{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T07:00:22Z","timestamp":1790146822484,"version":"4.0.1"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Ischemic placental disease (IPD) involves three obstetrical complications \u2013 preeclampsia, placental abruption, and fetal growth restriction \u2013 and is implicated in up to 55% of early deliveries. Despite substantial overlap in their etiology and epidemiologic risk profiles, existing studies have assessed their effects independently. Using data from the Consortium on Safe Labor (2002\u20132008; n = 203, 990), we examined the composite and separate effects of the IPD conditions on spontaneous and indicated preterm delivery (sPTD and iPTD). We systematically specified joint IPD probabilities, corresponding to combinations of hypothetical stochastic and deterministic interventions. Eliminating all IPD reduced sPTD (RR = 0.93; 95% CI = 0.92, 0.94) and iPTD (RR = 0.66; 95% CI = 0.64, 0.67) from observed levels. Eliminating preeclampsia alone reduced sPTD (RR = 0.94; 95% CI = 0.94, 0.95) and iPTD (RR = 0.72; 95% CI=0.71, 0.73). Partially reducing joint IPD co-occurrence among 58% of individuals who met criteria for high-risk, by magnitudes drawn from separate low-dose aspirin meta-analyses, yielded minimal reductions for sPTD (RR = 0.99; 95% CI=0.98, 0.99) and iPTD (RR = 0.89; 95%CI=0.88, 0.89). Preeclampsia drives IPD\u2019s association with both PTD subtypes; under the stated assumptions, hypothetically eliminating preeclampsia yielded the largest iPTD reduction.<\/jats:p>","DOI":"10.1093\/aje\/kwag230","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:07:13Z","timestamp":1790143633000},"source":"Crossref","is-referenced-by-count":0,"title":["Causal inference of multiple interrelated exposures: Contributions of ischemic placental disease to preterm delivery"],"prefix":"10.1093","author":[{"given":"Wen Wei","family":"Loh","sequence":"first","affiliation":[{"name":"Department of Advanced Computing Sciences, Maastricht University ,","place":["The Netherlands"]},{"name":"Department of Methodology and Statistics, Maastricht University ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cande V","family":"Ananth","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology and Reproductive Sciences, and Department of Medicine, Rutgers Robert Wood Johnson Medical School , New Brunswick, NJ ,","place":["USA"]},{"name":"Department of Biostatistics and Epidemiology, Rutgers School of Public Health , Piscataway, NJ ,","place":["USA"]},{"name":"Cardiovascular Institute of New Jersey , Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,23]]},"container-title":["American Journal of Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/aje\/advance-article-pdf\/doi\/10.1093\/aje\/kwag230\/71329936\/kwag230.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/aje\/advance-article-pdf\/doi\/10.1093\/aje\/kwag230\/71329936\/kwag230.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:07:13Z","timestamp":1790143633000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/aje\/advance-article\/doi\/10.1093\/aje\/kwag230\/8830558"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/aje\/kwag230","relation":{},"ISSN":["0002-9262","1476-6256"],"issn-type":[{"value":"0002-9262","type":"print"},{"value":"1476-6256","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,23]]},"article-number":"kwag230"}}