title: Challenges in Studying Modifiable Risk Factors for Birth Defects.
abstract: Conducting research to identify modifiable risk factors for birth defects is difficult for a variety of reasons. While some challenges are familiar to researchers across many disciplines, the confluence of issues affecting birth defects research may not be well understood by those outside of the field. This article describes several methodological challenges to the study of birth defects and ways these challenges might be addressed: (1) ascertainment, definition and classification of birth defects; (2) exposure assessment on modifiable risk factors; (3) analytical challenges related to small numbers and multiple statistical tests; (4) the role of genetics, including the collection of specimens and analysis of genetic data; and (5) challenges in translating research and demonstrating public health impact. Understanding these issues is important for researchers planning studies, reviewers evaluating the scientific merit of results from these studies, and consumers of the research, including fellow researchers, policy makers, health care providers, and families.
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E86, Atlanta, GA 30333, .
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Tinker
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E86, Atlanta, GA 30333, .
authors.forename: Suzanne
authors.initials: S
authors.lastname: Gilboa
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E86, Atlanta, GA 30333, .
authors.forename: Jennita
authors.initials: J
authors.lastname: Reefhuis
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E86, Atlanta, GA 30333, .
authors.forename: Mary M
authors.initials: MM
authors.lastname: Jenkins
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E86, Atlanta, GA 30333, .
authors.forename: Marcy
authors.initials: M
authors.lastname: Schaeffer
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E86, Atlanta, GA 30333, .
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Moore
keywords: birth defects; case classification; case definition; public health impact; research methods