Evidence map›Paper›PMID 34021436›Full record

ArticleMaternal and child health journal2021

Adverse Pregnancy Outcomes Following the Assassination of John F. Kennedy in 1963.

Alexa A Freedman, Gregory E Miller, Lauren S Keenan-Devlin, Britney P Smart, Janedelie Romero, Ann Borders, Linda M Ernst

Open access · greenAbstract readMulticenter Study
In one paragraph

Article in Maternal and child health journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.3field-weighted citation impact, top 19% 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

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Alexa A FreedmanDepartment of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, NorthShore University HealthSystem, Evanston, IL, USA. alexa.freedman@northwestern.edu.ORCID http://orcid.org/0000-0001-9745-7768
Gregory E MillerInstitute for Policy Research, Northwestern University, 1801 Maple Ave, Evanston, IL, 60201, USA.
Lauren S Keenan-DevlinDepartment of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, NorthShore University HealthSystem, University of Chicago, Pritzker School of Medicine, Evanston, IL, USA.
Britney P SmartDepartment of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, NorthShore University HealthSystem, Evanston, IL, USA.
Janedelie RomeroDepartment of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, NorthShore University HealthSystem, Evanston, IL, USA.
Ann BordersDepartment of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, NorthShore University HealthSystem, University of Chicago, Pritzker School of Medicine, Evanston, IL, USA.
Linda M ErnstDepartment of Pathology, NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine, Evanston, IL, USA.
NorthShore University HealthSystem · USNorthwestern University · US

Funding

Understanding socioeconomic disparities in perinatal risk: The role of epigenetic and transcriptional regulation in the placentaR01MD011749 · NIMHD · NORTHWESTERN UNIVERSITY · PI BORDERS, ANN E.B., MILLER, GREGORY EVAN · 2017 to 2021
$3.9M
Maternal psychological stress, adverse birth outcomes, and the role of inflammatory mediators in the placentaF32HD100076 · NICHD · NORTHWESTERN UNIVERSITY · PI FREEDMAN, ALEXA · 2019 to 2021
$192k
Eunice Kennedy Shriver National Institute of Child Health and Human Development F32HD100076NICHD NIH HHS F32 HD100076NIMHD NIH HHS R01 MD011749NIMHD NIH HHS R01MD011749
6 · The paper itself

Abstract

introductionWomen exposed to stressful events during pregnancy are thought to be at increased risk of adverse birth outcomes. However, studies investigating stressful events are often unable to control for important confounders, such as behavioral and genetic characteristics, or to isolate the impact of the stressor from other secondary effects. We used a discordant-sibling design, which provides stronger inferences about causality, to examine whether a widespread stressor with limited impact on day-to-day life (John F. Kennedy assassination) resulted in an increased risk of adverse birth outcomes.

methodsData were obtained from the Collaborative Perinatal Project, a prospective, multi-site cohort study conducted in the US from 1959 to 1965. Our analysis was restricted to singleton live births ≥24 weeks born before the assassination (n = 24,406) or in utero at the time (n = 5833). We also evaluated associations within siblings discordant for exposure (n = 1144). We used survival analysis to evaluate associations between exposure and preterm birth and marginal models to evaluate associations with birthweight and placental pathology.

resultsFirst trimester exposure was associated with preterm birth (hazard ratio (HR): 1.17; 95% CI: 1.05, 1.31). In the discordant-sibling model, the point estimate was similar (HR: 1.22; 95% CI: 0.36, 4.06). Third trimester exposure was associated with increased odds of fetal acute inflammation in the placenta (odds ratio (OR): 1.34, 95% CI: 1.05, 1.71). CONCLUSIONS FOR PRACTICE: First trimester exposure to an acute stressor was associated with preterm birth. We did not observe increased odds of placental pathology with first trimester exposure; however, stress may increase preterm birth risk through chronic placental inflammation, which was not evaluated in this sample.

Indexed as

Pregnancy OutcomePremature BirthCohort StudiesFemaleHumansInfant, NewbornPlacentaPregnancyProspective StudiesPlacentaPregnancyPreterm birthSiblingsStress

Identifiers

PMID34021436
PMCPMC8355166
OpenAlexW3161640311

What OpenQuestion holds

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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.