Grantee Research Project Results
Final Report: Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) Center for Environmental Health Disparities Research
EPA Grant Number: R836158Center: Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) Center for Environmental Health Disparities Research
Center Director: Van Doren Breton, Carrie
Title: Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) Center for Environmental Health Disparities Research
Investigators: Van Doren Breton, Carrie , Gilliland, Frank D. , Hricko, Andrea M. , Bastain, Theresa Frilund , Cockburn, Myles G , Dunton, Genevieve Frilund
Institution: University of Southern California
EPA Project Officer: Callan, Richard
Project Period: July 1, 2015 through June 30, 2020 (Extended to June 30, 2021)
Project Amount: $1,500,000
RFA: NIH/EPA Centers of Excellence on Environmental Health Disparities Research (2015) RFA Text | Recipients Lists
Research Category: Human Health
Objective:
The Maternal And Developmental Risks from Environmental and Social Stressors (MADRES) Center aimed to understand the impact of environmental exposures and social stressors on the health of mothers and their children, and particularly how these exposures contributed to health disparities. The Center was supported by various cores. These cores all worked together to support the Center’s research and widely disseminate findings. In the first cycle (2015-2020) of the MADRES Center, there were four Cores: a Population Core, an Exposure Core, a Community Engagement & Dissemination Core, and an Administrative Core with a robust Career Development Program.
From 2015-2020, the MADRES Center for Environmental Health Disparities supported two research projects:
- Project 1: Cumulative prenatal and infant environmental exposures and early childhood obesity risk investigated the effects of multiple exposures to environmental chemicals and psychosocial and behavioral risk factors on the development of obesity in childhood. The project made use of cortisol assessment and fat depot quantification, and state-of-the-art statistical methods.
- Project 2: Environmental exposures, stress, and maternal pregnancy-related weight outcomes investigated the effects of pre- and post-partum environmental exposures, as well as exposures to social stressors, on maternal gestational weight gain and postpartum weight retention. The project made use of personal exposure sampling, geolocation monitoring, and real-time electronic surveys.
Key accomplishments are outlined below.
Project 1:
Objective of Research:
We propose to investigate how multiple chemical environmental exposures, coupled with other known psychosocial and behavioral risk factors for obesity, affect overall early childhood growth trajectories as well as infant feeding behaviors and metabolic efficiency. We will do so in a large longitudinal pregnancy cohort design, using cutting-edge technologies of cortisol assessment and fat depot quantification, state-of-the-art statistical methods, and novel methods for evaluating mitochondrial function, to address the following specific aims:
AIM 1. To investigate the cumulative effects of multiple pre- and postnatal chemical exposures (ambient and near-roadway air pollution, arsenic and manganese body burden, and CalEnviroScreen 2.0 index of overall pollutant burden), using spatial and personal monitoring methods during pregnancy. We will examine the effects of these exposures on birth and infant health outcomes including birth weight and 12 month childhood height and weight growth trajectories for 750 low-income, primarily Hispanic infants.
AIM 2. To evaluate whether these environmentally-related birth and infant outcomes are larger in infants of mothers a) with high levels of psychosocial stress during pregnancy as measured by diurnal cortisol profiles; b) who are overweight/obese before pregnancy or gain excess weight during pregnancy; and c) who have greater exposures to negative built (e.g., connectivity, lack of parks) and social (e.g., crime, violence) environments.
AIM 3. To evaluate whether environmentally-related birth and infant outcomes are mediated through altered energy consumption (infant feeding) and mitochondrial function (mtDNAcn and mtDNA methylation).
AIM 4. To examine the cumulative effects of prenatal environmental exposures and cortisol levels on abdominal fat depots of infants at <1 month of age using abdominal MRI scans in a subset of 40 infants.
Project 2:
Objective of Research:
Project 2 of the MADRES will examine the effects of pre-and postpartum environmental exposures, coupled with exposures to social stressors, on excessive gestational weight gain and postpartum weight retention through altered psychological and behavioral responses. We will test these hypotheses in a longitudinal study of 750 primarily Hispanic, low-income pregnant women with assessments during pregnancy (1st-3rd trimesters) and postpartum (3, 6, 12 months). The specific aims are
AIM 1: To investigate the cross-sectional and longitudinal independent, cumulative, and interactive effects of multiple pre- and postpartum chemical environmental exposures (e.g., ambient and near-roadway air pollution, water contaminants, toxic releases) on maternal gestational weight gain and postpartum weight retention.
