By Bengt Källén
This e-book addresses methodological facets of epidemiological reviews on maternal drug use in being pregnant. Discussing the present assets of mistakes and the way they could produce flawed conclusions, it examines numerous epidemiological concepts and assesses their strengths and weaknesses. those refer either to the id of results (with particular emphasis on congenital malformations) and to the kinds of publicity (drug use).
Further, the e-book discusses the matter of confounding and the way to deal with it, and gives an easy creation to statistical data. detailed occasions, e.g. kinds of parental publicity, are tested. finally, the publication discusses pharmacovigilance and the knowledge challenge, concluding with a brief record of elements to contemplate whilst one desires to evaluation a broadcast 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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This publication addresses methodological facets of epidemiological reviews on maternal drug use in being pregnant. Discussing the present resources of errors and the way they could produce flawed conclusions, it examines a variety of epidemiological ideas and assesses their strengths and weaknesses. those refer either to the id of results (with certain emphasis on congenital malformations) and to the kinds of publicity (drug use).
Additional info for Drugs During Pregnancy: Methodological Aspects
Paed Allergy Immunol 24:28–32 Källén B, Borg N, Reiss M (2013c) The use of central nervous system active drugs during pregnancy. Pharmaceuticals 6:1221–1286 Kullander S, Källén B (1976) A prospective study on drugs and pregnancy. I Psychopharmaca Acta Obstet Gynecol Scand 55:25–33 Marsál K, Persson PH, Larsen T, Lilja H, Selbing A, Sultan B (1996) Intrauterine growth curves based on ultrasonically estimated foetal weights. Acta Paediatr 85:843–848 Nakhai-Pour HR, Broy P, Bérard A (2010) Use of antidepressants during pregnancy and the risk of spontaneous abortion.
Two or more malformations in the same infant may have different causes. Random hits are one explanation which may explain some infants with two malformations but very few infants with three or more malformations. If we suppose that 3 % of all infants have a major malformation, only one in 1100 will have two by the random occurrence of two different malformations and only about 1 in 37,000 will have three. The actual rates of infants with two or three different malformations are much higher. Another explanation to the presence of two malformation codes for the same infant is the phenomenon of sequences.
The clinical significance of a moderately reduced head circumference is uncertain. 7 Perinatal Morbidity Maternal drug use may be associated with perinatal morbidity. , heroin, but have also been described for instance after maternal use of antidepressants. They may appear as intrauterine asphyxia, respiratory problems in the neonate, hypoglycemia, jaundice, symptoms of central nervous system disturbances, etc. and are identified from diagnoses in medical records or from medical birth registers.