ArticleAmerican journal of epidemiology2011
On the pitfalls of adjusting for gestational age at birth.
Article in American journal of epidemiology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 179 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
179 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Association between Endotype of Prematurity and Mortality: A Systematic Review, Meta-Analysis, and Meta-Regression.Neonatology · 2023Pooled it
- Maternal Medication Use and Childhood Cancer in Offspring-Systematic Review and Considerations for Researchers.American journal of epidemiology · 2021Pooled it
- Ambient and household PM2.5 pollution and adverse perinatal outcomes: A meta-regression and analysis of attributable global burden for 204 countries and territories.PLoS medicine · 2021Pooled it
- Association of Histological and Clinical Chorioamnionitis With Neonatal Sepsis Among Preterm Infants: A Systematic Review, Meta-Analysis, and Meta-Regression.Frontiers in immunology · 2020Pooled it
- Trial
- Handling of multicohort data in pooled analysis of environmental exposures: confounding by cohort of the relationship between perfluoroalkyl substances and birthweight in the ECHO Program.American journal of epidemiology · 2026Article
- Chemical mixtures and birth weight: comparison of multipollutant models in the Maternal-Infant Research on Environmental Chemicals (MIREC) study.Environmental health : a global access science source · 2026Article
- The Impact of Early-Life Growth on Long-Term Cardiometabolic and Neurocognitive Outcomes in High-Income Countries: A Neglected Public Health Problem.Nutrition reviews · 2026Review
- Risk of adverse maternal outcomes among pregnancies with gestational diabetes mellitus in Ontario, Canada, 2012-2020: a retrospective cohort study.BMC pregnancy and childbirth · 2026Article
- Article
- The placental transcriptome serves as a mechanistic link between prenatal phthalate exposure and placental efficiency.Environment international · 2025Article
- Birth Characteristics and Bone Mineral Density and Content in Young Adults: The HUNT Study, Norway.Calcified tissue international · 2025Article
- Histologic Chorioamnionitis and Neurodevelopment in Preterm Infants.JAMA network open · 2025Article
- Risk Factors for Autism Spectrum Disorder in Individuals Born Preterm: A Systematic Review and Meta-Analysis of Population-Based Studies.Biological psychiatry global open science · 2025Article
- Association Between Endotype of Prematurity and Cystic Periventricular Leukomalacia: A Bayesian Model-Averaged Meta-Analysis.Children (Basel, Switzerland) · 2025Review
- Paternal and maternal exposures to per- and polyfluoroalkyl substances (PFAS) and birth outcomes: a multi-country cohort study.Environmental health : a global access science source · 2025Article
- Early-Onset Neonatal Infection and Epilepsy in Children.JAMA network open · 2025Article
- Placental Metabolism Is Linked to Prenatal Vitamin Supplement Use in the First Month of Pregnancy in the MARBLES Cohort.The Journal of nutrition · 2025Article
- Mycoestrogen Exposure during Pregnancy: Impact of theEnvironmental health perspectives · 2025Article
- Respiratory Related Hospitalization in Children With Exposure to Meconium Aspiration or Staining.Pediatric pulmonology · 2025Article
119 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
Preterm delivery is a powerful predictor of newborn morbidity and mortality. Such problems are due to not only immaturity but also the pathologic factors (such as infection) that cause early delivery. The understanding of these underlying pathologic factors is incomplete at best. To the extent that unmeasured pathologies triggering preterm delivery also directly harm the fetus, they will confound the association of early delivery with neonatal outcomes. This, in turn, complicates studies of newborn outcomes more generally. When investigators analyze the association of risk factors with neonatal outcomes, adjustment for gestational age as a mediating variable will lead to bias. In the language of directed acyclic graphs, gestational age is a collider. The theoretical basis for colliders has been well described, and gestational age has recently been acknowledged as a possible collider. However, the impact of this problem, as well as its implications for perinatal research, has not been fully appreciated. The authors discuss the evidence for confounding and present simulations to explore how much bias is produced by adjustments for gestational age when estimating direct effects. Under plausible conditions, frank reversal of exposure-outcome associations can occur. When the purpose is causal inference, there are few settings in which adjustment for gestational age can be justified.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.