Hypothesis 1 (main effects): Greater prepartum environmental exposures will be associated with a greater likelihood of excessive gestational weight gain and increased postpartum weight retention. Greater postpartum environmental exposures will lead to greater postpartum weight retention.
Hypothesis 2 (time specificity): Environmental exposures occurring during the first trimester of pregnancy will have larger effects on gestational weight gain and postpartum weight retention.
Hypothesis 3 (moderation): The above effects will be larger in women exposed to greater social stressors (e.g., neighborhood crime, violence, personal victimization, income inequality).
Hypothesis 4 (mediation): Psychological (i.e., perceived stress and cortisol [Hypothalamic–pituitary–adrenal-HPA axis biomarker]) and behavioral (i.e., physical activity and dietary intake) responses will, in part, mediate the above effects.
AIM 2: To examine the daily effects of chemical environmental exposures and social stressors on pre- and postpartum psychological stress and energy-balance behaviors using personal, real-time, in situ data capture strategies (e.g., personal exposure sampling, geolocation monitoring, real-time electronic surveys [ecological momentary assessment-EMA], accelerometry) in a subset of 60 women (720 person-days of monitoring).
Hypothesis 5: On any given day, greater personal environmental exposures (e.g., black carbon, PM2.5) and social stressors (e.g., arguments with spouse, demands made by family) will be associated with greater perceived stress, sedentary activity, and high-fat/high-sugar intake; flatter slope of cortisol decline across the day; and lower physical activity and fruit/vegetable/fiber intake.
Summary/Accomplishments (Outputs/Outcomes):
Project 1: Project 1 objectives were to evaluate the association between air pollution and metals with birthweight in infants, and to investigate whether these effects differed by psychosocial stress in pregnancy. We found that a doubling in hair arsenic was associated with a 72.2 g (95% CI: -144.3, -0.1) lower birth weight, after adjusting for potential confounders and gestational age at birth (Howe, 2020).
The inverse association between hair arsenic and birth weight was more pronounced among women who gained greater amounts of weight during pregnancy (Pinteraction=0.02). In analyses of ambient pollutants, we observe an interaction between air pollution and stress in pregnancy. Among babies born to mothers with high levels of maternal stress during the third trimester, there was a significant association between PM2.5 and PM10 exposure during pregnancy and lower birthweight. There was no significant association among babies born to mothers with lower stress scores. We have additionally explored associations between prenatal air pollutant exposures and infant growth in the first two years of life. We are currently exploring best model fits for non-linear growth trajectories. Initial observations suggest that traffic-related air pollutants (both CALINE and spatiotemporal models of NO2 and NOx) may be associated with different patterns of infant growth and that these patterns may be modified by infant sex and maternal prenatal stress levels. Results from these analyses are currently being drafted into a manuscript.
In other analyses related to Project 1, we have investigated maternal stress (PSS) and depression (CESD) in relation to birthweight and observe no significant associations. We have begun to evaluate the energy consumption data from the infant questionnaires in the first year of life. An initial profile of these infants shows that their weight at 12 months is minimally correlated with their birthweight (Pearson r= 0.27, p=0.06). We will continue to explore data on infant feeding practices in the first year of life in relation to maternal exposures and stress in association with infant weight at 12 months.
