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American Journal of Epidemiology Vol. 155, No. 4 : 302-303
Copyright © 2002 by The Johns Hopkins University School of Hygiene and Public Health

ORIGINAL CONTRIBUTIONS

Invited Commentary: Is Preterm Labor a Valid Endpoint in Perinatal Research?

George A. Macones

From the Department of Obstetrics and Gynecology and the Department of Biostatistics and Epidemiology, Leonard Davis Institute of Health Economics, University of Pennsylvania School of Medicine, Philadelphia, PA (e-mail: gmacones@mail.obgyn.upenn.edu).


   INTRODUCTION
 
In this issue of the American Journal of Epidemiology, Dayan et al. (1Go) present their findings from a cohort study whose purpose was to assess the relation between maternal anxiety and depression and preterm labor. Unraveling the relation between maternal psychological events and pregnancy outcome is of great importance, especially as we begin to understand the biologic plausibility of such a link. In this regard, Dayan et al. have made a valuable contribution to the existing body of literature on this subject. Their study, however, raises an important question for both observational and interventional perinatal research: Should preterm labor itself be used as an endpoint? I believe there are several relevant issues to consider in answering this question.

First, is preterm labor itself a clinically important health outcome? If not, is it a reasonable surrogate for another clinically important outcome? Dayan et al. make the argument that preterm . . . [Full Text of this Article]


   ACKNOWLEDGMENTS
 

   NOTES
 

   REFERENCES
 

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Related articles in Am. J. Epidemiol.:

Role of Anxiety and Depression in the Onset of Spontaneous Preterm Labor
J. Dayan, C. Creveuil, M. Herlicoviez, C. Herbel, E. Baranger, C. Savoye, and A. Thouin
Am. J. Epidemiol. 2002 155: 293-301. [Abstract] [FREE Full Text]  



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J. Dayan, C. Creveuil, M. Herlicoviez, C. Herbel, E. Baranger, C. Savoye, and A. Thouin
Dayan et al. Respond to "Is Preterm Labor a Valid Endpoint in Perinatal Research?"
Am. J. Epidemiol., February 15, 2002; 155(4): 304 - 304.
[Full Text] [PDF]