Cohort Study Article Review in Public Health
The hypothesis of the article was that paternal and maternal birth weight and gestational age have influence on the perinatal offspring risk of mortality. Moreover, the authors assumed that the perinatal risk factors can be hereditary and transmitted from generation to generation.
The article fits the category of the cohort study as it presents the correlational observational research. It is based on the observations of such variables as gestational age (23-27, 28-30, 31-33, 34-36, and 37-43 groups), birth weight (< 2000, 2000-2499, 2500-2999, 3000-3499, 3500-3999, 4000-4499, and 4500 or more reference groups), perinatal mortality, stillbirths, maternal education and congenital malformations over the long periods of time. The study analyzed the correlation of morality risk of the offspring that is not related to the disease, but to the hereditary factors, to some characteristics that are transmitted through generations. The cohort of people was unified by the criteria of the gestational age and weight. It deals with the life histories of the cohort of young people as it comprises the observation of two generations of the population.
The data from MBRN was collected in the period from 1967 to 2006. The singletons of both generations were examined. The gestational time periods were the subject of observation. The study itself was conducted in 2007 and published in 2008.
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The inclusion criteria for the females were the following: age 23-43, birth weight < 2000- < 4500, gestational life period, singleton, any education level, and mothers born at 28-43 weeks of gestation. The exclusion criteria were the following: the misclassified parental age, births with birth weight z-score evaluated more or equal to 4, any diseases that could influence the pregnancy period, unclassified birth weeks of gestation, having two or more children.
The main subject of the research is the perinatal mortality and its risks. The secondary subjects are the correlations between the gestation periods and mortality risks through generations, paternal relations, paternal and maternal associations with risk factors of the perinatal mortality.
The population-based research presented in the article was based on the data of the participants, whose information was found in MBRN. The participants of the study were selected according to some definite criteria that were mentioned above. Only singletons in both generations were chosen. They formed 520,794 of mother-offspring and 376,924 of father-offspring units for the analysis of birth weight impact. Regarding the study of gestational age influence, the groups comprised 353,460 father-offspring and 487,013 mother-offspring units.
The primary outcome of the research is that the mothers gestational age was highly associated with the perinatal mortality in offspring. At the same time, such variables as the birth weight and the paternal age were associated as insignificant for the risk factors. In addition, the hereditary factors appeared to be influential. It was proved that the female preterm delivery caused the increase of the perinatal mortality risk in the next generation.
The research has proved the existence of the inverse association between perinatal mortality and maternal gestational age while the analysis of the data for fathers gestational age and mothers birth weight showed no correlation.
The hypothesis was partially proven. The paternal and maternal birth weight and gestational age have influence on the perinatal offspring risk of mortality. However, only maternal characteristics appeared to be influential, and the birth weight of mothers and fathers was not significant. Moreover, perinatal risk factors can be hereditary and transmitted from generation to generation as the preterm delivery of mothers increased the possible risk of mortality in the next generation.
The studies of the reproductive capabilities of the population are very common and important nowadays. The article discussed above presents a number of significant evidences concerning not only the physical characteristics of partners, but also some female peculiarities that can be transmitted from generation to generation and have a negative impact on the gestational period and outcomes of pregnancy. The analysis of all risks is obviously important to decrease such negative outcomes like mortality or any deviations. Considering the fact that the study has proved that there exists a dependence between maternal age and prenatal mortality, it is necessary to study what age is the most suitable to avoid the awful experience and what physical factors are influential. In such a way, the most effective neonatal and prenatal care will be defined. It is also important to study more deeply how the risk of prenatal mortality is transmitted from mother to daughter. One more sphere that needs attention is the similar research of the impact of the same variables of those, who are not singletons, but have two or more children.
The public health is focused on the nations welfare. Therefore, population growth, birth rate and health are the primary issues that deserve attention. Considering the fact that the article deals with the reproductive capabilities, one cannot deny its relation to the sphere of the public health interests. The demographic indicators are obviously dependent on the birth and mortality rates and show the effectiveness of the work of the public health sector. Moreover, the research of the article should be defined as the one related to public health, not only because of the birth rate in the country, but also, because it has a great influence on the psychological state of some cohorts of population.