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Am J Epidemiol 2003; 158:938-940.
Copyright © 2003 by Johns Hopkins Bloomberg School of Public Health

ORIGINAL CONTRIBUTIONS

Invited Commentary: Hot Tubs and Miscarriage—Methodological and Substantive Reasons Why the Case Is Weak

Irva Hertz-Picciotto1  and Penelope P. Howards2

1 Department of Epidemiology and Preventive Medicine, University of California, Davis, Davis, CA.
2 Department of Epidemiology, University of North Carolina, Chapel Hill, NC.

Received for publication June 16, 2003; accepted for publication July 14, 2003.

The first 150 words of the full text of this article appear below.

Since the use of multivariable survival analysis for pregnancy outcome studies was first introduced into the reproductive epidemiology literature (1), few researchers examining fetal loss have applied these methods, which include Cox proportional hazards and other statistical models. Because logistic regression can yield misleading results, Li et al. (2) are to be commended for electing to make use of these methods. It might appear, therefore, that their study was methodologically strong.

Unfortunately, several key limitations to the study (2) and some of the authors’ decisions limit the credibility of their findings. A synopsis of the concerns follows. First, the response rate was very low. Second, data for early gestational weeks are sparse and may not be representative. Third, most of the cases were interviewed after they miscarried, and the association hinges on the subgroup of these women who both miscarried early and were interviewed . . . [Full Text of this Article]


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Related articles in Am. J. Epidemiol.:

Hot Tub Use during Pregnancy and the Risk of Miscarriage
De-Kun Li, Teresa Janevic, Roxana Odouli, and Liyan Liu
Am. J. Epidemiol. 2003 158: 931-937. [Abstract] [FREE Full Text]  

Li et al. Respond to "No Link between Hot Tubs and Miscarriage"
De-Kun Li, Teresa Janevic, Roxana Odouli, and Liyan Liu
Am. J. Epidemiol. 2003 158: 941. [Extract] [FREE Full Text]  



This article has been cited by other articles:


Home page
 Am J EpidemiolHome page
D.-K. Li, T. Janevic, R. Odouli, and L. Liu
Li et al. Respond to "No Link between Hot Tubs and Miscarriage"
Am. J. Epidemiol., November 15, 2003; 158(10): 941 - 941.
[Full Text] [PDF]