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特邀评论:病例交叉研究方法在早产触发因素研究中的应用。

Invited commentary: application of case-crossover methods to investigate triggers of preterm birth.

机构信息

Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA.

出版信息

Am J Epidemiol. 2010 Nov 15;172(10):1118-20; discussion 1121-2. doi: 10.1093/aje/kwq327. Epub 2010 Oct 1.

Abstract

Properties of the case-crossover design have appeal for investigation of acute triggers of preterm birth. Measured and unmeasured time-invariant risk factors are controlled by design, such that maternal race, socioeconomic status, and other personal factors will not confound the exposure-preterm birth association. In this issue of the Journal, Basu et al. (Am J Epidemiol. 2010;172(10):1108-1117) apply the case-crossover approach to assess the short-term relation between ambient apparent temperature and preterm birth. Novel application of the design to preterm birth, a "fatal" event exhibiting dramatic within-subject changes in risk, merits a review of the assumptions underlying the design. Implications of the referent time periods selected and the potential for confounding by seasonal patterns of conception are discussed in this commentary. The provocative associations observed by Basu et al. between high ambient apparent temperature and preterm birth should stimulate follow-up analyses and could ultimately have important public health implications. Future research can also help delineate the relative strengths and weaknesses of different temporal analytic strategies for investigating short-term associations between various exposures and preterm birth.

摘要

病例交叉设计的特性对于研究早产的急性触发因素具有吸引力。通过设计可以控制测量和未测量的时不变风险因素,例如母体种族、社会经济地位和其他个人因素不会混淆暴露与早产的关联。在本期《美国流行病学杂志》中,Basu 等人应用病例交叉法评估环境表观温度与早产之间的短期关系。该设计在早产方面的新颖应用,即“致命”事件,其风险在个体内部发生显著变化,值得对设计的基本假设进行审查。本评论讨论了参考时间段的选择以及受孕季节模式混杂的可能性。Basu 等人观察到的高环境表观温度与早产之间存在关联,这令人深思,应该会刺激后续分析,并最终对公共卫生产生重要影响。未来的研究还可以帮助阐明研究各种暴露与早产之间短期关联的不同时间分析策略的相对优势和劣势。

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