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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: An Evolving Paradigm

The Fetuses-at-Risk Approach: An Evolving Paradigm

(p.262) 14 The Fetuses-at-Risk Approach: An Evolving Paradigm
Reproductive and Perinatal Epidemiology

Robert W. Platt (Contributor Webpage)

Oxford University Press

The Fetuses-at-Risk approach can be extended in a number of ways, all related to the use of gestational age as a time axis and cohorts of conceptions, as opposed to cohorts of births, as the appropriate study sample for perinatal epidemiology. This chapter discusses difficulties in interpretation of associations between exposure and measures of mortality based on cohorts of births, and methods that have been developed to summarize fetal and infant mortality into a single measure, post-last menstrual period (post-LMP) mortality, and to model associations between exposures and this outcome using extensions of the Cox proportional hazards model. Similar problems arise in the study of small-for-gestational age, and of weight-for-gestational age in general; these are also discussed in this chapter.

Keywords:   fetuses-at-risk, gestational age, cox proportional hazards model, fetal mortality, neonatal mortality, perinatal mortality, last menstrual period, small-for-gestational age, missing data

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