Approaches for strengthening causal inference regarding prenatal risk factors for childhood behavioural and psychiatric disorders

Sarah J. Lewis*, Caroline Relton, Stanley Zammit, George Davey Smith

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

18 Citations (Scopus)

Abstract

BackgroundThe risk of childhood behavioural and psychiatric diseases could be substantially reduced if modifiable risk factors for these disorders were identified. The critical period for many of these exposures is likely to be in utero as this is the time when brain development is most rapid. However, due to confounding and other limitations of traditional epidemiological studies, identification of causal risk factors has proved challenging and on the whole research in this area has not been fruitful.

ScopeIn this review, we highlight several alternative approaches including; comparisons across settings, the use of negative controls and natural experiments, which includes migration studies, studies of individuals conceived using in vitro fertilisation and not least Mendelian randomisation. We have illustrated these approaches using examples of behavioural and psychiatric disorders.

ConclusionBy having these approaches outlined together in one review, researchers can consider which of these methods would be most suitable for their study question. We have particularly focussed on Mendelian randomisation, as this is a relatively novel concept, in doing so, we have illustrated the concept and discused the implementation and the limitations of this approach.

Original languageEnglish
Pages (from-to)1095-1108
Number of pages14
JournalJournal of Child Psychology and Psychiatry
Volume54
Issue number10
DOIs
Publication statusPublished - Oct 2013

Keywords

  • Mendelian randomisation
  • causal inference
  • childhood behaviour
  • psychiatric disorders
  • instrumental variable analysis
  • MENDELIAN RANDOMIZATION ANALYSIS
  • FETAL VALPROATE SYNDROME
  • CORONARY-HEART-DISEASE
  • NEURODEVELOPMENTAL DISORDERS
  • COGNITIVE DEFICITS
  • MATERNAL INEBRIETY
  • CONGENITAL-RUBELLA
  • GENETIC-VARIANTS
  • HEALTH OUTCOMES
  • SIBLING DESIGNS

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