By Bengt Källén
This e-book addresses methodological facets of epidemiological stories on maternal drug use in being pregnant. Discussing the prevailing assets of errors and the way they could produce improper conclusions, it examines numerous epidemiological ideas and assesses their strengths and weaknesses. those refer either to the id of results (with specified emphasis on congenital malformations) and to the categories of publicity (drug use).
Further, the booklet discusses the matter of confounding and the way to address it, and gives an easy creation to stats. specified occasions, e.g. sorts of parental publicity, are tested. finally, the ebook discusses pharmacovigilance and the knowledge challenge, concluding with a brief record of facets to think about whilst one desires to evaluation a broadcast paper within the box.
Though the booklet is essentially meant for pharmacologists, gynecologists and obstetricians, it is going to gain all medical professionals operating in perinatal care.
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Additional resources for Drugs During Pregnancy: Methodological Aspects
Historically, the limit was higher. Up to 2002 an age limit of 28 weeks was used in Sweden to define a dead fetus as an infant – if it was alive at birth it was defined as an infant, also if born before the 28th week. The variability in definition will not much affect rate estimates as most stillbirths occur late in pregnancy and most spontaneous abortions occur early. One can also discuss if there should be a lower age limit in analyses of miscarriages. Most likely, a high percentage of fertilized eggs and early embryos – which thus have the potential to develop into an infant – stop developing and the pregnancy may never be realized by the woman.
Among the 36,772 infants exposed to the drugs in question, only 980 entered the sibling study. As will be discussed in greater detail later in this book, all information on drug use may have two shortcomings. One is that a woman may have used a drug during pregnancy without this being identified. In interview or questionnaire studies, she may not have told about the drug use and in prescription studies she may have had access to and used drugs which were prescribed much earlier; most drugs have a shelf life of many years.
2013a). 8 10 20 30 40 50 Maternal age Fig. 1 Diagram showing the relationship between maternal age and parity and the risk for preterm birth, adjusted for year of birth, smoking, and body mass index or obesity could influence the exactness of the estimate. Infants born growth retarded may also have been sensitive for estimate errors. Gestational duration is shorter in twins or higher-order births than in singleton births. For this reason analyses of effects on gestational duration are usually restricted to singleton births.