The substudy for Aim 4 was launched in Fall 2018 and recruitment has been completed. Instead of using abdominal MRI scans which require a baby to be still in order to image, we used the Adolescent Humans Body Composition Analyzer (EchoMRI-AH, Echo Medical System, Houston, TX), which uses quantitative nuclear magnetic resonance (QMR) to measure whole body composition, fat and lean mass, and free water and total body water. The EchoMRI-AH accommodates infants and children up to 80 kg. EchoMRI is a body composition assessment method that uses a low strength magnetic field to count hydrogen atoms and therefore measure water and fat mass with remarkable precision. Additionally, EchoMRI has several advantages including rapid assessment time (<3.2 minutes) and measures that are not affected by subject movement. To date we have completed the target goal of 40 in the EchoMRI-AH. We have investigated the data from these 40 infants and observed that estimated weight and measured body weight have an excellent correlation (r=0.96). We also observed that lean mass is more highly correlated with measured weight than is fat mass. We have begun evaluating associations between air pollutants and ECHO MRI measures of fat and lean mass at 1 month of age. We have found that when stratified there is a marginal inverse univariate association in females with NOx for non-freeway minor roads (B= -0.06, p=0.06) whereas nothing is seen in males (B=0.01 p=0.92). After adjusting for days old at scan and GA the beta estimate remains constant, but loses marginal significance (B -0.06, b=0.12). We also observed a marginally significant inverse relationship between Cortisol Awakening Response (CAR) and lean mass in one-month old infants, suggesting that maternal stress during pregnancy may affect the distribution of adiposity in infants.
Project 2: Project 2’s objectives were to examine the effects of pre-and postpartum environmental exposures, coupled with exposures to social stressors, on excessive gestational weight gain (GWG) and postpartum weight retention through altered psychological and behavioral responses.
To address AIM 1 of Project 2, we now have one paper in publication and two additional manuscripts under review and in preparation, which are outlined below.
The published paper evaluated demographic predictors of arsenic exposure and was published in JESEE. We found that foreign-born Hispanic women had 8.6% higher %DMA and 7.7% lower %iAs than non-Hispanic women. Maternal age was also associated with higher %iAs.[i]
In the first manuscript under review, total cortisol secretion (area under the curve, AUC) was quantified using four salivary cortisol samples (awakening, 30 minutes after awakening, afternoon, and bedtime) that were collected at home on one day during the third trimester of pregnancy (N=176). Moderation of the association between total cortisol and GWG by pre-pregnancy BMI was tested using multiple linear regression with a multiplicative interaction term. There was no association between total cortisol secretion and GWG overall (p=0.82), but the association between total cortisol and GWG was stronger for women with class 1 pre-pregnancy obesity compared to women with normal pre-pregnancy BMI (interaction term p=0.04).
Current works in preparation pertain to sleep duration and GWG, as well associations between perceived stress and GWG. 256 women (mean age=29.1± 6.0 years) reported typical sleep duration (hours) on weekdays and weekends during late pregnancy (>20 weeks gestation). Total GWG (kg) was calculated as the difference between mother’s weight within two weeks before birth and pre-pregnancy weight. Multiple linear regression examined the associations of weekday and weekend sleep duration with total GWG, adding a multiplicative interaction between sleep duration and pre-pregnancy BMI category. Models controlled for gestational age at birth, maternal age, ethnicity by birthplace, education, employment, and parity. Overall, there were no significant association between sleep duration and total GWG (β=0.24, SE=0.29, p=0.41). However, in women with class 1 obesity (BMI of 30 to <35) before pregnancy, we found both weekday (β=1.11, SE=0.76, p=0.03) and weekend (β=1.28, SE=0.67, p<0.01) sleep duration to be positively associated with total GWG.
We also examined the longitudinal associations between perceived stress and GWG. Weight gain trajectories were analyzed using multilevel growth curve models with weight in kilograms modeled as a function of gestational age in weeks starting from week 0 at the start of pregnancy. A piece-wise approach was used to model changes in trajectories over the pregnancy with separate weight gain slopes allowed for early pregnancy (<20 weeks gestational age) and late pregnancy (≥20 weeks). This approach allows for different slope effects at different periods of the pregnancy (early vs. late) with no discontinuities. BMI category was included as a predictor for intercept and slope effects for both halves of the pregnancy. After list-wise deletion of missing data based on the parameters of the final model, the final analytic sample consisted of 222 women with a total of 3538 distinct weight measurements. Results showed that early pregnancy stress significantly increased weight gain rate (0.009) with no differences between normal and other BMI categories. Change in stress from early to late pregnancy significantly decreased weight gain rate (-0.011) with greater increases in stress corresponding to greater decreases in weight gain rate. This effect appeared to be limited to the normal BMI category as the overweight and obese categories appeared to be possess significantly more positive effects compared to the normal category (0.017 and 0.015). The interaction effect between early pregnancy stress and pregnancy change in stress was also significant with a positive effect (0.001) indicating that positive stress change exerts an additional increase in weight gain with the effect magnified with greater early pregnancy stress.
