ArticleBMC pregnancy and childbirth2015
The association between temporal changes in the use of obstetrical intervention and small-for-gestational age live births.
Article in BMC pregnancy and childbirth, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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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.
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Who cites it
4 citing papers in PubMed, 7 citations in OpenAlex.
- Maternal Characteristics and Prevalence of Infants Born Small for Gestational Age.JAMA network open · 2024Article
- Association of Temporal Changes in Gestational Age With Perinatal Mortality in the United States, 2007-2015.JAMA pediatrics · 2018Article
- The fetuses-at-risk approach: survival analysis from a fetal perspective.Acta obstetricia et gynecologica Scandinavica · 2018Review
- A Consilience of Inductions Supports the Extended Fetuses-at-Risk Model.Paediatric and perinatal epidemiology · 2016Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe literature attributes secular declines in small-for-gestational age (SGA) live births to changes in maternal smoking and other maternal characteristics. However, there are reasons to believe that the observed reductions in SGA may be a consequence of early delivery following obstetric intervention.
methodsWe examined temporal trends in obstetrical intervention and SGA among singleton live births in the United States from 1990 to 2010. The modified Kitagawa decomposition, based on the fetuses-at-risk approach, was used to assess the relative contribution of changes in the gestational age distribution and gestational age-specific SGA to overall changes in SGA. Reductions in SGA rates due to a left shift in the gestational age distribution were assumed to primarily reflect increased obstetrical intervention, whereas decreases in overall SGA due to decreases in gestational-age-specific SGA rates were assumed to reflect declines in risk factors.
resultsTemporal trends in SGA followed a non-linear pattern, with substantial declines from 10.1% in 1990-92 to 8.9% in 2002-04, followed by a small increase to 9.1% in 2008-10. Rates of maternal smoking steadily decreased throughout the same time period and changes in SGA rates were more consistent with changes in the gestational age distribution. The modified Kitagawa decomposition analysis also attributed the initial decline in SGA rates to changes in the gestational age distribution.
conclusionsComplex temporal pattern in SGA rates cannot be explained by the linear pattern of changes in factors like maternal smoking. Changes in the gestational age distribution are more consistent with the observed secular trends in SGA rates.
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