Evidence map›Paper›PMID 37969031›Full record

ArticlePaediatric and perinatal epidemiology2024

History of multifetal gestation and long-term maternal mortality.

Susanna D Mitro, Rajeshwari Sundaram, Yan Qiao, Jessica L Gleason, Edwina Yeung, Stefanie N Hinkle, Pauline Mendola, James L Mills, Sonia M Grandi, Sunni L Mumford and 3 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Paediatric and perinatal epidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
4.1field-weighted citation impact, top 6% 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

6 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Postpartum Haemorrhage and Long-Term Mortality.Paediatric and perinatal epidemiology · 2025
    Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 3 countries.

Susanna D MitroDivision of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.ORCID 0000-0003-3202-1941
Rajeshwari SundaramDivision of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.ORCID 0000-0002-6918-5002
Yan QiaoDivision of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
Jessica L GleasonDivision of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.ORCID 0000-0001-9877-7931
Edwina YeungDivision of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.ORCID 0000-0002-3851-2613
Stefanie N HinkleDepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-4312-708X
Pauline MendolaDepartment of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA.ORCID 0000-0001-5330-2844
James L MillsDivision of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
Sonia M GrandiDivision of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-8576-7854
Sunni L MumfordDepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-0133-3176
Enrique F SchistermanDepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-3757-641X
Cuilin ZhangBia-Echo Asia Centre for Reproductive Longevity & Equality, Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.ORCID 0000-0002-8014-2708
Katherine L GrantzDivision of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.ORCID 0000-0003-0276-8534
Eunice Kennedy Shriver National Institute of Child Health and Human Development · USUniversity of Pennsylvania · USKaiser Permanente · USNational University of Singapore · SGUniversity at Buffalo, State University of New York · USUniversity of Toronto · CA

Funding

University of California, San Francisco/Kaiser Permanente Northern California Division of Research Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) K12 ProgramK12AR084219 · NIAMS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Monica Gandhi, CYNTHIA C HARPER · 2023 to 2026
$3.1M
Pregnancy and perinatal complications and mortality: Collaborative Perinatal Project mortality linkage studyZIAHD008938 · NICHD · EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT · PI YEUNG, EDWINA · 2014 to 2025
$1.5M
Intramural NIH HHS Z99 HD999999NIAMS NIH HHS K12 AR084219NICHD NIH HHS HHSN275200800002I
6 · The paper itself

Abstract

backgroundMultifetal gestation could be associated with higher long-term maternal mortality because it increases the risk of pregnancy complications such as preeclampsia and preterm birth, which are in turn linked to postpartum cardiovascular risk.

objectivesWe examined whether spontaneously conceived multifetal versus singleton gestation was associated with long-term maternal mortality in a racially diverse U.S. COHORT:

methodsWe ascertained vital status as of 2016 via linkage to the National Death Index and Social Security Death Master File of 44,174 mothers from the Collaborative Perinatal Project (CPP; 1959-1966). Cox proportional hazards models with maternal age as the time scale assessed associations between history of spontaneous multifetal gestation (in the last CPP observed pregnancy or prior pregnancy) and all-cause and cardiovascular mortality, adjusted for demographics, smoking status, and preexisting medical conditions. We calculated hazard ratios (HR) for all-cause and cause-specific mortality over the study period and until age 50, 60, and 70 years (premature mortality).

resultsOf eligible participants, 1672 (3.8%) had a history of multifetal gestation. Participants with versus without a history of multifetal gestation were older, more likely to have a preexisting condition, and more likely to smoke. By 2016, 51% of participants with and 38% of participants without a history of multifetal gestation had died (unadjusted all-cause HR 1.14, 95% confidence interval [CI] 1.07, 1.23). After adjustment for smoking and preexisting conditions, a history of multifetal gestation was not associated with all-cause (adjusted HR 1.00, 95% CI 0.93, 1.08) or cardiovascular mortality (adjusted HR 0.99, 95% CI 0.87, 1.11) over the study period. However, history of multifetal gestation was associated with an 11% lower risk of premature all-cause mortality (adjusted HR 0.89, 95% CI 0.82, 0.96).

conclusionsIn a cohort with over 50 years of follow-up, history of multifetal gestation was not associated with all-cause mortality, but may be associated with a lower risk of premature mortality.

Indexed as

Cardiovascular DiseasesPregnancy ComplicationsPremature BirthFemaleHumansInfant, NewbornMaternal AgeMaternal MortalityPregnancymaternal mortalitymultiple pregnancypremature mortality

Identifiers

PMID37969031
PMCPMC10978292
OpenAlexW4388732656

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.