A Critical Appraisal of Selected Pieces of Health Research - Literature review Example

A critical appraisal of selected pieces of health research literature Lecturer’s Introduction to the health issue Women suffering from substance use disorders experience profound effects of drug use on their babies. During the pregnancy period, almost all the drugs ingested by the mother have the ability to pass through the placenta and reach the baby. As a result these illicit drugs consumed by the mother may reduce the amount of oxygen than reach the child, may affect the baby’s development leading to congenital abnormalities (Kuczkowski 2007, 582). As well, taking illegal drugs during pregnancy may affect how the placenta works resulting in an increased risk that the placenta may come away from the side of the uterus, and it may cause severe bleeding that can be life-threatening to the mother and the baby. The child may also suffer from withdrawal symptoms causing the baby to stay longer in the hospital for hospitalization for further treatment (Muckle et al. 2011, 1086). Alcohol consumption during pregnancy causes damage to the central nervous system of the developing fetus as well as birth defects. Utilization of alcohol also increases the associated risks of miscarriage, affects the baby size to term as babies are born smaller, and it may affect their attention and activity later in life (Harrison & Sidebottom 2009, 391). Tobacco smoking also may result in smaller babies born weaker and are more susceptible to disease. As well, smoking increases the risks of premature labor, miscarriages and placenta abruption (Bailey et al. 2012, 416). Cocaine and heroin use has been associated with baby’s development of withdrawal syndrome after birth, birth defects such as heart defects as well as an increased risk of HIV infection due to the sharing of the needles. Cannabis use effects on the baby have been associated with similar effects as discussed above. Statement of the research question What are the effects of drug use on young women during pregnancy? Brief description of the papers found For a number of young girls, substance use is a standard part of their developmental life and is linked to serious health consequences such as teenage pregnancy. Moreover illegal drug utilization is associated with an increased rate of teenage pregnancy and their use has been associated birth and congenital complications as described above i.e. smaller birth weight babies, placenta abruption, miscarriages, heart defects on the baby and premature labor (Muckle et al. 2011, 1085). In regards to the research question of the study, the papers analyzed describes the effects of these drugs use on the pregnant women such as tobacco and marijuana among adolescents. As well, the papers found examines the association between the intensity of substance use with sexual experience and teenage pregnancy and describes the factors and prevalence that are associated with substance use among young women receiving prenatal care. Critique of the first paper by Chang et al. 2011 The research process The first paper is a pilot study on the self-reported substance utilization among young pregnant women associated factors and their prevalence. The primary goal of the study is describing the prevalence and factors that are associated with self-reported illegal drugs utilization among young women. The study design The study design used for the study was a cross-sectional study design among 30 pregnant adolescent adults responding to a mail survey that contained the CRAFT tool of screening. The study design was appropriate for the study, as the participants had to complete an interview that entailed their self-reported information on drugs utilization during pregnancy including the likely contexts that they would use them (Knottnerus & Muris 2003, 1120). Population and approach to sampling The target population for the study was pregnant teenagers that had a substance use disorder. The age limit of the participants was 25 years of age that were having their prenatal care at Brigham and Women Hospital only in Boston. To ensure that only teenagers took part in the study, the upper age limit was chosen to be 25 years to include those teenagers that had fallen pregnant when they were 24 years of age still young. This approach was appropriate as the WHO classifies young individuals to be between 10-24 years. Recruitment and method of data collection The study participants that qualified to take part in the study received innovation letters of taking part in the research process that was issued by the researchers. An explanatory letter was attached to the innovation letter as well as Health Habits Survey that had the CRAFFT questions attached so that they would be able to understand the purpose of the study. The questions were about the diet, exercise, weight sleep pattern among others. A total of 100 letter were sent to the qualified participants and only those who were willing to participate in the research were asked to return their survey. The participants had to provide clinical data such as their expected conception date as well as their demographic information. Ethical issues and considerations Informed consent was obtained from the members in an effort to ensuring that only the willing members took part in the study. Moreover, for taking part in the study participant received a $60 check as appreciation and to take care of the expenses such as travel costs. Before the study was conducted, it was reviewed by the institutional review board and approved to ensure