Methods in Maternal and Child Health The field of maternal and child health, as
ID: 3446176 • Letter: M
Question
Methods in Maternal and Child Health
The field of maternal and child health, as a public health discipline, relies on epidemiologic studies to understand and improve the health of mothers, children, and families. Epidemiology is the study of the distribution and determinants of health-related states among specified populations and the application of that study to the control of health problems. One of the goals of epidemiology is to determine whether the effect of an exposure (e.g., zika virus) causes an outcome to occur (e.g., birth defect).
While experimental studies are better at establishing causality, they are often unethical to conduct when trying to answer certain research questions. For example, it would be unethical to expose pregnant women to Zika to then study its effects on fetal development. Therefore, we often have to rely on observational studies[1] to answer key questions in maternal and child health. However, observational studies come with limitations when trying to establish causality.
Question 1) Describe why observational studies are limited when trying to establish causality.
Question 2) Identify and describe one of the Bradford Hill criteria for establishing causality.
- Next read the news article and research paper posted on ELMS. For the research paper, focus on the abstract, introduction, and discussion sections – you do not need to read all of the methods and results sections (unless of course you want to).
news article: http://www.newsweek.com/antidepressant-use-during-pregnancy-may-increase-autism-risk-639386
Research paper (Antidepressants during pregnancy and autism in offspring: population based cohort study) link: file:///Users/Jodeh_H/Downloads/Rai_Antidepressants_Autism_bmj.j2811.full.pdf
if link does not work just type in the name of the research paper.
Question 3) Is this an observational study? How do you know?
Question 4) Do you think that antidepressants during pregnancy cause autism? Why or why not? (Note: There is no right or wrong answer.)
A. If causal, select at least two criteria from Bradford Hill Criteria that would suggest it is causal.
B. If you do not think this relationship is causal, justify how the findings may be biased (i.e., what other factors may explain this relationship).
Question 5) If the general public were to accept these findings as true (i.e., there is a causal relationship between antidepressant use during pregnancy and autism), what may be some unintended public health consequences that could occur as a result of these findings?
Explanation / Answer
Question 1) Describe why observational studies are limited when trying to establish causality.
Proving the cause and effect through observational study is really difficult because observing people in their natural environment cannot be done in a lab set-up. Even in a naturalistic observation if people come to know that someone is watching them they may tend to change their behaviour. This behaviour is better explained by a lurking variable which emerges as the result of the awareness when one knows that someone is observing them.
Question 2) Identify and describe one of the Bradford Hill criteria for establishing causality.
Temporal Relationship is one of the nine criteria of Bradford Hill criteria for establishing causality. It means that when a factor causes something to happen then it should be always the same factor that should cause that result. If any other factor comes in, then it’s not a casual relationship.
Question 3) Is this an observational study? How do you know?
It’s not an observational study because observational study is observing something as it happens. This is an archival research as it involves exploring old documents for current research.
Question 4) Do you think that antidepressants during pregnancy cause autism? Why or why not? (Note: There is no right or wrong answer.)
Many research on the cause and effect of antidepressants and autism have different outcomes. So the relationship is not yet established. Psychologists suggest not to believe the research results that is not proven without dispute, instead use the medication wisely and only when needed.
Question 5) If the general public were to accept these findings as true (i.e., there is a causal relationship between antidepressant use during pregnancy and autism), what may be some unintended public health consequences that could occur as a result of these findings?
If the public were to believe the findings, it will only make them more depressed. Pregnancy is the time when a women experience, irritation, mood swing and uncomfortable feeling for which they take antidepressants. If it is going to affect the child with autism, there may be more people undergo depression without antidepressants and it may affect both the mother’s and child’s health to a great extent.