Perinatal brain damage causation.
The search for causes of perinatal brain damage needs a solid theoretical foundation. Current theory apparently does not offer a unanimously accepted view of what constitutes a cause, and how it can be identified. We discuss nine potential theoretical misconceptions: (1) too narrow a view of what is a cause (causal production vs. facilitation), (2) extrapolating from possibility to fact (potential vs. factual causation), (3) if X, then invariably Y (determinism vs. probabilism), (4) co-occurrence in individuals vs. association in populations, (5) one cause is all that is needed (single cause attribution vs. multicausal constellations), (6) drawing causal inferences from very small numbers of observations (the tendency to generalize), (7) unstated causal inferences, (8) ignoring heterogeneity, and (9) failing to consider alternative explanations for what is observed. We hope that our critical discussion will contribute to fruitful research and help reduce the burden of perinatal brain damage.
Dammann
Olaf
O
Perinatal Infectious Disease Epidemiology Unit, OE 6415, Hannover Medical School, Hannover, Germany. ODammann@tufts-nemc.org
Leviton
Alan
A
D000037:Abruptio Placentae / Q000453:epidemiology / Q000503:physiopathology; D001720:Birth Injuries / Q000453:epidemiology* / Q000503:physiopathology; D015984:Causality; D020202:Cerebral Hemorrhage, Traumatic / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000453:epidemiology* / Q000503:physiopathology; D007231:Infant, Newborn; D007969:Leukomalacia, Periventricular / Q000453:epidemiology / Q000503:physiopathology; D011247:Pregnancy