Maternal and Child Health studies

Our researchers work with partners at all levels to assess health and safety issues, and develop programs to help improve the health and well-being of families and entire communities. Many of our studies look at potential effects on newborn health, including an association between gestational diabetes and an increased risk of autism in offspring, and whether flame retardants increase the risk of preterm birth.

Air Pollution and Pregnancy Complications in Complex Urban Environments: Risks, Heterogeneity, and Mechanisms (APPCUE)

To advance the understanding of the impact of air pollutant mixture and the built environment on pregnancy complications (gestational diabetes, gestational hypertension, and pre-eclampsia/eclampsia) and outcomes by leveraging prospectively- recorded and high-quality maternal clinical data from the electronic health record and address data with state-of-the-art spatiotemporal air pollution modeling and novel statistical methods that examine both individual and composite exposure profiles.

Principal Investigator:

Darios Getahun, MD, PhD, MPH

Funding Source:

National Institute of Environmental Health Sciences (NIEHS)

Funding Years:

2019 - 2023

Boostrix immunization in pregnant women

The goal of the Boostrix study is to examine pre-specified pregnancy-related adverse events in a cohort of women vaccinated with Boostrix at 27 weeks gestation or beyond compared to a matched historical unvaccinated control group.

Principal Investigator:

Hung Fu Tseng, PhD, MPH

Funding Source:

GlaxoSmithKline, LLC

Funding Years:

2017 - 2021

Digital Mindfulness Based Cognitive Therapy for Perinatal Depression

Mindfulness Based Cognitive Therapy (MBCT) an 8-session in-person intervention using mindfulness meditation and cognitive-behavioral strategies, has shown effectiveness in reducing residual depressive symptoms and risk for recurrence among pregnant women with histories of depression. A digital adaptation of MBCT for pregnant women, Mindful Mood Balance for Moms (MMBFM), was recently developed to overcome access barriers to in-person groups and increase potential for scale-up in OB care settings. We will address the following aims for this study: 1) Compare the clinical effectiveness (i.e. engagement and symptom reduction) of MMBFM supported by clinician vs. peer coaches among women with a history of prior depressive episodes; 2) examine specific mechanisms of action for MMBFM participants receiving clinician vs. peer coaching; 3) examine the effects of specific implementation strategies on reach of the MMBFM program; and 4) estimate the cost-effectiveness of MMBFM supported by clinician vs. peer coaches. We hypothesize that MMBFM will be more cost-effective when supported by peer vs. clinician coaches.

Funding Source:

National Institute of Mental Health (NIMH)

Funding Years:

2019 - 2024

Elective Induction of Labor and Pregnancy Outcomes

In 2008, 23% of births in the United States (nearly 1 million) were initiated by induction. Many inductions are elective, that is, performed without a medical or obstetric indication, typically for the woman’s comfort or convenience. In prior studies, this proportion has ranged from 13 to 49% of inductions. This suggests that 130,000 to 490,000 births in the U.S. each year are initiated by elective induction. As a pilot study, we examined the prevalence of induction from 2001-8 using linked electronic health data and birth certificate data at two integrated health care delivery systems, Kaiser Permanente Southern California (KPSC) and Group Health (GH). The prevalence of induction rose from 24% to 30%. Among all births, the prevalence of induction with no documented indication rose from 4.7% to 8.4%. At KPSC, we examined trends by race and ethnicity. Induction with no documented indication was more common in whites than any other group, but similar increases were seen in all groups.

Principal Investigator:

Darios Getahun, MD, PhD, MPH

Funding Source:

National Institute of Child Health and Human Development (NICHD)

Funding Years:

2013 - 2017

Research Categories:

Flame Retardant and Adverse Perinatal Oucome

Polybrominated diphenyl ether(s) (PBDEs) have been in widespread use in home construction, furniture, clothing and electronic appliances for decades. PBDEs save lives by giving occupants valuable time to extinguish or escape from a spreading fire, however, with time, they leach into the environment and have become one of the most prevalent of the persistent organic pollutants (POPs). Concentrations of PBDEs have been increasing in human tissues since their introduction into consumer products. Breast-milk and plasma concentrations of PBDEs are 10 to 100-fold higher in the United States than other countries. Studies of pregnancy tissues indicate that PBDEs are present in amniotic fluid, umbilical cord plasma, umbilical cord tissue, placenta, and fetal membranes. The role of these flame retardants on adverse pregnancy outcomes is understudied, however, some recent reports have shown significant effects on birth weight. PBDEs may affect human health as endocrine disruptors. Overt and subclinical hypothyroidism increases the risk for preterm birth through an unknown mechanism. Furthermore, T4 reduced the production of proinflammatory cytokines, reduced inflammation, improved bacterial clearance and survival in animal models of sepsis. We hypothesize that exposure of pregnant women to PBDEs may reduce bioactivity of the T3 and T4 leading to a proinflammatory environment and increasing their risk for preterm birth.

Principal Investigator:

Darios Getahun, MD, PhD, MPH

Funding Source:

National Institute of Environmental Health Sciences (NIEHS)

Funding Years:

2013 - 2017

Research Categories:

Menveo Pregnancy Registry Study

The objective of the Menveo Pregnancy Registry is to evaluate pregnancy outcomes among women immunized with the Menveo vaccine within 28 days prior to conception or at any time during pregnancy. The primary outcomes of interest include major congenital malformation, preterm birth, and low birth weight. Other pregnancy outcomes will be collected, including spontaneous abortions and stillbirths.

Principal Investigator:

Hung Fu Tseng, PhD, MPH

Funding Source:

GlaxoSmithKline, LLC

Funding Years:

2015 - 2018

Moderate Hypertension in Pregnancy: Safety and Effectiveness of Treatment

Evaluating the effect of treating mild-to-moderate hypertension in pregnancy, compare the risks of clinically important outcomes with different medications, and determine whether the benefits and risks vary by maternal race/ethnicity or obesity status.

Site Principal Investigator:

Kristi Reynolds, PhD, MPH

Funding Source:

National Institute of Child Health and Human Development (NICHD)

Funding Years:

2015 - 2020

Prenatal Antibiotic Use and Body Weight in Children

The goal of this study is to examine the potential relationship between antibiotic use during pregnancy and pediatric weight problems. Particular focus is given to infants exposed to intrapartum Group B streptococcus prophylaxis and its impact on a child’s body weight.

Principal Investigator:

Corinna Koebnick, PhD, MSc

Funding Source:

Centers for Disease Control and Prevention (CDC)

Funding Years:

2017 - 2019

Research Categories:

,

Risk of Cancer in Childhood and Adolescence Associated with Medical Imaging

The goal of this study it to evaluate patterns of medical imaging associated with cumulative exposure to radiation (CT, nuclear medicine, fluoroscopy, angiography, and radiography), and subsequent risk of childhood cancers.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2015 - 2020