PMID: 16615651Apr 18, 2006Paper

Methodologic issues in the design and analysis of epidemiologic studies of pregnancy outcome

Statistical Methods in Medical Research
David A SavitzAmy H Herring

Abstract

Using epidemiology to elucidate the causes of adverse pregnancy outcomes offers unique opportunities and poses distinctive challenges. The context of pregnancy includes contraception and planning, medical interventions altering the natural history, and the tendency for selective participation in demanding research protocols. Several key pervasive issues are considered in detail: 1) the close temporal proximity of determinants and outcomes, which makes separation of causes and effects difficult and introduces the real possibility of reverse causality; 2) non-random allocation of exposure, often done consciously in response to concerns about having a healthy pregnancy or to the health of the pregnancy itself, making confounding a major concern; 3) heterogeneity of pregnancy outcomes, with endpoints such as pregnancy loss and preterm birth arising through diverse pathways that are not easily identified and if grouped, could diminish the magnitude of observed associations; and 4) racial and ethnic disparities, which pose a public health challenge in the USA and offer a potentially important opportunity for identifying preventable causes of adverse pregnancy outcome. Sophisticated biological and statistical methods are needed to adv...Continue Reading

References

Feb 1, 1991·American Journal of Obstetrics and Gynecology·D A SavitzJ M Thorp
Sep 1, 1989·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·J P Lavery, L A Shaw
Jul 28, 1988·The New England Journal of Medicine·A J WilcoxB C Nisula
Apr 1, 1995·Paediatric and Perinatal Epidemiology·M A Klebanoff, P H Shiono
Jan 1, 1994·Epidemiologic Reviews·C Holzman, N Paneth
Feb 1, 1997·Environmental Health Perspectives·R E Chapin, R A Sloane
Aug 24, 2000·Epidemiology·J M RobinsB Brumback
May 24, 2003·Biometrics·David B DunsonSamuel J Arbes
May 7, 2004·Epidemiology·Lisa B Signorello, Joseph K McLaughlin
Mar 25, 2005·Paediatric and Perinatal Epidemiology·David A SavitzThaddeus L MacDonald

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Citations

Nov 26, 2008·American Journal of Epidemiology·Timothy B GageHoward Stratton
Aug 24, 2017·Reproductive Biology and Endocrinology : RB&E·Sae Kyung ChoiJong Chul Shin
May 16, 2009·American Journal of Industrial Medicine·John D MeyerSusan Reisine
Feb 4, 2010·Environmental Health Perspectives·Craig HansenSally D Perreault
Oct 11, 2011·Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing·Barbara L WilsonTiffany L Locus

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