1887

Chapter 6 : Methodologic Issues in Perinatal Research

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $15.00

Preview this chapter:
Zoom in
Zoomout

Methodologic Issues in Perinatal Research, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555818210/9781555811327_Chap06-1.gif /docserver/preview/fulltext/10.1128/9781555818210/9781555811327_Chap06-2.gif

Abstract:

This chapter presents an overview of the methods and study designs used to assess the possible association between sexually transmitted diseases (STDs) and adverse pregnancy outcomes. The chapter defines what is meant by random and systematic error, explains how they relate to specific types of epidemiologic study designs, and suggests how errors can be minimized at both the design and analysis phases of investigation. The types of epidemiologic research designs and the quantitative estimates of effect that derive from the study designs is reviewed. The various sources of systematic error (bias), with particular emphasis on how they relate to specific types of epidemiologic studies and how they can be reduced by appropriate design and analytic strategies, is delineated. The two broad types of error can be characterized as random error and systematic error. Perinatal epidemiologic studies should focus on outcomes of major importance to the fetus, infant, or mother, including stillbirth, neonatal death, neonatal infant morbidity, major congenital malformations, and maternal mortality and morbidity. Reverse causality bias is particularly likely to occur in cross-sectional studies. Reverse causality is eliminated by ensuring that exposure occurs prior to the development of the outcome. Finally, differential information bias can be minimized by ensuring adequate blinding of subjects, investigators, and care givers. It is also often useful to blind care givers to avoid the occurrence of co-interventions, i.e., additional interventions in one of the treatment arms capable of influencing the outcome and thereby confounding the effect of the study treatment.

Citation: Kramer M. 1999. Methodologic Issues in Perinatal Research, p 87-100. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch6
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

Figures

Image of Figure 1
Figure 1

Random error: the effect of sample size. RR, relative risk; n, sample size; CI, confidence interval.

Citation: Kramer M. 1999. Methodologic Issues in Perinatal Research, p 87-100. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch6
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 2
Figure 2

Information bias: illustrative examples. RR, relative risk; n, sample size.

Citation: Kramer M. 1999. Methodologic Issues in Perinatal Research, p 87-100. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch6
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 3
Figure 3

Selection bias: illustrative example. RR, relative risk; OR, odds ratio.

Citation: Kramer M. 1999. Methodologic Issues in Perinatal Research, p 87-100. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch6
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 4
Figure 4

Confounding: illustrative example. RR, relative risk.

Citation: Kramer M. 1999. Methodologic Issues in Perinatal Research, p 87-100. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch6
Permissions and Reprints Request Permissions
Download as Powerpoint

References

/content/book/10.1128/9781555818210.chap6
1. Abrams, B.,, and V. Newman. 1991. Small-for-gestational-age birth: maternal predictors and comparison with risk factors of spontaneous preterm delivery in the same cohort. Am. J. Obstet. Gynecol. 161:785790.
2. Barros, F. C.,, S. R. A. Huttly,, C. G. Victora,, B. R. Kirkwood,, and J. P. Vaughan.1992. Comparison of the causes and consequences of prematurity and intrauterine growth retardation: a longitudinal study in Southern Brazil. Pediatrics 90:238244.
3. Chalmers, I., 1989. Evaluating the effects of care during pregnancy and childbirth, p. 338. In I. Chalmers,, M. Enkin,, and M. J. N. C. Keirse (ed.), Effective Care in Pregnancy and Childbirth. Oxford University Press, Oxford, United Kingdom.
4. Chomitz, V. R.,, E. Lieberman,, and L. Cheung. 1992. Healthy mothers—healthy beginnings. Center for Health Communications, Harvard School of Public Health, Cambridge, Mass.
5. Hogue, C. J. R.,, J. W. Buehler,, L. T. Strauss,, and J. C. Smith. 1987. Overview of the National Infant Mortality Surveillance (NIMS) project—design, methods, results. Public Health Rep. 102:126138.
6. Keirse, M. J. N. C. 1984. Epidemiology and aetiology of the growth retarded baby. Clin. Obstet. Gynaecol. 11:415437.
7. Kessel, S. S.,, J. Villar,, H. W. Berendes,, and R. P. Nugent. 1984. The changing pattern of low birth weight in the United States: 1970 to 1980. JAMA 25:19781982.
8. Kramer, M. S. 1987. Determinants of low birth weight: methodological assessment and meta-analysis. Bull. W.H.O. 65:663737.
9. Kramer, M. S. 1990. Birth weight and infant mortality: perceptions and pitfalls. Paediatr. Perinat. Epidemiol. 4:381390.
10. Kramer, M. S.,, M. Olivier,, F. H. McLean,, D. M. Willis,, and R. H. Usher. 1990. The impact of intrauterine growth retardation and body proportionality on fetal and neonatal outcome. Pediatrics 85:707713.
11. Kramer, M. S.,, F. H. McLean,, E. Eason,, and R. H. Usher. 1992. Maternal nutrition and spontaneous preterm birth. Am. J. Epidemiol. 136:574583.
12. Stein, Z. A.,, and M. Susser. 1984. Intrauterine growth retardation: epidemiological issues and public health signifcance. Sem. Perinatol. 8:514.
13. Wen, S. W.,, R. L. Goldenberg,, G. R. Cutter,, J. H. Hoffman,, and S. P. Cliver. 1990. Intrauterine growth retardation and preterm delivery: prenatal risk factors in an indigent population. Am. J. Obstet. Gynecol. 162:213218.

Tables

Generic image for table
Table 1

Well-established determinants of intrauterine growth retardation and preterm birth

Citation: Kramer M. 1999. Methodologic Issues in Perinatal Research, p 87-100. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch6
Generic image for table
Table 2

Analytic studies

Citation: Kramer M. 1999. Methodologic Issues in Perinatal Research, p 87-100. In Hitchcock P, MacKay H, Wasserheit J, Binder R (ed), Sexually Transmitted Diseases and Adverse Outcomes of Pregnancy. ASM Press, Washington, DC. doi: 10.1128/9781555818210.ch6

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error