ReviewActa obstetricia et gynecologica Scandinavica2018
The fetuses-at-risk approach: survival analysis from a fetal perspective.
Review in Acta obstetricia et gynecologica Scandinavica, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.
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Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.
- Association between Endotype of Prematurity and Mortality: A Systematic Review, Meta-Analysis, and Meta-Regression.Neonatology · 2023Pooled it
- The Effect of Prenatal Treatments on Offspring Events in the Presence of Competing Events: An Application to a Randomized Trial of Fertility Therapies.Epidemiology (Cambridge, Mass.) · 2020Trial
- An Epidemiologic First Principles Approach to Assessing Changes in the Frequency of Early Term Birth.Paediatric and perinatal epidemiology · 2026Article
- Temporal trends in risk of acute kidney injury among patients with preeclampsia in Canada: a retrospective cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Article
- Observational
- Maternal Diabetes, Fetal Growth, and Stillbirth Risk: A Population-Wide Retrospective Cohort Study From Victoria, Australia.Diabetes care · 2025Article
- Stillbirth risk by fetal size among 126.5 million births in 15 countries from 2000 to 2020: A fetuses-at-risk approach.BJOG : an international journal of obstetrics and gynaecology · 2025Article
- Variation in risk factors and timing of birth for different types of preterm birth: A historical cohort study.Acta obstetricia et gynecologica Scandinavica · 2025Article
- Funisitis increases the risk of death or cerebral palsy in extremely preterm infants.American journal of obstetrics and gynecology · 2025Article
- Maternal Obesity and Neonatal Death in Preterm US Pacific Islander Neonates Using 2 Analytic Approaches.JAMA network open · 2025Article
- Managing obstetric and gynecologic complications in obese women: Evidence-Based Strategies for Optimizing Outcomes and Reducing Risks.Annals of medicine and surgery (2012) · 2025Review
- Methodologic considerations in estimating racial disparity of mortality among very preterm infants.Pediatric research · 2025Review
- Who Is at Risk for Stillbirth? The Discussion Continues.Paediatric and perinatal epidemiology · 2025Article
- Maternal region of birth and stillbirth trends in Victoria, Australia, 2012-2019: a cohort study.BMJ public health · 2025Article
- The impact of isolated obesity compared with obesity and other risk factors on risk of stillbirth: a retrospective cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Indications affect neonatal outcomes following early rescue ICSI: a retrospective study.Journal of assisted reproduction and genetics · 2024Article
- Cohort selection and the estimation of racial disparity in mortality of extremely preterm neonates.Pediatric research · 2024Observational
- Article
- Article
- Offspring school performance at age 12 after induction of labor vs non-intervention at term: A linked cohort study.Acta obstetricia et gynecologica Scandinavica · 2023Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Several phenomena in contemporary perinatology create challenges for analyzing pregnancy outcomes. These include recent increases in iatrogenic delivery at late preterm and early term gestation, which are incongruent with the belief that stillbirth and neonatal death risks decrease exponentially with advancing gestational age. Perinatal epidemiologists have also puzzled over the paradox of intersecting birthweight-specific and gestational age-specific perinatal mortality curves for decades. For example, neonatal mortality rates among preterm infants of women who smoke are substantially lower than neonatal mortality rates among preterm infants of non-smoking women, whereas the reverse pattern occurs at term gestation. This mortality crossover is observed across several contrasts (for example, women with hypertensive disorders of pregnancy vs. normotensive women, older vs. younger women, twins vs. singletons) and outcomes (stillbirth, neonatal death, sudden infant death syndrome and cerebral palsy), and irrespective of how advancing "maturity" is defined (birthweight or gestational age). One approach proposed to address and explain these unexpected phenomena is the fetuses-at-risk model. This formulation involves a reconceptualization of the denominator for perinatal outcome rates from births to surviving fetuses. In this overview of the fetuses-at-risk model, we discuss the central tenets of the births-based and the fetuses-based formulations. We also describe the extension of the fetuses-at-risk approach to outcomes into and beyond the neonatal period and to a multivariable adaptation. Finally, we provide a substantive context by discussing biological mechanisms underlying the fetuses-at-risk model and contemporary obstetric phenomena that are better understood from that model than from one based on births.
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