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American Journal of Epidemiology Vol. 152, No. 12 : 1117-1119
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health

ORIGINAL CONTRIBUTIONS

Invited Commentary: Intersecting Perinatal Mortality Curves by Gestational Age–Are Appearances Deceiving?

Rolv T. Lie

From the Division for Medical Statistics and Medical Birth Registry of Norway, University of Bergen, Bergen, Norway.


   INTRODUCTION
 
In this issue of the Journal, Cheung et al. (1Go) present data on the perinatal mortality of twins and singletons from Sweden. A familiar picture of intersecting mortality curves by absolute gestational age emerges. For lower gestational ages, twins have lower mortality than do singletons but for higher gestational ages, twins have higher mortality. The picture persists after adjustment for known risk factors for low gestational age. The authors conclude that twins are initially healthier than singletons, and that they do not benefit as much as singletons do from longer gestational duration. Intersecting mortality curves are often seen when standardizing for gestational age or birth weight. To conclude that twins are initially healthier is to base a longitudinal interpretation on cross-sectional data. Things may not be as . . . [Full Text of this Article]


   NOTES
 

   REFERENCES
 

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Related articles in Am. J. Epidemiol.:

Cheung et al. Respond to "Are Appearances Deceiving?"
Yin Bun Cheung, Paul Yip, and Johan Karlberg
Am. J. Epidemiol. 2000 152: 1120. [Extract] [FREE Full Text]  

Mortality of Twins and Singletons by Gestational Age: A Varying-Coefficient Approach
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Am. J. Epidemiol. 2000 152: 1107-1116. [Abstract] [FREE Full Text]