Over Year 5, we finished data collection for the Project 2 EMA substudy as part of AIM 2. In total, we recruited 63 women (100% Hispanic, mean age = 28.6 [SD = 6.0], 45% Spanish speaking). A total of 63 women completed the first trimester data collection, 52 women completed third trimester data collection, and 51 women have completed the 5-6.5 months postpartum data collection.
In AIM 2, to date, ecological momentary assessment (EMA) data have been cleaned and processed for 63 women in their first trimester assessment, 51 women in their third trimester, and 49 women at the 5-6.5 months postpartum assessment.
We have three publications under review stemming from AIM 2, which are outlined below.
We used data from 49 women (380 person-days) who participated in the real-time personal monitoring sub-study nested within the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort study. Over four days at two time points (early and late pregnancy), participants completed up to 5 randomly prompted mobile phone surveys to report current prenatal distress level that were used to calculate day-level averages. Participants also collected saliva samples four times each day, which was used to calculate daily total cortisol secretion, represented by the area under the curve (AUC). There was a marginally significant day-level association between prenatal distress and cortisol AUC during early pregnancy (B = 5.91, p =0.07) and a significant negative association during late pregnancy (B = 4.16, p =0.04).
In the second publication from AIM 2, pregnant women (N=65) from the MADRES cohort completed four days of EMA during their first trimester. Women responded to five random prompts per day about their current affect and past two-hour food intake. Multilevel models tested the within- and between-subjects associations of affective states at one prompt predicting food intake in the next two hours and associations between past two-hour food intake predicting current affective state. Pre-pregnancy BMI was examined as a moderator in models. When women with lower pre-pregnancy BMI had higher positive affect (PA) or lower negative affect (NA) than their average, they were subsequently more likely to consume fruits/vegetables in the next two hours. However, women with higher pre-pregnancy BMI showed the opposite pattern with lower PA and higher NA leading to consumption of fruits/vegetables. When women had lower PA than their average, they were subsequently more likely to consume fast food in the next two hours but only among women with lower pre-pregnancy BMI. Intake of chips or fries was associated with higher subsequent PA in women with lower pre-pregnancy BMI and lower subsequent PA in women with higher pre-pregnancy BMI. Intake of sweets/pastries was associated with lower subsequent NA, and this did not differ by BMI.
For the third publication, we conducted 4-day continuous monitoring in 62 pregnant, predominantly low-income Hispanic women enrolled in the MADRES cohort, during their 1st and 3rd trimester and at 4-6 months postpartum. Geolocation data were used with a trip/stay detection algorithm to derive time-activity and mobility patterns. Stays were classified into contexts (home/non-home, and by land use category) and microenvironments (indoor/outdoor). Trips were classified into pedestrian- or vehicle-based modes. Generalized mixed-effect models were used to examine whether daily time-activity and mobility patterns changed during pregnancy and early postpartum, and whether they differed by individual sociodemographic and residential neighborhood factors. Women spent on average 17.3 ± 6.6 h/day at home, with 2.3 ± 6.5 h/day spent outdoors at/near home. Commercial and service locations were the most popular non-home destinations, while parks and open spaces were seldom visited. Women made 3.5 ± 3.8 trips daily (63.7 ± 73.0 min/day). Approximately 25% were pedestrian-based. Daily time spent at home increased by 0.7 hour (not significant) postpartum. Women were less likely to visit commercial and services locations and make vehicle-based trips postpartum compared to the 3rd trimester. Employed women spent more time away from home, and those living in neighborhoods with higher perceived safety made fewer vehicular trips.
Cores:
Administrative Core
The primary goal of the Administrative Core of the MADRES Center for Environmental Health Disparities (“MADRES Center”) was to provide an efficient infrastructure coordinating and facilitating activities across the Center and to promote scientific integration and community engagement with the ultimate goal of achieving health and environmental equity. The overarching goal of the Core was to ensure multidisciplinary interactions among clinical, social, and public health scientists and community outreach faculty and staff to enhance a world-class research and outreach program in environmental health disparities.
