{"doi":"10.1007/s10654-018-0373-0","title":"Two denominators for one numerator: the example of neonatal mortality","abstract":null,"journal":"European Journal of Epidemiology","year":2018,"id":633842,"datarank":0.40620753016533157,"base_score":2.70805020110221,"endowment":2.70805020110221,"self_citation_contribution":0.40620753016533157,"citation_network_contribution":0.0,"self_endowment_contribution":0.40620753016533157,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":14,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":643027,"name":"Olga Basso","orcid":"0000-0001-9298-4921","position":1,"is_corresponding":false},{"id":247402,"name":"Clarice R. Weinberg","orcid":"0000-0002-7713-8556","position":2,"is_corresponding":false},{"id":433685,"name":"Allen J. Wilcox","orcid":"0000-0002-3376-1311","position":3,"is_corresponding":false},{"id":294198,"name":"Quaker E. Harmon","orcid":"0000-0002-5866-848X","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Two denominators for one numerator: the example of neonatal mortality","abstract":"Preterm delivery is one of the strongest predictors of neonatal mortality. A given exposure may increase neonatal mortality directly, or indirectly by increasing the risk of preterm birth. Efforts to assess these direct and indirect effects are complicated by the fact that neonatal mortality arises from two distinct denominators (i.e. two risk sets). One risk set comprises fetuses, susceptible to intrauterine pathologies (such as malformations or infection), which can result in neonatal death. The other risk set comprises live births, who (unlike fetuses) are susceptible to problems of immaturity and complications of delivery. In practice, fetal and neonatal sources of neonatal mortality cannot be separated-not only because of incomplete information, but because risks from both sources can act on the same newborn. We use simulations to assess the repercussions of this structural problem. We first construct a scenario in which fetal and neonatal factors contribute separately to neonatal mortality. We introduce an exposure that increases risk of preterm birth (and thus neonatal mortality) without affecting the two baseline sets of neonatal mortality risk. We then calculate the apparent gestational-age-specific mortality for exposed and unexposed newborns, using as the denominator either fetuses or live births at a given gestational age. If conditioning on gestational age successfully blocked the mediating effect of preterm delivery, then exposure would have no effect on gestational-age-specific risk. Instead, we find apparent exposure effects with either denominator. Except for prediction, neither denominator provides a meaningful way to define gestational-age-specific neonatal mortality.","is_dataset_classified":null,"base_score":2.70805020110221,"endowment":2.70805020110221,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"29516296","pmcid":"PMC6023405","openalex_id":"https://openalex.org/W2793743635","authors":[],"funders":[{"funder_name":"Intramural NIH HHS","grant_id":"Z99 ES999999","title":null},{"funder_name":"Intramural NIH HHS","grant_id":"ZIA ES044003","title":null},{"funder_name":"Intramural Program, National Institute of Environmental Health Sciences, National Institutes of Health","grant_id":"","title":null}],"total_grants":3,"fwci":2.7859,"citation_percentile":0.90360924,"influential_citations":0,"citation_trend":[{"year":2018,"count":2},{"year":2019,"count":2},{"year":2020,"count":1},{"year":2021,"count":3},{"year":2022,"count":2},{"year":2023,"count":1},{"year":2025,"count":3}],"oa_status":"green","license":"http://www.springer.com/tdm","oa_locations":[{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/6023405","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/6023405","host_type":"repository"},{"url":"http://link.springer.com/article/10.1007/s10654-018-0373-0/fulltext.html","host_type":"publisher"},{"url":"http://link.springer.com/content/pdf/10.1007/s10654-018-0373-0.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1007/s10654-018-0373-0","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/29516296","host_type":"repository"}],"fields_of_study":["Global Maternal and Child Health","Neonatal Respiratory Health Research","Birth, Development, and Health","Fetus","Gestational Age","Humans","Infant","Infant Mortality","Infant, Newborn","Premature Birth","Risk Factors"],"mesh_terms":["Fetus","Gestational Age","Humans","Infant","Infant Mortality","Infant, Newborn","Risk Factors","Premature Birth"],"keywords":["Medicine","Epidemiology","Pediatrics","Public health","Neonatal mortality","Infant mortality","Internal medicine","Population","Pathology","Environmental health","Preterm Delivery","Fetal Pathology","Gestational-age Paradox"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-06T12:45:46.497402Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}