Placental abruption and perinatal mortality with preterm delivery as a mediator: disentangling direct and indirect effects.

ABSTRACT: The authors use recent methodology in causal inference to disentangle the direct and indirect effects that operate through a mediator in an exposure-response association paradigm. They demonstrate how total effects can be partitioned into direct and indirect effects even when the exposure and mediator interact. The impact of bias due to unmeasured confounding on the exposure-response association is assessed through a series of sensitivity analyses. These methods are applied to a problem in perinatal epidemiology to examine the extent to which the effect of abruption on perinatal mortality is mediated through preterm delivery. Data on over 26 million US singleton births (1995-2002) were utilized. Risks of mortality among abruption and nonabruption births were 102.7 and 6.2 per 1,000 births,

SUBMITTER: Ananth CV 

PROVIDER: S-EPMC3159429 | biostudies-literature | 2011 Jul

REPOSITORIES: biostudies-literature