ArticlePaediatric and perinatal epidemiology2016
Constructing Causal Diagrams for Common Perinatal Outcomes: Benefits, Limitations and Motivating Examples with Maternal Antidepressant Use in Pregnancy.
Article in Paediatric and perinatal epidemiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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.
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
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of maternal antidepressant use in pregnancy and short- and long-term offspring's outcomes.Archives of women's mental health · 2018Pooled it
- The relationship between crowding in the delivery ward and the risk of postpartum hemorrhage.Acta obstetricia et gynecologica Scandinavica · 2025Article
- Racial/ethnic differences in the clinical presentation and survival of breast cancer by subtype.Frontiers in oncology · 2024Article
- Associations of periconceptional oral contraceptive use with pregnancy complications and adverse birth outcomes.International journal of epidemiology · 2023Article
- Mediation Analysis of Maternal Smoking, Gestational Age, and Birth Weight on the Texas-Mexico Border.Southern medical journal · 2023Article
- Association of Caesarean delivery and breastfeeding difficulties during the delivery hospitalization: a community-based cohort of women and full-term infants in Alberta, Canada.Canadian journal of public health = Revue canadienne de sante publique · 2023Article
- Analysis of Prenatal Exposure to Opioid Analgesics and Scholastic Skills in Children in Fifth Grade in Norway.JAMA network open · 2022Article
- Ability of municipality-level deprivation indices to capture social inequalities in perinatal health in France: A nationwide study using preterm birth and small for gestational age to illustrate their relevance.BMC public health · 2022Article
- Racial disparities in caesarean delivery among nulliparous women that delivered at term: cross-sectional decomposition analysis of Nebraska birth records from 2005-2014.BMC pregnancy and childbirth · 2022Article
- Associations Between Late-Onset Preeclampsia and the Use of Calcium-Based Antacids and Proton Pump Inhibitors During Pregnancy: A Prospective Cohort Study.Clinical epidemiology · 2022Article
- Association of Timing and Duration of Prenatal Analgesic Opioid Exposure With Attention-Deficit/Hyperactivity Disorder in Children.JAMA network open · 2021Article
- Are small-for-gestational-age preterm infants at increased risk of overweight? Statistical pitfalls in overadjusting for body size measures.Journal of perinatology : official journal of the California Perinatal Association · 2021Article
- Sleep Apnea and Poor COVID-19 Outcomes: Beware of Causal Intermediates and Colliders.American journal of respiratory and critical care medicine · 2021Article
- Maternal persistent marijuana use and cigarette smoking are independently associated with shorter gestational age.Paediatric and perinatal epidemiology · 2020Article
- Interpreting the pharmacoepidemiology literature in obstetrical studies: A guide for clinicians.Seminars in perinatology · 2020Review
- Neonatal Risk in Children of Women With Congenital Heart Disease: A Cohort Study With Focus on Socioeconomic Status.Journal of the American Heart Association · 2019Article
- Review
- Past-month cannabis use among U.S. individuals from 2002-2015: An age-period-cohort analysis.Drug and alcohol dependence · 2018Article
- Revisiting the Table 2 fallacy: A motivating example examining preeclampsia and preterm birth.Paediatric and perinatal epidemiology · 2018Article
- The Role of Preterm Birth in the Association Between Opioid Maintenance Therapy and Neonatal Abstinence Syndrome.Paediatric and perinatal epidemiology · 2018Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundCovariate selection to reduce bias in observational data analysis has primarily relied upon statistical criteria to guide researchers. This approach may lead researchers to condition on variables that ultimately increase bias in the effect estimates. The use of directed acyclic graphs (DAGs) aids researchers in constructing thoughtful models based on hypothesised biologic mechanisms to produce the least biased effect estimates possible.
methodsAfter providing an overview of different relations in DAGs and the prevailing mechanisms by which conditioning on variables increases or reduces bias in a model, we illustrate examples of DAGs for maternal antidepressants in pregnancy and four separate perinatal outcomes.
resultsBy comparing and contrasting the diagrams for maternal antidepressant use in pregnancy and spontaneous abortion, major malformations, preterm birth, and postnatal growth, we illustrate the different conditioning sets required for each model. Moreover, we illustrate why it is not appropriate to condition on the same set of covariates for the same exposure and different perinatal outcomes. We further discuss potential selection biases, overadjustment of mediators on the causal path, and sufficient sets of conditioning variables.
conclusionIn our efforts to construct parsimonious models that minimise confounding and selection biases, we must rely upon our scientific knowledge of the causal mechanism. By structuring data collection and analysis around hypothesised DAGs, we ultimately aim to validly estimate the causal effect of interest.
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