Implications of Using a Fetuses-at-Risk Approach When Fetuses Are Not at Risk

Paediatric and Perinatal Epidemiology
Olga Basso

Abstract

Gestational-age-specific rates of postnatal endpoints are sometimes estimated with denominators based on fetuses-at-risk (FAR), rather than live births. However, as infants can only be included in the numerator after they are born alive, interpretation of such rates is problematic. Using simple algebra it can be shown that, at each gestational week, FAR rates of postnatal endpoints are the product of the conventional risk of outcome among live births and the probability of live birth, which increases from near zero early in gestation to close to one in the final weeks. The consequences of such a pattern of live birth on FAR rates are further illustrated in hypothetical scenarios with known conditions. FAR rates of postnatal endpoints will generally increase towards the end of pregnancy due to the rising probability of live birth, regardless of the 'true' effect of immaturity on risk. In the presence of an exposure that increases the probability of early birth, the same mechanism will cause FAR rates to be higher in the exposed group, even if the exposure has no effect. Gestational-age-specific FAR rates of postnatal outcomes strongly depend on the probability of live birth. Thus, they reflect neither the causal effect of gestat...Continue Reading

References

Mar 21, 1998·British Journal of Obstetrics and Gynaecology·L HilderB Thilaganathan
Dec 25, 2003·BMC Pregnancy and Childbirth·K S JosephEllen Wood
Jul 20, 2004·American Journal of Epidemiology·Mark A Klebanoff, Kenneth C Schoendorf
Jul 20, 2004·American Journal of Epidemiology·Allen J Wilcox, Clarice R Weinberg
Nov 25, 2004·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·K S Joseph
Jan 27, 2005·American Journal of Obstetrics and Gynecology·Gordon C S Smith
Feb 23, 2005·Archives of Disease in Childhood. Fetal and Neonatal Edition·C GreenwoodP Doyle
Sep 1, 2007·BMC Pregnancy and Childbirth·Aaron B Caughey
Mar 18, 2008·American Journal of Epidemiology·Nigel Paneth
Apr 22, 2010·Epidemiology·Olga Basso, Allen Wilcox
Feb 2, 2011·Paediatric and Perinatal Epidemiology·Tyler J VanderWeele, Sonia Hernández-Diaz
Mar 5, 2011·Epidemiology·Olga Basso, Allen J Wilcox
Sep 8, 2011·BJOG : an International Journal of Obstetrics and Gynaecology·K S Joseph
Sep 29, 2011·American Journal of Epidemiology·Allen J WilcoxOlga Basso
Jul 4, 2012·BMC Pregnancy and Childbirth·Sarka LisonkovaK S Joseph
Apr 10, 2013·BMC Pregnancy and Childbirth·Sarka LisonkovaK S Joseph
Nov 30, 2013·American Journal of Epidemiology·Michael S KramerRobert W Platt
Feb 12, 2014·International Journal of Epidemiology·Nathalie AugerJay S Kaufman
Mar 14, 2014·Developmental Medicine and Child Neurology·Håvard TrønnesDag Moster
Oct 11, 2014·International Journal of Epidemiology·Michael S KramerRobert W Platt

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Citations

Jan 16, 2016·Paediatric and Perinatal Epidemiology·Olga Basso
Jan 16, 2016·Paediatric and Perinatal Epidemiology·Enrique F Schisterman, Lindsey A Sjaarda
Jan 16, 2016·Paediatric and Perinatal Epidemiology·K S Joseph
Jan 16, 2016·Paediatric and Perinatal Epidemiology·Aaron B Caughey, Jonathan M Snowden
Jul 26, 2017·Acta Obstetricia Et Gynecologica Scandinavica·K S Joseph, Michael S Kramer
Dec 2, 2017·Acta Obstetricia Et Gynecologica Scandinavica·Carmen Messerlian, Olga Basso
Mar 9, 2018·European Journal of Epidemiology·Quaker E HarmonAllen J Wilcox
Feb 12, 2019·JAMA Pediatrics·Olga Basso
Feb 12, 2019·JAMA Pediatrics·Luigi Gagliardi
Feb 28, 2019·Paediatric and Perinatal Epidemiology·Jonathan M Snowden
Jan 22, 2020·Paediatric and Perinatal Epidemiology·Olga Basso
Jul 7, 2017·Current Epidemiology Reports·K S JosephSarka Lisonkova
Sep 5, 2020·Clinical Epidemiology·Jørn Olsen, Zeyan Liew
May 16, 2019·Current Epidemiology Reports·Jonathan M SnowdenOlga Basso

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