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Birth Defects, Causal Attributions, and Ethnicity in the National Birth Defects Prevention Study

  • Original Research
  • Published:
Journal of Genetic Counseling

Abstract

In order to translate research findings into effective prevention strategies, it is important to understand people's beliefs about the causes of poor health outcomes. However, with the exception of knowledge and beliefs about folic acid supplementation, little is known regarding women's causal attributions women regarding birth defects. We employed Attribution Theory constructs to analyze open-text interview responses from 2,672 control mothers in the National Birth Defects Prevention Study who gave birth in 1997–2005. Common themes included use of alcohol, tobacco, illicit drugs, and medications during pregnancy. Stress and emotional upset were also suggested as possible causes of birth defects. Genetic- and heredity-related responses were more likely to be mentioned by Asian/Pacific Islander women compared to non-Hispanic Whites. Hispanic women were less likely to suggest several specific possible teratogens, such as paint, pesticides, or other chemicals, but were more likely to suggest events occurring during childbirth. Differences also emerged among ethnic groups for theoretical constructs, although most responses were categorized as controllable, changeable over time, and with an internal locus of causality.

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Acknowledgements

Funding for this study was provided in part by the Texas Center for Birth Defects Research and Prevention, at the Texas Department of State Health Services, through cooperative Agreement No. U50/CCU613232 from the Centers for Disease Control and Prevention (CDC). No manifest or potential conflicts of interest are noted. The authors thank participating families, staff and scientists from all NBDPS sites; also Dr. Deanna Hoelscher, University of Texas Health Science Center School of Public Health for her assistance in selecting an appropriate health behavior theory, and Valerie Clark, MPH for data cleaning and manuscript development. We thank the California Department of Public Health Maternal Child and Adolescent Health Division for providing data. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the California Department of Public Health.

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Amy Case, Marjorie Royle, Angela Scheuerle, Suzan Carmichael, Karen Moffitt, and Tunu Ramadhani declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Birth Defects Epidemiology & Surveillance Branch, Texas Department of State Health Services, P.O. Box 149347, Austin, TX, 78714-9347, USA

    Amy P. Case, Angela E. Scheuerle, Karen Moffitt & Tunu Ramadhani

  2. New Jersey Department of Health, Trenton, NJ, USA

    Marjorie Royle

  3. Tesserae Genetics, Dallas, TX, USA

    Angela E. Scheuerle

  4. Stanford University, Stanford, CA, USA

    Suzan L. Carmichael

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  1. Amy P. Case
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  4. Suzan L. Carmichael
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  5. Karen Moffitt
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  6. Tunu Ramadhani
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the National Birth Defects Prevention Study

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Correspondence to Amy P. Case.

Appendices

Appendices

Appendix 1

Table 5 Themes and associated text strings
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Appendix 2

Table 6 Assignment of categories to attribution theory constructs
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Case, A.P., Royle, M., Scheuerle, A.E. et al. Birth Defects, Causal Attributions, and Ethnicity in the National Birth Defects Prevention Study. J Genet Counsel 23, 860–873 (2014). https://doi.org/10.1007/s10897-014-9708-5

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  • DOI: https://doi.org/10.1007/s10897-014-9708-5

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