Community Engagement Core
The Community Engagement Core (CEC) is a longstanding and respected source of scientific information for diverse stakeholders interested in developing science-based environmental health-protective policies for environmentally impacted communities. Over the grant cycle, the CEC worked to build a cadre of female leaders who were knowledgeable about the role of pollution in reproductive and neonatal health, who understood how chemicals influence mothers and babies and who knew steps to limit exposures. As part of this we formed a community advisory board and developed culturally relevant infographics and popular education curricula. These participatory curricula, developed in partnership with community, covered toxins in the environment, exposure to chemicals through consumer products, air pollution, and steps to reduce the use of toxic products inside the homes, as well as safe cleaning and living practices in the home related to COVID-19. Our dissemination activities translated the research to urban health disparity populations through infographics, social media, and conferences. In conjunction with the development of the MADRES cohort, the engagement activities focused on building environmental health literacy among a health disparity population that faces multiple economic and social stressors. The foundational work has established a strong community-centered platform to disseminate new science grounded in the realities and complexities of mothers living in these urban communities.
Figure 1: MADRES Framework for building Environmental Health Literacy and NIMHD Domains & Levels of Influence
Exposure Core
The Exposure Core provided measurement and modeling methods, exposure assessment expertise, data generation and analysis support, and training to Center investigators and staff. Major efforts led by the Exposure Core, Dr. Habre, her team, and collaborators at Sonoma Technology Inc. (subcontract) in this Center grant cycle included the following:
Development of methods and datasets constructing complete residential history timelines at the daily level for all MADRES participants that captured residential mobility and any temporal (reported or imputed temporal coverage) and spatial uncertainty (geocoding quality) in residential information. Timelines covered the conception and pre-conception period starting two years before delivery or birth until the latest follow-up time point and accurately defined gestational periods and age at the daily level. These timelines allowed Center investigators to examine specific gestational windows of susceptibility to identify sensitive windows and to understand the effects of multiple co-occurring exposures that increased risk of adverse health effects studied in the Center.
Population Core
The Population Core focused on recruitment of pregnant women into the cohort and follow-up of the cohort. We successfully reached our target of enrolling 750 pregnant women into the MADRES cohort. Despite a challenging political environment, the effort to recruit a large health disparity cohort with nearly 50% immigrants from Latin America was enormously successful. We partnered with three clinical sites to recruit participants: the LAC+USC Medical Center prenatal clinic, the Eisner Health Women’s Health Center, and South Central Family Health Center. Of the 750 women consented into the cohort, approximately 8% experienced a pregnancy loss, and to date, 570 babies have been born. Fewer than 8% of the cohort have dropped out and an even smaller percentage were lost to follow-up. A profile of the cohort was published in 2019 in BMC Pregnancy and Childbirth (Bastain et al.[i]
The Population Core also successfully recruited participants from the larger cohort into the two sub studies and completed data collection for each sub study. Forty newborn infants were recruited into the infant body composition sub study for Project 1 and 65 pregnant women were recruited into the real-time personal monitoring sub study for Project 2.
Career Development Investigator:
Dr. Claudia Toledo-Corral gained valuable experience and over the course of the 5-year grant she became an independent investigator in environmental health disparities research in the form of establishing her own laboratory and being promoted to Associate Professor at her home institution (California State University, Northridge).
Conclusions:
Eliminating racial/ethnic disparities in maternal morbidity or in exposures to environmental hazards is a national priority. By identifying a focused set of exposures, the MADRES Center was positioned to inform appropriate stakeholders of key targets for intervention, more protective health policies, and community empowerment.
In the first cycle, the primary goal was to understand the developmental origins of childhood obesity and excessive gestational weight gain and postpartum weight retention in a minority and low-income population in order to reduce the disproportionate burden of disease born by these individuals. The MADRES Center had two scientific research projects whose overarching aims were to examine whether pre- and postpartum environmental exposures to air pollutants and heavy metals, coupled with exposures to psychosocial stressors, lead to excessive gestational weight gain and postpartum weight retention in women (Project 2) and to perturbed infant growth trajectories and increased childhood obesity risk through altered psychological, behavioral and/or metabolic responses (Project 1).
