Timing and patterns of exposures during pregnancy and their implications for study methods

American Journal of Epidemiology
I Hertz-PicciottoJ J Beaumont

Abstract

Patterns of exposure variability across pregnancy were examined for medical, lifestyle, residential, and occupational exposures in a population-based sample of 357 livebirths from 10 rural California counties. A new measure of variability, the ratio of overall prevalence to time-window-specific prevalence, is introduced. The higher the overall : time window (OTW) ratio, the greater the potential for misclassification when using anytime-during-pregnancy prevalence for an agent that exerts its effect in a smaller time window. Exposures to cigarettes, marijuana, saunas/hot tubs, factors related to location of residence, and some workplace substances tended to be of longer duration. Intertrimester concordance was high (kappa's > 0.8) for smoking, residential proximity to crops, and use of video display terminals; moderately high (kappa's between 0.4 and 0.8) for many occupational exposures; and low (kappa's < 0.4) for illnesses, which tended to be of short duration. The lowest OTW ratios were for smoking and some residential exposures (1.1-1.3), while OTW ratios were much higher for paint applications, influenza, vaginal infections, and ultrasound (reaching, e.g., 4-6). Use of anytime-during-pregnancy exposure indices can bias meas...Continue Reading

Citations

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