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Residential mobility during pregnancy: implications for environmental teratogenesis
M J Khoury1, W Stewart, A Weinstein
1Department of Epidemiology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205.
Journal of Clinical Epidemiology
|January 1, 1988
Summary
Mothers move frequently during pregnancy, leading to inaccurate tracking of environmental teratogen exposure. Using residence at birth misclassifies exposure, potentially hiding links between environmental factors and birth defects.
Area of Science:
- Environmental Health
- Reproductive Epidemiology
- Teratology
Background:
- Environmental teratogens are suspected to cause birth defects early in pregnancy.
- Birth defect studies often use residence at birth as a proxy for early pregnancy residence.
- High population mobility in the U.S. can lead to residence misclassification.
Purpose of the Study:
- To evaluate the bias introduced by using residence at birth instead of residence during early pregnancy.
- To assess the impact of residential mobility on identifying environmental teratogens.
Main Methods:
- Analysis of data from the Maryland Birth Defects Reporting and Information System (1984).
- Ascertainment of 295 infants with sentinel birth defects.
- Examination of maternal residential changes from conception to birth.
Main Results:
- 20% of mothers changed address between conception and birth; 22% moved to a different county.
- Residential mobility was highest among white women aged 20-24.
- Misclassification of exposure increases with mobility and population exposure frequency, weakening observed associations.
Conclusions:
- Using residence at birth as a proxy for early pregnancy residence can lead to misclassification of environmental teratogen exposure.
- This misclassification can weaken associations and cause environmental teratogens to be overlooked.
- Accurate identification of environmental teratogens requires collecting residence information from early pregnancy, not solely at birth.