One of the primary accomplishments of the MADRES Center in the first cycle was to establish a new pregnancy cohort of 750 predominantly Hispanic, socioeconomically disadvantaged women which has been described in Bastain et al. Despite a challenging political environment, the effort to recruit a large health disparity cohort with nearly 50% immigrants from Latin America was enormously successful. The Center established three community health partnerships from which we recruited participants: the LAC+USC Medical Center prenatal clinic, the Eisner Health Women’s Health Center, and the South Central Family Health Center. These partnerships enabled the collection of data for both projects and provided strong clinical contributions to the research projects. Of the 750 women consented into the cohort, approximately 8% experienced a pregnancy loss, and fewer than 8% of the cohort have dropped out and an even smaller percentage were lost to follow-up.
Characterizing environmental exposures to air pollutants and heavy metals was a cross-cutting center goal. We derived state-of-the art residential-level air pollution exposures for all MADRES participants, many at a daily time resolution, starting two years before delivery and up to the latest follow up point. These exposures include traffic-related air pollution geospatial metrics by road class; residential point-based spatiotemporal metrics, including daily inverse-distance-square weighted ambient air pollutants (PM2.5, PM10, NO2, O3; daily line source dispersion model (CALINE47) estimates of traffic-related NOx from nearby roadway emissions using the most highly refined data inputs possible; and biweekly residential spatiotemporal NO2 and NOx estimates from an ensemble learning-based model. We also conducted a preliminary geospatial analysis characterizing patterns in neighborhood-level exposures. MADRES participants’ neighborhoods significantly differed from average Los Angeles neighborhoods by environmental exposures, food, and recreational resources, built environment, socioeconomic composition, social cohesion, and education programs. We found that living in “suburban-like” and “high poverty food desert” neighborhoods was associated with higher pregnancy-specific stress and general stress compared to living in “high poverty, toxic/hazardous pollution” neighborhoods. Additionally, we have characterized prenatal metals exposures for 355 participants, with a focus on arsenic and manganese for use in health studies. Finally, we collected and processed time-resolved PM2.5 personal exposure data and GPS monitoring data for 65 MADRES participants for four days at three timepoints (first trimester, third trimester and four-to-six months after birth) to quantify personal exposures. The MADRES Center’s research projects were built on these shared population and exposure resources.
Another major Center accomplishment was the development of the Eagles RISE internship program for underrepresented, first-generation college students. A total of 18 students completed internships ranging from 15-30 weeks over the first grant cycle. Each intern completed 180 or 360 hours of fieldwork/academic work. Student intern projects included conducting community-based workshops on environmental toxins, participating in environmental health fairs, developing research survey tools, conducting data entry and basic statistical data analysis, and participating in data collection for the MADRES Center projects. The Community Engagement and Dissemination Core (CEDC) worked diligently to disseminate MADRES Center findings to communities and focused on capacity building for interns and community partners. Culturally appropriate infographics and curricula were developed about toxics in the home and environment, exposure to chemicals through consumer products, and outdoor air pollution. A community advisory board (CAB) was formed, consisting of five Latina women from health disparity communities in urban LA County. The CAB met biannually with MADRES Center researchers to provide key insights into recruitment strategies, community engagement and research dissemination. We created two foundational bilingual workshops: one that was an introduction to environmental health and another trained community members to create their own green cleaning products. Since 2016, we have trained 12 Eagles Rise interns to facilitate nearly 50 bilingual workshops, reaching over 2,500 predominantly Latina women. These foundational workshops provided a platform from which to develop additional workshops, including one on air quality.
In sum, the MADRES Center (1) built a de novo pregnancy cohort of 750 women from health disparity populations in Los Angeles, (2) created long-lasting clinical and community partnerships with diverse groups of clinicians, community activists, promotoras, and public health officials and (3) built a robust internship program to support students from health disparity populations. We are beginning to see encouraging results from this large investment of time and resources and expect many more in the future.
