Department of Epidemiology

TulaneSchool of Public Health and Tropical Medicine

Reproductive Epidemiology

EPID 6480

Classroom: 1203, Tidewater Building, Wednesday, 9:00-11:30 am

Xu Xiong, MD, DrPH

Associate Professor of Epidemiology

TidewaterBuilding, Room 2022

Phone: (504) 988-137

Fax: (504) 988-1568

Email:

TA:Mengxi Zhang

Email:

Office Hours:Tuesday 4:00PM-5:00PM

Guest lecturers:

Gabriella Pridjian, MD, Professor and Chair, Dept. of Obstetrics & Gynecology, School of Medicine

Emily Harville, PhD, Associate Professor of Epidemiology, School of Public Health and Tropical Medicine

Pierre Buekens, MD, MPH, PhD, Professor and Dean, School of Public Health and Tropical Medicine

  1. Course Outline:

This course provides students analytical skills necessary to conduct epidemiological studies in reproductive health in human populations. Reproductive epidemiology covers broad health issues from the pre-conception, prenatal, delivery and post-natal periods and emphasizes health issues affecting both women and infants. Relevant methodological, clinical, policy and programmatic issues will be presented will practical illustrations from domestic and international settings. Students will be able to design a reproductive health epidemiology study, discuss relevant methodological issues in reproductive health epidemiology studies, and apply reproductive/perinatal health data to improve reproductive programs and policy.

  1. Course Objectives:

By the completion of the course, the students will be able to:

  • Measure the key reproductive health indicators, both morbidity and mortality.
  • Appraise key epidemiologic study design and measurement issues in reproductive health.
  • Identify the sources of data used in reproductive epidemiology and the strengths and weaknesses of the different data sources.
  • Choose different methodologies used to collect data and conduct analysis on reproductive epidemiology topics.
  • Discuss with key study design and measurement issues in topics such as infertility, birth defects and early reproductive loss, pregnancy-induced hypertension, and low birth weight.
  • Evaluate relationships between lifestyle, occupational factors and reproductive outcomes.
  • Select the key variables for the evaluation of prenatal care.
  • Identify the common pregnancy-induced disorders (e.g., anemia, pregnancy-induced hypertension, gestational diabetes mellitus) and their prevalence, risk factors, maternal and infant outcomes.
  • Review the epidemiology of preterm birth and understand key differences in the conducting and interpretation of results of studies of preterm birth, intrauterine growth restriction and low birth weight
  • Describe the epidemiology of stillbirth/fetal death, early neonatal death, infant mortality, perinatal mortality and maternal mortality.
  • Criticize key evidence-based medicine approaches in reproductive health (methodological and ethics features of randomized clinical trials, systematic review or meta-analysis, Cochrane Collaboration).
  • Examine key evidence-based global health issues in reproductive health, especially in developing countries.
  • Assess the concept and public health significance of possible fetal origins of some health problems in later life (e.g., obesity, hypertension, type II diabetes, and cardiovascular disease).
  • Determine the public health significance of major reproductive and perinatal problems and the importance of epidemiologic studies in developing prevention strategies.
  1. Prerequisite:

Students must have completed introductory epidemiology and biostatistics courses (EPID 6030, BIOS 6030).

  1. Course Format:

In-class lectures, and directed group discussions of course materials and projects. Students will be expected to read assigned readings and be prepared to discuss them. Students will be expected to select one specific topic and analyze existing perinatal data and write abstract and present their individual project.

  1. My Tulane Blackboard:

be used for course materials, announcements, assignments, communication regarding the class and additional useful information. It is the student’s responsibility to check the course site for changes to the syllabus or announcements.

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  1. Course evaluation:

Evaluation will be based on:

-Classroom participation: 20%

-Journal article critique: 20%

-Quiz (1, 2, 3): 30%

-Secondary data analysis project: 30%

The approximate guidelines for the transformation of percentages into grade points for this course are:

A>95%

A-90-95%

B+85-89%

B80-84%

B-70-79%

C50-69%

  1. Textbooks:

Allen J. Wilcox.Fertility and Pregnancy: An EpidemiologicPerspective (First Edition). Oxford 2010

  1. Reading materials:

Reading materials and handouts will be delivered to the students before each section including each section course syllabus and 1-2 suggested readings.

