ArticleEpidemiology (Cambridge, Mass.)2011
Might rare factors account for most of the mortality of preterm babies?
Article in Epidemiology (Cambridge, Mass.), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Neonatal mortality risk associated with preterm birth in East Africa, adjusted by weight for gestational age: individual participant level meta-analysis.PLoS medicine · 2012Pooled it
- Stillbirths and the race-specific gap in neonatal death among extremely preterm births.Scientific reports · 2025Article
- Vanishing twins, selectionEvolution, medicine, and public health · 2025Article
- Birth Weight, Gestational Age, and Risk of Cardiovascular Disease in Early Adulthood: Influence of Familial Factors.American journal of epidemiology · 2023Article
- Inferring fetal growth restriction as rare, severe, and stable over time.European journal of epidemiology · 2023Article
- Effect of Correcting the Postnatal Age of Preterm-Born Children on Measures of Associations Between Infant Length-for-Age z Scores and Mid-Childhood Outcomes.American journal of epidemiology · 2021Article
- On endocrine disruption at the workplace - how to get from suggestive to conclusive evidence?Scandinavian journal of work, environment & health · 2020Article
- Maternal hypertension and survival in singletons and twins born at 23-29 weeks: not just one answer….Pediatric research · 2019Article
- Two denominators for one numerator: the example of neonatal mortality.European journal of epidemiology · 2018Article
- Causal inference in studies of preterm babies: a simulation study.BJOG : an international journal of obstetrics and gynaecology · 2018Article
- Gestational age and birthweight for risk assessment of neurodevelopmental impairment or death in extremely preterm infants.Archives of disease in childhood. Fetal and neonatal edition · 2016Article
- Three alternative methods to resolve paradoxical associations of exposures before term.European journal of epidemiology · 2016Article
- Re: "analyzing risks of adverse pregnancy outcomes".American journal of epidemiology · 2015Article
- Fetuses-at-risk, to avoid paradoxical associations at early gestational ages: extension to preterm infant mortality.International journal of epidemiology · 2014Article
- Subtypes of preterm birth and the risk of postneonatal death.The Journal of pediatrics · 2013Article
- On the pitfalls of adjusting for gestational age at birth.American journal of epidemiology · 2011Article
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2 authors.
Funding
Abstract
backgroundPreterm delivery has a variety of causes, with each of these presumably carrying its own mortality risk. To the extent that they add to the risk of mortality, the various pathologic factors triggering preterm delivery will confound the causal contribution of gestational age to mortality, inflating the observed rates of gestational-age-specific mortality. We have previously estimated that about half of the mortality of US preterm singletons may be due to unmeasured pathologies that increase mortality risk and also cause preterm birth. In this paper, we examine the impact that rare factors may have, at least in theory, on preterm mortality.
methodsWe constructed a simple model of gestational-age-specific mortality, in which we arbitrarily selected a function to represent the mortality due to immaturity alone ("baseline" risk). We then added "unmeasured" confounding factors that cause mortality and also cause preterm birth. This construct allowed us to calculate, in simple scenarios, the proportion of preterm mortality that could be caused by unmeasured confounding.
resultsWe found that rare pathologies with moderate-to-strong effects can substantially contribute to preterm mortality. The presence of such rare factors can also produce an intersection of gestational-age-specific mortality curves when stratifying by known risk factors.
conclusionsIt is possible that a few relatively rare factors may account for a large fraction of preterm mortality. The search for such factors should be a primary focus of future research on preterm delivery.
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