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Reproductive and Perinatal Epidemiology$
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Germaine M. Buck Louis and Robert W. Platt

Print publication date: 2011

Print ISBN-13: 9780195387902

Published to Oxford Scholarship Online: May 2011

DOI: 10.1093/acprof:oso/9780195387902.001.0001

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The Fetuses-at-Risk Approach: Causal and Noncausal Models

The Fetuses-at-Risk Approach: Causal and Noncausal Models

Chapter:
(p.243) 13 The Fetuses-at-Risk Approach: Causal and Noncausal Models
Source:
Reproductive and Perinatal Epidemiology
Author(s):

K.S. Joseph

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780195387902.003.0065

This chapter discusses a new and controversial development in perinatal epidemiology. The chapter begins with an overview of some traditional concepts in perinatology, namely, the calculation of birth weight and gestational age-specific perinatal mortality rates and the use of dual, overlapping time scales for estimating the duration of gestational and chronologic age. This is followed by a review of the conundrums extant in contemporary perinatology and a proposal for an alternative formulation (called the fetuses-at-risk approach) for the calculation of rates in perinatal epidemiology. The focus under this alternate approach is on incidence measures, with gestational age treated as survival time. Latent period considerations for perinatal phenomena that have intrauterine origins are also an integral part of this formulation. Finally, there is reframing of the traditional and fetuses-at-risk models as serving prediction (noncausal) and causal functions, respectively.

Keywords:   perinatal mortality, gestational age, time scales, fetuses-at-risk approach, epidemiologic methods

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