thus infant health outcomes) through three biological mechanisms (see our upcoming Medicaid paper); 5)
Teenage/Adolescent pregnancy definition: 1.American Pregnancy association: A teenage pregnancy, as defined by the American Pregnancy Association, is a pregnancy that occurs for a woman under the age of 20. Although technically not a teenager, a young woman 12 or under who is pregnant falls into this definition of teenage pregnancy as well.
2.WHO: Teenage pregnancy (%) Percentage of pregnant women aged 19 years or younger in a given period of time.
3.UNICEF: The United Nations Children Fund (UNICEF), defines teenage pregnancy as “a teenage girl, usually within the ages of 13-19, becoming pregnant and refers to girls who have not reached legal adulthood, which varies across the world” Ref: United Nations Children's Fund 2008. The state of the world's children 2009. Maternal and newborn health, unicef.