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A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Methodological Considerations for Preterm Birth Research
Thokozile R Malaba1, Marie-Louise Newell2,3, Landon Myer1,4
1Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Insights
Maternal infection is a key factor in preterm birth, especially in low-income nations. Research on HIV and ART needs to address biases to accurately understand preterm birth risks.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- Preterm birth complications are a major cause of infant mortality and long-term health issues.
- Maternal infection is a significant etiological pathway for preterm birth, particularly in low-to-middle income countries.
- In sub-Saharan Africa, maternal HIV infection and antiretroviral therapy (ART) use are linked to increased preterm birth risk.
Purpose of the Study:
- To focus on the maternal infection pathway of preterm birth.
- To highlight methodological considerations, specifically selection and measurement bias, in preterm birth research.
- To illustrate the impact of biases on studies examining the relationship between HIV/ART and preterm births.
Main Methods:
- Review of methodological considerations in preterm birth research.
- Illustration of bias impact using HIV/ART and preterm birth studies.
- Discussion of population-level data estimation challenges.
Main Results:
- Methodological biases, including selection and measurement bias, can significantly impact research findings on preterm birth.
- Studies investigating the link between HIV/ART and preterm births are particularly susceptible to these biases.
- Challenges exist in obtaining accurate population-level estimates from routine data.
Conclusions:
- Strengthening antenatal care services is crucial for improving the quality of population data on preterm birth.
- Optimizing current and future study designs by addressing methodological considerations is essential.
- Accurate research on preterm birth risk factors, like HIV/ART, requires careful bias mitigation.
Abstract:
Complications from preterm birth are a leading cause of infant mortality, with long-term implications for morbidity and quality of life of preterm infants. There are many important risk factors for preterm births however in this article, we focus on the maternal infection etiological pathway, given its significance in low-to-middle income countries. In high preterm birth settings such as sub-Saharan Africa, maternal HIV infection and antiretroviral therapy (ART) use have been associated with an increased risk of preterm births. Consequently, we highlight methodological considerations related to selection and measurement bias in preterm birth research. We further illustrate the potential impact of these biases in studies investigating the relationship between HIV/ART and preterm births. We also briefly discuss issues related to population-level estimations based on routinely collected clinical or civil registration data. We conclude by emphasizing the importance of strengthening of antenatal care services to improve quality of population data as well as optimizing current and future study designs, by taking into account the important methodological considerations described in this article.
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