The Disillusionment of DOHaD Epidemiology.

The Disillusionment of DOHaD Epidemiology. Am J Epidemiol. 2019 Oct 02;: Authors: Gilman SE, Hornig M Abstract DOHaD (the Developmental Origins of Health and Disease) promises a greater understanding of early development but has left unresolved the balance of risks and benefits to offspring of medication use during pregnancy. Masarwa et al. (Am J Epi 2018;187(8):1817-1827) conducted a meta-analysis of the association between in utero acetaminophen exposure and risks for Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). A challenge of meta-analyzing results from observational studies is that summary measures of risk do not correspond to welldefined interventions when the individual studies adjusted for different covariate sets, which was the case here. This challenge limits the usefulness of observational metaanalyses for inferences about etiology and treatment planning. With that limitation understood, Masarwa et al. reported a 20-30% higher risk of ADHD and ASD following prenatal acetaminophen exposure. Surprisingly, most of the original studies did not report diagnoses of ADHD or ASD. As a result, their summary estimates of risk are not informative about children's likelihood of ADHD and ASD diagnoses. The long-term promise of DOHaD remains hopeful, but in the short-term more effort is needed to critically evaluate observational studies suggesting risks associated with medications used to treat con...
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research