Table Of ContentReproductiveand
PerinatalEpidemiology
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Reproductiveand
PerinatalEpidemiology
Edited by
GermaineM.BuckLouis
Robert W. Platt
1
1
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Library of Congress Cataloging-in-Publication Data
Reproductive and perinatal epidemiology / [edited by]
Germaine Buck Louis and Robert Platt.
p. ; cm.
Includes bibliographical references.
ISBN 978-0-19-538790-2
1. Obstetrics. 2. Perinatology. 3. Epidemiology. I. Louis, Germaine Buck.
II. Platt, Robert.
[DNLM: 1. Genital Diseases, Female—epidemiology. 2. Epidemiologic Methods.
3. Infant, Newborn, Diseases—epidemiology. 4. Pregnancy Complications—epidemiology.
WP 140 R4244 2011]
RG526.R47 2011
618.2—dc22
2010025520
9 8 7 6 5 4 3 2 1
Printed in the United States of America
on acid-free paper
Dedicated to our spouses, sons, and daughters,
and Summer Institute students from whom we have learned much…
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Preface
Reproductive and perinatal epidemiology has been a longstanding subspecialty of
epidemiology, and is characterized by a relatively small but dedicated group of
practicing epidemiologists. In 2002, the Society for Paediatric and Perinatal
Research (SPER) surveyed its membership regarding the availability and compo-
sition of formal graduate courses in reproductive and perinatal epidemiology,
along with issues pertaining to the recruitment and retention of students in this
area. The survey revealed that approximately 40% of academic institutions repre-
sented in the study reported formal graduate course offerings in either/both repro-
ductive and perinatal epidemiology. Two key fi ndings emerged from the survey
that were relevant to the development of the summer institute: there was consider-
able heterogeneity in the content, format, and frequency of course offerings; and
an urgent need existed to expand options for formalized training in the fi eld, par-
ticularly given the absence of such courses in most institutions. The Summer
Institute in Reproductive and Perinatal Epidemiology was one global attempt to
help build the next generation of reproductive and perinatal epidemiologists.
The origin of the Summer Institute began in 2004, when representatives from
the Eunice Kennedy Shriver National Institute of Child Health and Human
Development (NICHD) and the Institute of Human Development, Child and Youth
Health (IHDCYH) met at NICHD to discuss strategies for developing formal
training programs in reproductive and perinatal epidemiology. There was unani-
mous support for developing an intensive training program, and the following
year was spent recruiting faculty who were willing to develop an integrative cur-
riculum. In addition, each year, an esteemed reproductive or perinatal epidemiolo-
gist is selected to be the keynote speaker for the Institute. In 2005, the inaugural
Summer Institute for Reproductive and Perinatal Epidemiology was held in Woods
Hole, Massachusetts. At the time this book went to press, 120 students from
throughout the world representing 14 countries and 49 academic institutions have
participated in the Summer Institute.
In planning the curriculum for the Summer Institute, the faculty recognized the
absence of a suitable textbook in reproductive and/or perinatal epidemiology
designed from a curriculum perspective. This prompted the faculty to develop
curriculum for the Institute that met the following criteria: (a) coverage of key
reproductive and perinatal outcomes inclusive of each topic’s descriptive and ana-
lytic epidemiology; (b) an international perspective for the presentation of research
fi ndings; and (c) identifi cation of key methodologic issues underlying each end-
point. Suffi ce to say, the overarching goal of the Summer Institute is to provide
students with an appreciation of the epidemiology of successful and unsuccessful
viii PREFACE
human reproduction and development, largely from a public health perspective,
along with important measurement and study design issues related to particular
outcomes. The faculty collaborated to remove redundancy and to reinforce meth-
odologic issues shared by two or more outcomes. Course evaluations completed
by students were used to further refi ne the Institute’s curriculum, which essen-
tially became the content of this book, enhanced by contributions from keynote
speakers. This book is a compilation of the faculty and students’ efforts in perfect-
ing the Summer Institute’s curriculum for sharing with others interested in the
fi eld. The authors remain indebted to and appreciative of the students who inspired
the origins and development of this text.
ACKNOWLEDGMENTS
The authors wish to acknowledge the teaching provided by two other summer
institute faculty Drs. Mark Klebanoff and Michael Kramer, and keynote speakers
Drs. Nigel Paneth and Jon Tyson for their participation in the summer institute.
