Introduction
Critical appraisal is an important factor to determine the relevance, validity, and transparency of the research. This paper presents the critical appraisal of the article ‘Light drinking in pregnancy, a risk for behavioral problems and cognitive deficits at 3 years of age’ with special focus on the relevance of this article, validity of the article, and validity of the result of the research in the article.
Critical appraisal
It is a critical appraisal of the article ‘Light drinking in pregnancy, a risk for behavioral problems and cognitive deficits at 3 years of age’ which was published by Oxford University Press on behalf of the International Epidemiological Association. “Critical appraisal is the process of systematically examining research evidence to assess its validity, relevance and results before using it to inform a decision.” (Abdel-Ghaffar, n.d., p.12). Critical appraisal is an important part of the evidence-based clinical practice to assess the validity of the research before going to implement the results of the study.
Relevance of the study
Researches have shown that heavy drinking during pregnancy affects children in their cognitive and behavioral development. But, there prevails ignorance on whether light drinking of the pregnant lady will affect the fetus. The objective of the study is to assess whether there is any behavioral problem and cognitive deficits among the children of those who drink lightly during pregnancy. It is a relevant subject for the time being. There are strong debates throughout the world that emphasizes the side effects of using alcohol by pregnant ladies. The result of the study shows that children born to mothers who drink lightly during pregnancy do not inflict the problem of behavioral disorders and cognitive deficits. But, the research reveals that children of heavy drinking mothers during pregnancy expose to different health issues. The result of the study can be taken for public information since there lacks of knowledge on the problem.
Validity of the study
This study used the Millennium Cohort study which is a longitudinal study of infants who are born in the United Kingdom and the sample was taken from England, Wales, Scotland, and Northern Island. Interviews and home visits were the two methods used in the assessment. Three questionnaires were used, namely, Strengths and Difficulties Questionnaire (SDQ) to assess the behavioral problems and British Ability Scale (BAS) and the Bracken School Readiness Assessment (BSRA) to assess the cognitive deficits of the children. The questions in the interview focused on the socio-economic situation, health problems, and drinking during pregnancy. The study addressed the real problem and achieved its objectives. Interviews were conducted by experts. There were two steps in the study and the first part of the survey was conducted when the cohort members were aged 9 months and the second part of the survey was conducted when they became three years. Therefore, they completed the follow-up accurately.
Results of the study
The findings answer the research objective that drinking lightly during pregnancy will not lead to the behavioral problems and cognitive deficits of the children. The result is very significant and precise to the objective of the study. It was noticeable that the J-shaped relationship between drinking during pregnancy and scores obtained by the children. There were no variations between the results of abstinent mothers and light drinkers at the time of pregnancy.
In this study, two-third of the mothers were those who include in the category of abstinence, twenty-nine percent were light drinkers, six percent were moderate drinkers and two percent were heavy drinkers.
Strengths and limitations of the study
“The data used in our study were from a large nationally representative sample of young children that were collected prospectively. However, the Millennium Cohort Study sample is not representative of all pregnancies or births and so data on miscarriages, stillbirths, and neonatal deaths were not included.” (Kelly, Y., Sacker, Gray, Kelly, J., Wolke & Quigley, 2008, p.6). This study unravels the widespread alcohol consumption of pregnant women even though there is a social stigma. The main drawbacks in the study are when there is a stigma about the consumption of alcohol, people will be reluctant to be open about and it is very difficult to give correct measurements for the light drinkers. It cannot be defined accurately what amount is regarded as a light drink, and therefore, it may be hard to restrict the problem to a questionnaire. There may be some other causes for the behavioral problem of children other than the consumption of alcohol. Therefore, the factors like genetic make-up, social determinants such as financial condition; family background, etc also should be taken into consideration and should be assessed very systematically and scientifically.
Recommendations
Pregnant women may probably be loathed to reveal about the intake of alcohol since there exists stigma in society. Therefore the use of a questionnaire would be inappropriate to scribe the responses of the clients. There is vagueness in many of the terms used in the study. Some concepts are beyond the actual definition. For example, light drinking cannot be defined objectively and it varies from person to person. Social drinkers can be categorized as light drinkers but the question is up to what level and quantity. Therefore the responses of the client cannot be limited to some of the questions paused in the questionnaire. To get accurate data for the study and to get the pulse of the clients, it is better to use in-depth interviews and observant participation methods. The quantitative nature of the study may hamper accurate results and thereby reliability. The next flaw of this study is that it had two sweeps. The first had conducted when the children were at nine years of old and the second sweep was conducted when the children were at three years of old. These two sweeps of the study cannot bring effective and reliable information on how the slight drinking of mothers affects the children since there are other leading factors to the development of cognitive and behavioral defects. If the study is conducted using the interview method, the researcher can include the questions according to the changing perceptions of the social norms. When the social norms are being changed in time, the questionnaire which is developed years back will not be apt at the time of the study. Therefore what I would suggest is that it could have been made better and the result could have more been reliable if the study had been conducted qualitatively.
Conclusion
The consumption of alcohol by pregnant women is considered a risk factor for the physical, mental, and cognitive growth of children. Public people have not received accurate information on this issue. The above-referred article shows the outcome of the research on whether the light drinking habit of the mother hampers the development of the fetus in her womb. This paper substantiates the fact that slight drinking of pregnant women will not affect the cognitive and behavioral disorders of the children. The study is needed of the time and it is valid to provide current information on the problem. At the same time, it has underestimated the result of the study being used by questionnaire and quantitative study.
Reference List
Abdel-Ghaffar, S. (n.d.). Critical appraisal: An overview: What is critical appraisal?. Faculty of Medicine, Cairo University. Web.
Kelly, Y., Sacker, A., Gray, R., Kelly, J., Wolke, D., & Quigley, M A. (2008). Light drinking in pregnancy, a risk for behavioral problems and cognitive deficits at 3 years of age: Strengths and limitations of the study. International Journal of Epidemiology, 1-12. Oxford University Press.