Below are data from a case-control study about the risk of spontaneous abortion related to the “exposure” of prior induced abortion (Levin AA, et. al. JAMA 1980). Cases included women who were hospitalized at a Boston hospital for spontaneous abortion through 27 weeks gestation. Controls consisted of women who delivered live born infants at the same hospital within a few days of the case’s pregnancy loss.
Prior induced abortion
Spontaneous abortion case
Estimate the exposure odds ratio (reflecting prior induced abortion) for cases versus controls. Describe in words what this means. Explain how this exposure odds ratio relates to the odds ratio for disease outcome (i.e. hospitalized spontaneous abortion).
Is the relative risk of hospitalized spontaneous abortions for women who had a prior induced abortion versus those who did not likely to be larger or smaller than the odds ratio calculated in part a? Would you expect the difference between the two measures of risk (RR and OR) to be large? Why or why not.
Calculate the 95% confidence interval for the odds ratio by following the steps below.
Take the natural log of the odds ratio:
Calculate the variance of the natural log of the odds ratio:
Calculate the standard error by taking the square root of the variance obtained in step ii:
Multiply 1.96 by the standard error obtained in step iii:
Calculate the lower limit of the 95% confidence interval for the natural log of the odds ratio by taking the value from step i and subtracting the value from step iv:
Calculate the upper limit of the 95% confidence interval for the natural log of the odds ratio by taking the value from step i and adding the value from step iv:
Calculate the lower limit of the 95% confidence interval for the odds ratio by exponentiating the value from step v:
Calculate the upper limit of the 95% confidence interval for the odds ratio by exponentiating the value from step vi:
Using one sentence, formally report the estimated odds ratio and its 95% confidence interval. Interpret whether this suggests that prior induced abortion is significantly associated with hospitalized spontaneous abortion. Briefly justify your reasoning.
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