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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 D...
Incorporating Social Theory and Missing Data Approaches to Better Inform Autism Spectrum Disorder Research: Application to the Association Between Labor Epidural Analgesia and ASD

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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  
Autism spectrum disorder
키워드  
Epidemiologic research
키워드  
ASD risk factors
키워드  
Labor epidural analgesia
키워드  
Vaginal deliveries
기타저자  
The University of North Carolina at Chapel Hill Epidemiology
기본자료저록  
Dissertations Abstracts International. 87-02B.
전자적 위치 및 접속  
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MARC

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■006m          o    d                
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■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.

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