Evidence map›Paper›PMID 40170527›Full record

ArticlePaediatric and perinatal epidemiology2025

Left Truncation in the Periviable Period and the Black Survival Advantage.

Tim A Bruckner, Allison Stolte, Brenda Bustos, Alison Gemmill, Joan A Casey, Hedwig Lee, Ralph A Catalano

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Paediatric and perinatal epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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.

Tim A BrucknerDepartment of Health, Society, and Behavior, Joe C. Wen School of Population and Public Health, University of California, Irvine, California, USA.
Allison StolteDepartment of Health, Society, and Behavior, Joe C. Wen School of Population and Public Health, University of California, Irvine, California, USA.ORCID https://orcid.org/0000-0003-0702-2344
Brenda BustosDepartment of Health, Society, and Behavior, Joe C. Wen School of Population and Public Health, University of California, Irvine, California, USA.ORCID https://orcid.org/0000-0003-4784-6292
Alison GemmillDepartment of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.ORCID https://orcid.org/0000-0001-5879-9730
Joan A CaseyDepartment of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA.
Hedwig LeeDepartment of Sociology, Duke University, Durham, North Carolina, USA.
Ralph A CatalanoSchool of Public Health, University of California, Berkeley, California, USA.

Funding

Science CoreP2CHD065563 · NICHD · DUKE UNIVERSITY · PI Giovanna M Merli · 2015 to 2026
$5.7M
Racial disparities in preterm births and fetal lossesR01HD103736 · NICHD · UNIVERSITY OF CALIFORNIA-IRVINE · PI BRUCKNER, TIM ALLEN · 2021 to 2025
$2.7M
Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentNICHD NIH HHS P2C HD065563NICHD NIH HHS R01 HD103736
6 · The paper itself

Abstract

backgroundInfants born in the periviable period show an extremely high risk of infant death. At all gestational ages in the periviable period, non-Hispanic (NH) Black infants counterintuitively show relatively lower infant mortality risk than do NH white infants. The literature theorises that cohort variation over time in pregnancy loss (a form of left truncation in utero) could explain a portion of this survival advantage.

objectivesWe test this left truncation hypothesis in the US (Jan 1996 to Jun 2018) by focusing on NH Black singleton periviable males. We use twin sex ratios as a gauge of cohort left truncation against frail males.

methodsWe retrieved US birth and infant death records for all NH Black and NH white singleton infants born in the periviable range for 282 monthly conception cohorts. We used high and low outliers in the monthly sex ratio of extremely preterm twins (M:F), where a higher sex ratio indicates less selection against frail males. We applied augmented time-series methods which control for both autocorrelation and confounding.

resultsNH Black male periviable singleton infants show a stronger survival advantage (relative to NH whites) for cohorts with high outliers in left truncation (4.0 fewer deaths per 100 live births, 95% confidence interval 1.0, 7.2).

conclusionsElevated left truncation in utero may contribute to the survival advantage of NH Black male singletons in the periviable period. Observed racial/ethnic differences in infant mortality across conception cohorts vary, at least in part, from left truncation.

Indexed as

Black or African AmericanFetal ViabilityInfant, Extremely PrematureInfant MortalityFemaleGestational AgeHumansInfantInfant, NewbornMalePregnancySex RatioUnited StatesWhiteinfant mortalityleft truncationperiviablesurvival advantagevanishing twin

Identifiers

PMID40170527
PMCPMC12714363

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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.