ArticleOccupational and environmental medicine2017
Comparison of gestational dating methods and implications for exposure-outcome associations: an example with PM2.5 and preterm birth.
Article in Occupational and environmental medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- The effect of antenatal isoniazid preventive therapy on birth outcomes in Western Kenya.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2023Article
- Sulfur dioxide reduction at coal-fired power plants in North Carolina and associations with preterm birth among surrounding residents.Environmental epidemiology (Philadelphia, Pa.) · 2023Article
- Impacts of gestational age uncertainty in estimating associations between preterm birth and ambient air pollution.Environmental epidemiology (Philadelphia, Pa.) · 2018Article
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5 authors.
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Abstract
objectivesEstimating gestational age is usually based on date of last menstrual period (LMP) or clinical estimation (CE); both approaches introduce potential bias. Differences in methods of estimation may lead to misclassification and inconsistencies in risk estimates, particularly if exposure assignment is also gestation-dependent. This paper examines a 'what-if' scenario in which alternative methods are used and attempts to elucidate how method choice affects observed results.
methodsWe constructed two 20-week gestational age cohorts of pregnancies between 2000 and 2005 (New Jersey, Pennsylvania, Ohio, USA) using live birth certificates: one defined preterm birth (PTB) status using CE and one using LMP. Within these, we estimated risk for 4 categories of preterm birth (PTBs per 10
resultsMore births were classified preterm using LMP (16%) compared with CE (8%). RD divergences increased between cohorts as exposure period approached delivery. Among births between 28 and 31 weeks, week 7 PM
conclusionsDifferent results from analyses restricted to births with both CE and LMP are most likely due to differences in dating methods rather than selection issues. Results are sensitive to choice of gestational age estimation, though degree of sensitivity can vary by exposure timing. When both outcome and exposure depend on estimate of gestational age, awareness of nuances in the method used for estimation is critical.
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