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Incorporating Social Theory and Missing Data Approaches to Better Inform Autism Spectrum Disorder Research: Application to the Association Between Labor Epidural Analgesia and ASD
Incorporating Social Theory and Missing Data Approaches to Better Inform Autism Spectrum Disorder Research: Application to the Association Between Labor Epidural Analgesia and ASD
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202104712
- ISBN
- 9798291554883
- DDC
- 614.4
- 저자명
- Ingol, Taniqua.
- 서명/저자
- Incorporating Social Theory and Missing Data Approaches to Better Inform Autism Spectrum Disorder Research: Application to the Association Between Labor Epidural Analgesia and ASD
- 발행사항
- [Sl] : The University of North Carolina at Chapel Hill, 2025
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2025
- 형태사항
- 131 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 87-02, Section: B.
- 주기사항
- Advisor: Daniels, Julie L.
- 학위논문주기
- Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2025.
- 초록/해제
- 요약Background: Many potential causes of autism spectrum disorder (ASD) have been reported in the literature; however, findings are often inconclusive due to issues like measurement error and selection bias, which are compounded by structural racism. Accurate identification of ASD risk factors requires understanding and addressing the ways in which structural racism contributes to bias in epidemiologic research. This dissertation used social theory to conceptualize how structural racism influences bias in the association between labor epidural analgesia and ASD, and incorporated missing data methods to address those biases.Methods: We used data from the Study to Explore Early Development, a U.S. multi-site, population-based case-control study of children aged 2-5 years with ASD and two control groups. Results: In Aim 1, we investigated the association between labor epidural analgesia and ASD and found no strong evidence to support an association, even after conducting several sensitivity analyses. Subtle associations emerged when the analysis was restricted to vaginal deliveries, however, they attenuated after adjustment for additional confounders (i.e., prolonged labor). We found no appreciable effect measure modification by the birthing person's race and ethnicity. In Aim 2, we derived a validation cohort from children with multiple ASD measurements and used it to apply Multiple Imputation for Measurement Error to address missing outcome data due to loss to follow-up. We found that excluding those. lost to follow-up slightly underestimated the observed association reported in Aim 1, though not enough to alter conclusions Conclusions: We found no evidence to support an association between labor epidural analgesia and ASD. However, as we continue to investigate ASD risk factors, it's crucial to consider how variations in diagnostic practices, as well as systemic inequities, can influence systematic error and the associations we observe. Careful attention to these factors ensures that research conclusions are both valid and generalizable.
- 일반주제명
- Epidemiology
- 일반주제명
- Neurosciences
- 일반주제명
- Medicine
- 일반주제명
- Obstetrics
- 키워드
- ASD risk factors
- 기타저자
- The University of North Carolina at Chapel Hill Epidemiology
- 기본자료저록
- Dissertations Abstracts International. 87-02B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■020 ▼a9798291554883
■035 ▼a(MiAaPQ)AAI32118916
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a614.4
■1001 ▼aIngol, Taniqua.
■24510▼aIncorporating Social Theory and Missing Data Approaches to Better Inform Autism Spectrum Disorder Research: Application to the Association Between Labor Epidural Analgesia and ASD
■260 ▼a[Sl]▼bThe University of North Carolina at Chapel Hill▼c2025
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2025
■300 ▼a131 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 87-02, Section: B.
■500 ▼aAdvisor: Daniels, Julie L.
■5021 ▼aThesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2025.
■520 ▼aBackground: Many potential causes of autism spectrum disorder (ASD) have been reported in the literature; however, findings are often inconclusive due to issues like measurement error and selection bias, which are compounded by structural racism. Accurate identification of ASD risk factors requires understanding and addressing the ways in which structural racism contributes to bias in epidemiologic research. This dissertation used social theory to conceptualize how structural racism influences bias in the association between labor epidural analgesia and ASD, and incorporated missing data methods to address those biases.Methods: We used data from the Study to Explore Early Development, a U.S. multi-site, population-based case-control study of children aged 2-5 years with ASD and two control groups. Results: In Aim 1, we investigated the association between labor epidural analgesia and ASD and found no strong evidence to support an association, even after conducting several sensitivity analyses. Subtle associations emerged when the analysis was restricted to vaginal deliveries, however, they attenuated after adjustment for additional confounders (i.e., prolonged labor). We found no appreciable effect measure modification by the birthing person's race and ethnicity. In Aim 2, we derived a validation cohort from children with multiple ASD measurements and used it to apply Multiple Imputation for Measurement Error to address missing outcome data due to loss to follow-up. We found that excluding those. lost to follow-up slightly underestimated the observed association reported in Aim 1, though not enough to alter conclusions Conclusions: We found no evidence to support an association between labor epidural analgesia and ASD. However, as we continue to investigate ASD risk factors, it's crucial to consider how variations in diagnostic practices, as well as systemic inequities, can influence systematic error and the associations we observe. Careful attention to these factors ensures that research conclusions are both valid and generalizable.
■590 ▼aSchool code: 0153.
■650 4▼aEpidemiology
■650 4▼aNeurosciences
■650 4▼aMedicine
■650 4▼aObstetrics
■653 ▼aAutism spectrum disorder
■653 ▼aEpidemiologic research
■653 ▼aASD risk factors
■653 ▼aLabor epidural analgesia
■653 ▼aVaginal deliveries
■690 ▼a0766
■690 ▼a0564
■690 ▼a0317
■690 ▼a0380
■71020▼aThe University of North Carolina at Chapel Hill▼bEpidemiology.
■7730 ▼tDissertations Abstracts International▼g87-02B.
■790 ▼a0153
■791 ▼aPh.D.
■792 ▼a2025
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17358508▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.