I. CLASS SCHEDULE:Wednesday, 9:00-11:30 am

EPID 6480: Reproductive Epidemiology

(Subject to Change)

Class Date / Topic / Contents / Wilcox Book Readings / Evaluation & Assignment Due Date
Section 1
Jan. 14 / Introduction /
  • Syllabus/Course Evaluation
  • Overview of Reproductive Health and Reproductive Epidemiology
/ Chapters 1, 8 / Article critique: Literature/article search
Section 2
Jan. 21 / Study Design /
  • Overview of Basic Epidemiologic Study Designs
  • Reproductive Data Sources
/ Chapters 2, 3
Section 3
Jan. 28 / Early Pregnancy /
  • Infertility/ Assisted Reproductive Technologies /Multiple Pregnancies
  • Early Pregnancy Loss/abortions
  • Unintended Pregnancy/Teen Pregnancy
  • Delayed Childbearing
/ Chapters 2, 9, 10 / Article critique: Article submission
Section 4
Feb. 4 / Birth Defects /
  • Cause of Abnormal Development
  • Principle of Teratology Defects
  • Major Congenital Malformation
  • Surveillance & Prevention of Birth Defects
/ Chapters 11, 16 / Data analysis project: Topic choice & dataset delivery
Section 5
Feb. 11 / Prenatal Screening
(Prof. Gabriella Pridjian) /
  • Screening of High Risk Pregnancy & Genetic Disorders
/ Chapters 4, 5 / Quiz_1
Section 6
Feb. 18 / Prenatal Care
Lab: (9:00-11:45 am) /
  • Measurement of Prenatal Care
  • Prenatal Care and Pregnancy Outcomes
/ Chapter 6
Section 7
Feb. 25 / Reproductive Risk Assessment
(Dr. Emily Harville) /
  • Major Issues in Exposure Assessment
  • Lifestyle Factors and Pregnancy Outcomes
  • Occupational and Environmental Hazard
/ Chapters 7, 17
Section 8
Mar. 4 / Pregnancy Complications I: /
  • Anemia: Prevalence & Birth Outcomes
  • Gestational Diabetes Mellitus: Screening & Birth Outcomes
/ Chapters 13, 17
Section 9
Mar. 11 / Pregnancy Complications II: /
  • Gestational Diabetes Mellitus: Screening & Birth Outcomes
  • Hypertensive Disorders in Pregnancy
/ Chapters 18, 19 / Data analysis project: Data analysis & results
Section 10
Mar. 18 / Preterm Birth and Low Birth Weight /
  • Preterm Birth, Fetal Growth Restriction & Low Birth Weight
  • Etiology of Preterm Birth and Low Birth Weight
  • Prevention of Preterm Birth
/ Chapters 14, 15 / Quiz_2
Section 11
Mar. 25 / Perinatal Mortality and Infant Mortality /
  • Fetal deaths, Stillbirths, Neonatal Deaths, and Perinatal Deaths
  • Birth Weight and Perinatal Mortality
/ Chapter 12
Section 12
Apr. 1 / NO CLASS(Spring break)
Section 13
Apr.8 / Global Reproductive Health /
  • Global Maternal and Child Health
/ Chapter 18 / Data analysis project: Abstract submission
Section 14
Apr. 15 / Evidence-Based Global Health
(Dr. Pierre Buekens) /
  • Evidence-Based Global Health: Maternal and Infant Mortality in Developing Countries
/ Chapter 18
Section 15
Apr. 22 / Long-Term Impacts of Perinatal Health /
  • Fetal Origins of Adult Disease
Hypothesis: Strengths and Limitations / Chapter 20 / Quiz_3
Section 16
May 6 / Final exam
8:00-10:00 am /
  • Oral Presentation
/ Data analysis project: Oral Presentation