Evidence map›Paper›PMID 25437315›Full record

ArticleEpidemiology (Cambridge, Mass.)2015

Controlled direct effects of preeclampsia on neonatal health after accounting for mediation by preterm birth.

Pauline Mendola, Sunni L Mumford, Tuija I Männistö, Alexander Holston, Uma M Reddy, S Katherine Laughon

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PubMed Full text at PMC Publisher
In one paragraph

Article in Epidemiology (Cambridge, Mass.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
5.6field-weighted citation impact, top 4% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.

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  13. A principled approach to mediation analysis in perinatal epidemiology.American journal of obstetrics and gynecology · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Pauline MendolaFrom the aDivision of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD; bDiabetes Prevention Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu, Finland; cNaval Medical Center Portsmouth, Department of Pediatrics, Portsmouth, VA; and dDivision of Extramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD.
Sunni L Mumford
Tuija I Männistö
Alexander Holston
Uma M Reddy
S Katherine Laughon
Eunice Kennedy Shriver National Institute of Child Health and Human Development · USNaval Medical Center Portsmouth · US

Funding

Intramural NIH HHS Z99 HD999999NICHD NIH HHS HHSN267200603425C
6 · The paper itself

Abstract

backgroundPreeclampsia is characterized by alterations in angiogenic factors that may increase neonatal morbidity independent of preterm birth.

methodsWe estimated the controlled direct effect of preeclampsia on neonatal outcomes independent of preterm birth among 200,103 normotensive and 10,507 preeclamptic singleton pregnancies in the Consortium on Safe Labor (2002-2008). Marginal structural models with stabilized inverse probability weights accounted for potential confounders in the pathway from preeclampsia to preterm birth to neonatal outcomes, including mediator-outcome confounders related to preeclampsia status, such as cesarean delivery. Controlled direct effects of preeclampsia on perinatal mortality, small for gestational age (SGA), neonatal intensive care unit (NICU) admission, respiratory distress syndrome, transient tachypnea of the newborn, anemia, apnea, asphyxia, peri- or intraventricular hemorrhage, and cardiomyopathy were estimated for the hypothesized intervention of term delivery for all infants.

resultsWhen delivery was set at ≥37 weeks, preeclampsia increased the odds of perinatal mortality (odds ratio = 2.2 [95% confidence interval = 1.1-4.5], SGA = (1.9 [1.8-2.1]), NICU admission (1.9 [1.7-2.1]), respiratory distress syndrome (2.8 [2.0-3.7], transient tachypnea of the newborn (1.6 [1.3-1.9]), apnea (2.2 [1.6-3.1]), asphyxia (2.7 [1.5-4.9]), and peri- or intraventricular hemorrhage (3.2 [1.4-7.7]). No direct effect of preeclampsia at term was observed for anemia or cardiomyopathy. Our results appear robust in the presence of moderate confounding, and restriction to severe preeclampsia yielded similar findings.

conclusionPreeclampsia was directly associated with adverse neonatal outcomes beyond morbidity mediated by preterm birth. Although severe neonatal outcomes were less common at later gestational ages, marginal structural models suggested elevated neonatal risk due to preeclampsia even if it was possible to deliver all infants at term.

Indexed as

Term BirthAdultAsphyxia NeonatorumCerebral HemorrhageFemaleHumansInfant, NewbornIntensive Care Units, NeonatalMalePerinatal MortalityPre-EclampsiaPregnancyPremature BirthRespiratory Distress Syndrome, NewbornRisk FactorsTransient Tachypnea of the Newborn

Identifiers

PMID25437315
PMCPMC6198799
OpenAlexW2028427212

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.