By Bengt Källén
This ebook addresses methodological facets of epidemiological reports on maternal drug use in being pregnant. Discussing the present assets of blunders and the way they could produce improper conclusions, it examines numerous epidemiological strategies and assesses their strengths and weaknesses. those refer either to the identity of results (with targeted emphasis on congenital malformations) and to the categories of publicity (drug use).
Further, the e-book discusses the matter of confounding and the way to address it, and gives an easy creation to stats. exact occasions, e.g. types of parental publicity, are tested. finally, the publication discusses pharmacovigilance and the knowledge challenge, concluding with a brief record of facets to contemplate while one desires to assessment a printed paper within the box.
Though the publication is basically meant for pharmacologists, gynecologists and obstetricians, it is going to profit all medical professionals operating in perinatal care.
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Additional resources for Drugs During Pregnancy: Methodological Aspects
Some studies have been made on Down syndrome to test this hypothesis but with no clear-cut results. 42 6 Congenital Malformations Chromosome anomalies should be included in the group “major malformations,” but in the analysis of specific malformations, they should be left out (or treated as a separate group). 3 External Factors Maternal use of drugs as a teratogenic factor is the main theme of the present book. Other external factors may disturb embryonic development with malformations as a result.
Effects on the risk of childhood asthma, ADHD, and autism. Different approaches can be used in order to identify long-term outcomes. In small studies, various psychological tests can be applied in order to identify effects of maternal drug use. Usually mean values are compared between exposed and unexposed groups, a method which is un-sensitive if the exposure has caused an increased risk of an uncommon outcome. The mean intelligent quotient may be nearly the same in the two study groups, but the exposure may have increased the risk for mental retardation.
Different malformation types. , use of valproic acid and spina bifida), obviously the two techniques will be equivalent and both are based on sampling from the population in order to get estimates of the expected number of malformed infants after exposure, either estimated from exposure rate in all infants (case-control) or as outcome rate in all infants (cohort). Similarly, expected numbers for the other three groups (unexposed with outcome, exposed, and unexposed without outcome) can be calculated and from these four observed and expected numbers, a chi-square analysis can be made to look for the statistical significance of possible differences in exposure rates between outcome groups or outcome rates between exposure groups (which will be the same).
Drugs During Pregnancy: Methodological Aspects by Bengt Källén