Publicaciones / Peer-Reviewed


BMJ Open – Abortion legislation, maternal healthcare, fertility, female literacy, sanitation, violence against women and maternal deaths: a natural experiment in 32 Mexican states

“Although less permissive states exhibited consistently lower maternal mortality rates, this finding was not explained by abortion legislation itself. Rather, these differences were explained by other independent factors, which appeared to have a more favourable distribution in these states.”
Koch E, Chireau M, Pliego F, Stanford J, Haddad S, Calhoun B, Aracena P, Bravo M, Gatica S, Thorp J
BMJ Open 2015:5:e006013


English and Spanish versions available here


PLOS ONE -Women’s Education Level, Maternal Health Facilities, Abortion Legislation and Maternal Deaths: A Natural Experiment in Chile from 1957 to 2007

“Increasing education level appears to favourably impact the downward trend in the MMR, modulating other key factors such as access and utilization of maternal health facilities, changes in women’s reproductive behaviour and improvements of the sanitary system.”
Koch E, Thorp J, Bravo M, Gatica S, Romero CX, Aguilera H, Ahlers I (2012)


Versión en español aquí

Journal of Epidemiology & Community Health – A landmark for popperian epidemiology: refutation of the randomised Aldactone evaluation study

“This paper presents two studies with contradictory results that are in a synchronic relation, forming a complete logical analysis unit: one hypothesis corroborated experimentally in a RCT confronted with a populational reality of an observational study in which its predictions are questioned.”

Koch, E., Otarola, A., & Kirschbaum, A. (2005).
Journal of Epidemiology and Community Health, 59(11), 1000–1006.

Full text available here.

Public Health – Women’s education level, contraceptive use and maternal mortality estimates.

“Finally, it is important to remark that when official records of maternal deaths and live births are reliable and readily available, these should be preferred over indirect estimates of MMR.”  

E. Koch, B. Calhoun, P. Aracena, S. Gatica, M. Bravo

PUBLIC HEALTH 128(4):384-387

Abstract available here
Full-text available on request

Journal of Epidemiology & Community Health – Impact of parity on anthropometric measures of obesity controlling by multiple confounders: a cross-sectional study in Chilean women

“Parity modestly influences BMI, but does not seem to be related to WC, WHR and WHtR after controlling by confounders. Parity can increase adiposity but not necessarily following an abdominal pattern.”

Koch, E., Bogado, M., Araya, F., Romero, T., Diaz, C., Manriquez, L., Paredes, M., Roman, C., Taylor, A., Kirschbaum, A. (2008).

Journal of Epidemiology & Community Health, 62(5), 461-470.


Full text available here

International Journal of Women’s Health – Fundamental discrepancies in abortion estimates and abortion-related mortality: A reevaluation of recent studies in Mexico with special reference to the International Classification of Diseases

“Currently, approximately 98% of maternal deaths in Mexico are related to causes other than induced abortion, such as hemorrhage, hypertension and eclampsia, indirect causes, and other pathological conditions… Rather, maternal health in Mexico would greatly benefit from increasing access to emergency and specialized obstetric care.“

Koch, E., Aracena, P., Gatica, S., Bravo, M., Huerta-Zepeda, A., & Calhoun, B. C. (2012). International Journal of Women’s Health, 4, 613–623.

Full text available here

Public Health – Impact of education, income and chronic disease risk factors on mortality of adults: does ‘a pauper-rich paradox’ exist in Latin American societies?


“In  this  prospective  cohort  study  conducted  in  a  middle-income  Latin  American country,  the  protective  effect  of education   was   not   related   to   income,   and   it   was   not completely explained by the effects of adverse biological and behavioural chronic  disease  risk  factors  detected  in  adult life  and  consistently  associated  with all-cause  mortality.”

Koch, E., Romero, T., Romero, C., Akel, C., Manríquez, L., Paredes, M., Roman, C., Taylor, A., Vargas, M., Kirschbaum, A. (2010).

Public Health, 124(1), 39-48.

Abstract available here

Full-text available on request

Annals of Epidemiology – Early Life and Adult Socioeconomic Influences on Mortality Risk: Preliminary Report of a ‘Pauper Rich’ Paradox in a Chilean Adult Cohort

“These findings suggest a ‘pauper rich’ paradox in transitioning Latin American economies. Income level does not seem sufficient to improve survival in cohorts exposed to adverse early life influences reflected by education and height.”

Koch, E., Romero, T., Romero, C. X., Aguilera, H., Paredes, M., Vargas, M., & Ahumada, C. (2010).

Annals of Epidemiology, 20(6), 487-492.

Abstract available here

Full-text available on request

Revista Médica de Chile – Socioeconomic and educational inequities as independent predictors for mortality in a developing country. A cohort study in San Francisco, Chile

Socioeconomic and educational inequities as independent predictors for mortality in a developing country. A cohort study in San Francisco, Chile

“In a society in socioeconomic transition, low socioeconomic position and especially low educational level are risk factors for mortality even after adjusting for known mortality risk factors.”

Koch, E., Romero, T., Romero, C., Manríquez, L., Paredes, M., Ortúzar, E., Taylor, A., Roman, C., Kirschbaum, A., Diaz, C. (2007).

Revista Médica de Chile,  135(11), 1370-1379.

Full text available here

Medical Hypotheses – Popperian epidemiology and the logic of bi-conditional modus tollens arguments for refutational analysis of randomised controlled trials

“According to this popperian model, applicability of the randomised controlled trial (RCT) results to clinical practice implies transferring of all its empirical content, in other words, the totality of its truth and falsity contents. Thus, to ignore the explicit falsity-content of a RCT such as RALES may jeopardise its potential benefits in clinical practice as suggested by recent studies.”

Koch, E., Otarola, A., Romero, T., Kirschbaum, A., & Ortuzar, E. (2006).

Medical Hypotheses, 67(4), 980-988.


Abstract available here

Full-text available on request

International Journal of Hypertension – Overcoming Barriers in the Management of Hypertension: The Experience of the Cardiovascular Health Program in Chilean Primary Health Care Centers

“The success in improving the BP control to values <140/90 mmHg from 45.3% to 59.7% underscores the contribution of this program in the Chilean primary care cardiovascular preventive strategies.”

Sandoval, D., Bravo, M., Koch, E., Gatica, S., Ahlers, I., Henríquez, O., & Romero, T. (2012).

International Journal of Hypertension, 2012, 405892.


Full text available here

Revista Chilena de Obstetricia y Ginecología – Consenso Salud Materna para Chile en el Nuevo Milenio.

“Chile represents a positive evolution in terms of maternal and infant health in last fifty years. This trend in the last ten years has remained stable… Efforts must be done focusing in the day around the birth, mainly in rural and poorest areas of the country.”

González, R., Koch, E., Poblete, JA., Vera, C., Muñoz, H., Carroli, G., et al.(2013).
Revista Chilena de Obstetricia y Ginecología 78(2), 142-147.

Full text available here