Dataset Information

Estimating the effect of Prenatal Care Coordination in Wisconsin: A sibling fixed effects analysis.

ABSTRACT:

Objective

To estimate Prenatal Care Coordination's (PNCC) effect on birth outcomes for Wisconsin Medicaid-covered deliveries.

Data source

A longitudinal cohort of linked Wisconsin birth records (2008-2012), Medicaid claims, and state-administered social services.

Study design

We defined PNCC treatment dichotomously (none vs. any) and by service level (none vs. assessment/care plan only vs. service uptake). Outcomes were birthweight (grams), low birthweight (<2500 g), gestational age (completed weeks), and preterm birth (<37 weeks). We estimated PNCC's effect on birth outcomes, adjusting for maternal characteristics, using inverse-probability of treatment weighted and sibling fixed effects regressions.

Data collection/extraction methods

We identified 136 224 Medicaid-paid deliveries, of which 33 073 (24.3 percent) linked to any PNCC claim and 22 563 (16.6 percent) linked to claims for PNCC service uptake.

Principal findings

Sibling fixed effects models-which best adjust for unobserved confounding and treatment selection-produced the largest estimates for all outcomes. For example, in these models, PNCC service uptake was associated with a 1.3 percentage point (14 percent) reduction and a 1.8 percentage point (17 percent) reduction in the probabilities of low birthweight and preterm birth, respectively (all P < .05).

Conclusions

PNCC's modest but significant improvement of birth outcomes should motivate stronger PNCC outreach and implementation of similar programs elsewhere.

SUBMITTER: Mallinson DC

PROVIDER: S-EPMC6980950 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Publications

Estimating the effect of Prenatal Care Coordination in Wisconsin: A sibling fixed effects analysis.

Mallinson David C DC Larson Andrea A Berger Lawrence M LM Grodsky Eric E Ehrenthal Deborah B DB

Health services research 20191107 1

<h4>Objective</h4>To estimate Prenatal Care Coordination's (PNCC) effect on birth outcomes for Wisconsin Medicaid-covered deliveries.<h4>Data source</h4>A longitudinal cohort of linked Wisconsin birth records (2008-2012), Medicaid claims, and state-administered social services.<h4>Study design</h4>We defined PNCC treatment dichotomously (none vs. any) and by service level (none vs. assessment/care plan only vs. service uptake). Outcomes were birthweight (grams), low birthweight (<2500 g), gestat ...[more]

PMID: 31701531

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Project description:Indirect parental genetic effects may be defined as the influence of parental genotypes on offspring phenotypes over and above that which results from the transmission of genes from parents to their children. However, given the relative paucity of large-scale family-based cohorts around the world, it is difficult to demonstrate parental genetic effects on human traits, particularly at individual loci. In this manuscript, we illustrate how parental genetic effects on offspring phenotypes, including late onset conditions, can be estimated at individual loci in principle using large-scale genome-wide association study (GWAS) data, even in the absence of parental genotypes. Our strategy involves creating "virtual" mothers and fathers by estimating the genotypic dosages of parental genotypes using physically genotyped data from relative pairs. We then utilize the expected dosages of the parents, and the actual genotypes of the offspring relative pairs, to perform conditional genetic association analyses to obtain asymptotically unbiased estimates of maternal, paternal and offspring genetic effects. We apply our approach to 19066 sibling pairs from the UK Biobank and show that a polygenic score consisting of imputed parental educational attainment SNP dosages is strongly related to offspring educational attainment even after correcting for offspring genotype at the same loci. We develop a freely available web application that quantifies the power of our approach using closed form asymptotic solutions. We implement our methods in a user-friendly software package IMPISH (IMputing Parental genotypes In Siblings and Half Siblings) which allows users to quickly and efficiently impute parental genotypes across the genome in large genome-wide datasets, and then use these estimated dosages in downstream linear mixed model association analyses. We conclude that imputing parental genotypes from relative pairs may provide a useful adjunct to existing large-scale genetic studies of parents and their offspring.

Dataset Information

Estimating the effect of Prenatal Care Coordination in Wisconsin: A sibling fixed effects analysis.

Objective

Data source

Study design

Data collection/extraction methods

Principal findings

Conclusions

Publications

Estimating the effect of Prenatal Care Coordination in Wisconsin: A sibling fixed effects analysis.

Similar Datasets

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