Joint modelling of competing risks and current status data: an application to a spontaneous labour study

Youjin Lee, Mei‐Cheng Wang, Katherine L. Grantz and Rajeshwari Sundaram

Journal of the Royal Statistical Society Series C, 2019, vol. 68, issue 4, 1167-1182

Abstract: The second stage of labour begins when the cervix is fully dilated and pushing begins until the fetus is delivered. A Caesarean delivery (CD) or operative vaginal delivery (OVD) is typically encouraged after the recommended time set by ‘expert consensus’. This recommended time has been set out of concern for an increased chance of maternal and neonatal morbidities due to a prolonged second stage of labour, but without thorough consideration of heterogeneous risks for spontaneous vaginal delivery (SVD) and morbidities among women. To provide quantitative evidence for the recommendation, the first step is to compare the risks for SVD, CD or OVD, and the risks of maternal or neonatal morbidities simultaneously across the duration of the second stage of labour. To address such risk comparisons statistically, one needs to study the joint distribution for the time to delivery due to each mode and time to maternal or neonatal morbidity given information provided for each individual. We introduce a joint model which combines the competing risks data for delivery time and current status data for any type of maternal or neonatal morbidity given each woman's baseline characteristics. These two processes are assumed dependent through individual‐specific frailty under the joint model. Our numerical studies include a simulation that reflects the structure of observed real data and a detailed real data analysis based on nearly 12000 spontaneous labours. Our finding indicates the necessity to incorporate maternal characteristic such as age or body mass index in assessing the probability for delivery due to SVD, CD or OVD and the onset of morbidities across the second stage of labour.

Date: 2019
References: Add references at CitEc
Citations:

Downloads: (external link)
https://doi.org/10.1111/rssc.12351

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:bla:jorssc:v:68:y:2019:i:4:p:1167-1182

Ordering information: This journal article can be ordered from
http://ordering.onli ... 1111/(ISSN)1467-9876

Access Statistics for this article

Journal of the Royal Statistical Society Series C is currently edited by R. Chandler and P. W. F. Smith

More articles in Journal of the Royal Statistical Society Series C from Royal Statistical Society Contact information at EDIRC.
Bibliographic data for series maintained by Wiley Content Delivery ().