Why The Association Between Sexual Intercourse and Fetal Death Is Not Necessarily Causal: A Science Perspective

An investigator examined cases of fetal death in 27,000 pregnancies and classified mothers according to whether they had experienced sexual intercourse within 1 month before delivery. It was found that 11% of the mothers of fetuses that died and 2.5% of the mothers of fetuses that survived had had sexual intercourse during the period. It was concluded that intercourse during the month preceding delivery caused the fetal deaths. This conclusion:a. May be incorrect because mothers who had intercourse during the month before childbirth may differ in other important characteristics from those who did notb. May be incorrect because there is no comparison groupc. May be incorrect because prevalence rates are used where incidence rates are neededd. May be incorrect because of failure to achieve a high level of statistical significancee. Both b and c

A – May be incorrect because mothers who had intercourse during the month before childbirth may differ in other important characteristics from those who did not

The correct answer is a.

The conclusion that intercourse during the month preceding delivery caused the fetal deaths may be incorrect because mothers who had intercourse during the month before childbirth may differ in other important characteristics from those who did not. This means that there may be confounding factors that could explain the association between sexual intercourse and fetal death. As a result, it is not appropriate to infer a causal relationship between these two variables.

Option b is incorrect because there is a comparison group (mothers of fetuses that survived) that is used to quantify the difference in sexual intercourse rates between the two groups.

Option c is incorrect because prevalence rates are appropriate when studying the association between a risk factor (in this case, sexual intercourse) and an outcome (fetal death) that has already occurred.

Option d is incorrect because statistical significance alone does not establish causality. It only measures the likelihood that the observed association occurred by chance.

Therefore, option e is also incorrect.

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