Term Paper on "Low Birth Weight Babies and Asthma"

Term Paper 5 pages (1313 words) Sources: 2 Style: APA

[EXCERPT] . . . .

Low Birth Weight Babies and Asthma in Urban Populations

This paper is a critical review of the article by Lenna Nepomnyaschy and Nancy Reichman, published in the American Journal for Public Health. It will review the purpose of the study, its study design, and the sample selection. In addition, it will analyze what correlations there may be in a fairly complex series of confounding variables. Finally, it will review the practice implications of the study for the nurse.

Purpose and Objective of this Epidemiological Research

The authors make it clear that there have been a large number of studies in the past to attempt to correlate low birth weight with asthma in young children, but these studies did not, in the authors' opinions, control adequately for a number of additional factors which could have contributed to asthma in babies and children at the age of three.

The authors' conclusions are preliminary, but they contend that, even when normalized for other confounding conditions, such as maternal demographic, socioeconomic, medical and behavioral risk factors, the correlation remained strong between low birth weight and asthma at the age of three. They also found a statistically significant correlation between measures of neighborhood housing quality and poverty.

Study Design

The study attempted to count babies and toddlers from a representative group within urban populations, which is a partial nod to Gordon's dictum to "be able to identify the specific factors which put [high risk] groups at high risk and try to modify those factors (Gordon, 2004)." The study population did not mirror the general U.S. population, and it also differed from the large urban center population in important ways: according to the paper, the mothers were more likely to be non-marital birth mothers, and a significant number of surveyed mothers and their babies dropped out of the study from birth to age 3. The dropout numbers, as reported in the study, are as follows:

4,898 total included in the survey

3,319 interviewed 3 years later (68%)

2,994 for which medical records were available from the 4,898 (61%)

2,032 for which medical records were available from the 3,319 (61%)

The choice of sample population is quite complete, but leaves some questions open:

1. Which cities were chosen? The study shows that 20 cities were included, but does not indicate where they were in the U.S. This question of location could be important, particularly if the asthma results need to be controlled for climate. if, for example, there were more cities than proportionately in the U.S. In northern climes, such as Minneapolis and Chicago, there could be a greater number of children who contract asthma in whole or in part due to inadequate heating or exposure to the cold.

2. Why were multiple births excluded? The authors point out that much of low birth weight trends is due to multiple births. This variable would be helpful to understand.

3. What are the commonalities in those who did not have medical data available, or were not available for follow-up three years later? If the toddlers and mothers were not available, were there confounding variables, such as housing, drug use and/or low birth weight? If the demographic variables were similar for both groups -- those followed up and those not followed up -- this should be indicated in the study.

3. The importance of prenatal drug use and smoking pre- and post-natally was demonstrated to be relatively low in comparison to other factors, with little statistical significance. Since the drug use and smoking were self-declared, it would be helpful to understand the correlation between a subsample of mothers' lab results (for the 61% where medical records were available) against their self-declared behaviors. A representative sample may have been enough to indicate whether or not the self-declared behaviors were in fact accurate indicators of actual drug and/or tobacco use.

4. The authors claim that there may have been mothers who were less than 18 at the… READ MORE

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