ArticleAmerican journal of epidemiology2025
Causal effects of competing obstetrical interventions: mediators of placental abruption and perinatal mortality.
Article in American journal of epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Placental abruption and perinatal mortality in twins: novel insight into management at preterm versus term gestations.European journal of epidemiology · 2024Article
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2 authors.
Funding
Abstract
Placental abruption, the premature placental separation, confers increased perinatal mortality risk with preterm delivery as an important pathway through which the risk appears mediated. Although pregnancies complicated by abruption are often delivered through an obstetrical intervention, many deliver spontaneously. We examined the contributions of clinician-initiated (PTDIND) and spontaneous (PTDSPT) preterm delivery at < 37 weeks as competing causal mediators of the abruption-perinatal mortality association. Using the Consortium for Safe Labor (2002-2008) data (n = 203 990; 1.6% with abruption), we applied a potential outcomes-based mediation analysis to decompose the total effect into direct and mediator-specific indirect effects through PTDIND and PTDSPT. Each mediated effect describes the reduction in the counterfactual mortality risk if that preterm delivery subtype was shifted from its distribution under abruption to without abruption. The total effect risk ratio (RR) of abruption on perinatal mortality was 5.4 (95% CI, 4.6-6.3). The indirect effect RRs for PTDIND and PTDSPT were 1.5 (95% CI, 1.4-1.6) and 1.5 (95% CI, 1.5-1.6), respectively; these corresponded to mediated proportions of 25% each. These findings underscore that PTDIND and PTDSPT each play essential roles in shaping perinatal mortality risks associated with placental abruption.
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