References:
Ellen IG, University NY, Mijanovich T, University NY, Dillman KN, University NY. Neighborhood Effects on Health: Exploring the Links and Assessing the Evidence. Journal of Urban Affairs. 2019;23(3‐4):391- 408.
Farzan, S. F., Howe, C. G., Chavez, T. A., Hodes, T. L., Johnston, J. E., Habre, R., Dunton, G., Bastain, T. M., & Breton, C. V. (2021). Demographic predictors of urinary arsenic in a low-income predominantly Hispanic pregnancy cohort in Los Angeles. Journal of exposure science & environmental epidemiology, 31(1), 94–107. https://doi.org/10.1038/s41370-020-0251-1
Howe, C. G. (2020). Arsenic and birth outcomes in a predominately lower income Hispanic pregnancy cohort in Los Angeles. Environmental Research, 184, 109294. https://doi.org/10.1016/j.envres.2020.109294
Journal Articles: 10 Displayed | Download in RIS Format
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Alderete TL, Song AY, Bastain T, Habre R, Toledo-Corral CM, Salam MT, Lurmann F, Gilliland FD, Breton CV. Prenatal traffic-related air pollution exposures, cord blood adipokines and infant weight. Pediatric Obesity 2018:13(6):348-356. |
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Farzan SF, Howe CG, Chavez TA, Hodes TL, Johnston JE, Habre R, Dunton G, Bastain TM, Breton CV. Demographic predictors of urinary arsenic in a low-income predominantly Hispanic pregnancy cohort in Los Angeles. Journal of exposure science & environmental epidemiology 2020:1-4. |
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Hernandez-Castro I, Eckel S, Howe C, Niu Z, Kannan K, Robinson M, Foley H, Grubbs B, Al-Marayati L, Lerner D, Lurvey N, Aung M, Habre R, Dunton G, Farzan S, Breton C, Bastain T. Sex-specific effects of prenatal organophosphate ester (OPE) metabolite mixtures and adverse infant birth outcomes in the maternal and developmental risks from environmental and social stressors (MADRES) pregnancy cohort. ENVIRONMENTAL RESEARCH 2023;226(115703) |
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Hernandez-Castro I, Eckel S, Chen X, Yang T, Vigil M, Foley H, Kannan K, Robinson M, Grubbs B, Lerner D, Lurvey N, Al-Marayati L, Habre R, Dunton G, Farzan S, Aung M, Brexton C, Bastain T. Prenatal exposures to organophosphate ester metabolites and early motor development in the MADRES cohort. ENVIRONMENTAL POLLUTION 2024;342(123131) |
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Maldonado L, Farzan S, Toledo-Corral C, Dunton G, Habre R, Eckel S, Johnson M, Yang T, Grubbs B, Lerner D, Chavez T, Breton C, Bastain T. A Vegetable, Oil, and Fruit Dietary Pattern in Late Pregnancy is Linked to Reduced Risks of Adverse Birth Outcomes in a Predominantly Low-Income Hispanic and Latina Pregnancy Cohort. JOURNAL OF NUTRITION 2022;. |
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Niu Z, Habre R, Chavez T, Yang T, Grubbs B, Eckel S, Berhane K, Toledo-Corral C, Johnston J, Dunton G. Association Between Ambient Air Pollution and Birth Weight by Maternal Individual- and Neighborhood-Level Stressors. JAMA NETWORK OPEN 2022;5(10) |
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Peterson A, Habre R, Niu Z, Amin M, Yang T, Eckel S, Farzan S, Lurman F, Pavlovic N, Grubbs B, Walker D, Al-Marayati L, Grant E, Lerner D, Bastain T, Breton C. Identifying pre-conception and pre-natal periods in which ambient air pollution exposure affects fetal growth in the predominately Hispanic MADRES cohort. NATURE HUMAN BEHAVIOR 2022;21(1):115 |
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Zhang Y, Chen Z, Berhane K, Urman R, Chatzi V, Breton C, Gilliland F. The Dynamic Relationship Between Asthma and Obesity in Schoolchildren. American Journal of Epidemiology 2020;189(6):583-591. |
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O’Connor SG, Habre R, Bastain TM, