{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T21:09:56Z","timestamp":1774472996176,"version":"3.50.1"},"reference-count":47,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,4,22]],"date-time":"2016-04-22T00:00:00Z","timestamp":1461283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Placental abruption has a profound impact on perinatal mortality, but implications for neurodevelopment during childhood remain unknown. We examined the association between abruption and neurodevelopment at 8 months and 4 and 7 years and evaluated the extent to which these associations were mediated through preterm delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Secondary analysis of a multicenter prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Multicenter <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content> National Collaborative Perinatal Project (1959\u201376).<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women that delivered singleton live births.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Analyses of <jats:styled-content style=\"fixed-case\">IQ<\/jats:styled-content> scores were based on marginal structural models (<jats:styled-content style=\"fixed-case\">MSM<\/jats:styled-content>) to account for losses to follow\u2010up. We also carried out a causal mediation analysis to evaluate if the association between abruption and cognitive deficits was mediated through preterm delivery, and performed a sensitivity analysis for unobserved confounding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>We evaluated cognitive development based on the Bayley scale at 8 months (Mental and Motor Scores), and intelligent quotient (<jats:styled-content style=\"fixed-case\">IQ<\/jats:styled-content>) based on the Stanford\u2013Binet scale at 4 years and the Wechsler Intelligence Scale for Children at 7 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The confounder and selection\u2010bias adjusted risk ratio (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>) of abnormal 8\u2010month Motor and Mental assessments were 2.35 (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.39, 3.98) and 2.03 (95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.13, 3.64), respectively, in relation to abruption. The associations at 4 years were attenuated and resolved at 7 years. The proportion of children with abruption\u2010associated neurological deficits mediated through preterm delivery ranged from 27 to 75%. Following adjustment for unobserved confounding the proportion mediated through preterm delivery was attenuated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The effect of abruption on neurodevelopmental outcomes appears restricted to an effect that is largely mediated through preterm delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Increased risk of cognitive deficits in relation to abruption appears to be mediated through preterm delivery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.14049","type":"journal-article","created":{"date-parts":[[2016,4,22]],"date-time":"2016-04-22T21:53:16Z","timestamp":1461361996000},"page":"463-472","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Neurodevelopmental outcomes in children in relation to placental abruption"],"prefix":"10.1111","volume":"124","author":[{"given":"CV","family":"Ananth","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology College of Physicians and Surgeons Columbia University New York NY USA"},{"name":"Department of Epidemiology Joseph L. 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