that it was safe and beneficial (Walker 2007, 43). Finding and authors interpretation of finding From the results, at least a third of the participants abused alcohol or cannabis and had a lifelong diagnosis. CRAFFT was very suitable for determining the prenatal substance utilization. Education, number of children; age and race were not associated with abuse. Rather drug abuse, before pregnancy was later associated with prenatal abuse as the participants, indicated the lesser likelihood of drug abuse in intimate, convivial and negative coping contexts in pregnancy. Thus, CRAFFT screening and determining the context of drug use were identified as promising approaches to the determination of prenatal substance use. Critique of the second paper by Cavazos-Rehg et al. 2011 The research process The second paper critique is a study with an aim of examining the effects of marijuana and tobacco utilization in the pregnancy period on the growth, morphology and gestational age of the fetus among young adolescent mothers. The study design The study design for the paper is a longitudinal study where adolescent pregnant women were obtained from a prenatal clinic in an effort to determining the effects of drug use in pregnancy. Participants were interviewed and observed throughout the pregnancy period as well as at the time of delivery to determine the effects of drug utilization to the mothers and infants. After, the infants were later examined for 2-3 days in determining the effects. Population and approach to sampling The target population for the study was young women who were 18 years and below attending their prenatal clinic at a university hospital. Only women who meet the inclusion criteria were included in the study and a total of 310 mothers were included in the study that was significant for the study. Recruitment and method of data collection The participants who meet the inclusion criteria for the study who came to the health facility by the fifth month of their gestation were interviewed to participate in the study. Information was then collected on drug use in the first, second and third trimester of pregnancy as well as within 24 to 48 hours of baby’s delivery. Information that was obtained during data collection included the participant’s medical, demographic, sexual, psychiatric history as well as the infant’s behavioral, physical and cognitive characteristics. The measures of substance use were developed and extensively tested in an effort to ensuring the accuracy of the data collected. Ethical issues and considerations It is crucial to ensure that the ethical considerations of a research study are adhered to. This includes seeking for consent to conduct the study as well as approval seeking from the participants to taking part in the study (Howard et al. 2011, 159). However, the research did not obtain these ethical considerations as they are not mentioned anywhere in the study. Finding and authors interpretation of finding From the study results, the majority of the participants were African Americans with a maternal average age of 16 years. Tobacco utilization during pregnancy was thus associated with reduced birth weight of the babies, their length and chest circumferences for their gestational ages as well as physical anomalies especially after marijuana exposure among whites prenatally. From the authors interpretation, the effects of drug use among young adolescent mothers were prominent among the mothers and child as compared to adult’s mothers abusing the drugs. Thus, young maternal age increases the risks of negative effects of drug use on the mothers and their offsprings. Critique of the third paper by Cornelius et al. 1995 The research process The third paper objective was examining the association between the intensity as well as the initiation of substance use risk for engaging in sexual intercourse without or with a history of teenage pregnancy. The study design The study design was a cross-sectional behavioral surveillance nationally representative survey among high school female students. Population and approach to sampling The study focused its research on female participants from three major ethnic groups i.e. the whites, Hispanics and African Americans and other participants were excluded from the study. The multinational logistic regression was used in assessing the relationship between the age of initiation of the substance and the intensity likelihood of being sexually experienced and teenage pregnancy. Recruitment and method of data collection Only the females who meet the inclusion criteria for the study participated in the research. The participants had to respond to questions in an effort to determining their sexual intercourse experience, age of drug abuse initiation, as well as their pregnancy history. The participants were further grouped into three categories that are the non-experimental users, new users and the non-users that were appropriate for the study. Moreover, additional variables were also included in the study that entailed the ethnicity, location, and the participant’s feelings in an effort to determining risk behaviors occurring in different locations. Ethical issues and considerations Consent seeking among the participants is essential to ensuring voluntary participation. It is essential to educate the participants on the importance of carrying out the study for them to be able to understand its significance and participate fully. It is also important to get the approval for conducting the research institutional review board in an effort to ensuring that