Modeling the Relationship between Maternal Blood Type, and Pregnancy Complications and Delivery Outcome through Moderated Mediation Analysis
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University of Ghana
Abstract
Pregnancy complications and adverse delivery outcome are of global concern, yet, their causal
mechanism(s) are unknown. Although, there have been studies to expound the importance of
maternal blood type in pregnancy, and to associate pregnancy complications with maternal blood
type, unfortunately, only direct relationships have been assessed. This study employs antepartum
and intrapartum risk scores, to give a fuller picture of the complex causal relationship between
maternal blood type and pregnancy complications and delivery outcomes, through a moderated
mediated relationship, and a double-mediated relationship respectively. Methods: This was a
retrospective study of the maternal delivery records of Battor Catholic Hospital in the Volta region
of Ghana. The antepartum, intrapartum, and neonatal variables from the maternal delivery records
book were extracted and together with the maternal life status, these variables were converted into
antepartum and intrapartum risk scores and pregnancy delivery outcome scores, according to the
degree of their adverse effect on the life of mother and child. Pregnancy complications were
converted into pregnancy complications scores, according to their prevalence and case fatality
rates. Mediated and moderated mediated models, were employed in R to analyze the data. The
index of moderated mediation between maternal blood type and pregnancy complications outcome
was significant (effect = 0.14, BootSE = 0.04 and CI = (0.07, 0.24)) and the indirect effects (when
HIPRSI = 0, effect = -0.071, BootSE = 0.02 and CI = (-0.11, -0.04)) of maternal blood type through
the risk of pregnancy and delivery was also significant. The double-mediated relationship between
maternal blood type and pregnancy delivery outcome was significant (effect = 0.17, se = 0.05 and
p-value < 0.001). In conclusion, maternal blood type is the potential cause of pregnancy
complications and adverse delivery outcome
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MPhil. Statistics