the research is ethical and safe (Walker 2007, 44). However, moral consideration has not been taken into consideration in the research study. Finding and authors interpretation of finding From the study finding, it was clearly evident that substance abuse among the teenagers across the different substances resulted in an increased rate of sexual intercourse. This directly was linked to an increase in teenage pregnancies especially on marijuana abuse where a dose-response relationship was observed to increase the rate of teenage pregnancies. This was similar for other drugs such as cigarette and alcohol. Thus, it is crucial to screen teenagers from substance use behaviors to determine those who can benefit from pregnancy prevention strategies. Summary and comparison The first paper is a pilot cross-sectional study with an aim of describing the prevalence and factors that are associated with self-reported illegal drugs utilization among young women aged 25 years and below. From the results, at least a third of the participants abused alcohol or cannabis and had a lifelong diagnosis. CRAFFT was very suitable for determining the prenatal substance utilization. Education, number of children; age and race were not associated with abuse rather drug abuse before pregnancy was later associated with prenatal abuse. Ethical considerations were taken into account such as seeking consent from the study participants and before the study was conducted, it was reviewed by the institutional review board and approved. The second study is a longitudinal study with an aim of examining the effects of marijuana and tobacco utilization in the pregnancy period on the growth, morphology and gestational age of the fetus among young adolescent mothers. The sampling method, method of data collection and the population was appropriate for the study were 310 participants who meet the study inclusion criteria took part in the research. The study revealed that drug utilization during pregnancy increases the chances of baby’s anomalies such as low birth weight and congenital defects. The young maternal age was associated to increase the risks of negative effects of drug use among mothers and their offsprings. However, the study never took into account the ethical considerations, as they were not stipulated in the study article. The third literature piece is a cross-sectional behavioral survey examining the association between the intensity as well as the initiation of substance use risk for engaging in sexual intercourse without or with a history of teenage pregnancy. Questions were used as a method of data collection, and the population and sampling design were appropriate for the study. However, just like the second literature piece, the study never employed any ethical considerations to protect the participants and ensure that the research was safe. From the research finding, it was evident that substance abuse among the teenagers across the different materials resulted in an increased rate of sexual intercourse directly linked to an increase in teenage pregnancies. Conclusion Women suffering from substance use disorders experience profound effects of drug use on their babies as well as on their health drugs as drugs consumed have the ability to pass through the placenta and reach the baby. This has been linked to increased complications during pregnancy and anomalies to the infant’s i.e. congenital defects and low birth weight. Drug use has also been linked to an increased rate of sexual activity among the teenagers resulting in increased pregnancies. It is, therefore, important to screen teenagers from substance use behaviors to determine those who can benefit from pregnancy prevention strategies by involving them in rehabilitation programs in an effort of reducing the associated pregnancy risks from drug abuse. References Bailey, B.A. et al., 2012. Infant Birth Outcomes among Substance Using Women: Why Quitting Smoking during Pregnancy is Just as Important as Quitting Illicit Drug Use. Maternal and Child Health Journal, 16, pp.414–422. Cavazos-Rehg, P.A. et al., 2011. Substance use and the risk for sexual intercourse with and without a history of teenage pregnancy among adolescent females. Journal of studies on alcohol and drugs, 72, pp.194–198. Chang, G. et al., 2011. Self-reported Alcohol and Drug Use in Pregnant Young Women: A Pilot Study of Associated Factors and Identification. Journal of addiction medicine, 5, pp.221–226. Cornelius, M.D. et al., 1995. Prenatal tobacco and marijuana use among adolescents: effects on offspring gestational age, growth, and morphology. Pediatrics, 95, pp.738–743. Harrison, P.A. & Sidebottom, A.C., 2009. Alcohol and drug use before and during pregnancy: An examination of use patterns and predictors of cessation. Maternal and Child Health Journal, 13, pp.386–394. Howard, H.C. et al., 2011. Informed consent in the context of pharmacogenomic research: ethical considerations. The pharmacogenomics journal, 11, pp.155–161. Knottnerus, J.A. & Muris, J.W., 2003. Assessment of the accuracy of diagnostic tests: the cross-sectional study. J. Clin. Epidemiol., 56, pp.1118–1128. Kuczkowski, K.M., 2007. The effects of drug abuse on pregnancy. Current opinion in obstetrics & gynecology, 19, pp.578–585. Muckle, G. et al., 2011. Alcohol, smoking, and drug use among inuit women of childbearing age during pregnancy and the risk to children. Alcoholism: Clinical and Experimental Research, 35, pp.1081–1091. Walker, W., 2007. Ethical considerations in phenomenological research. Nurse researcher, 14, pp.36–45. Read More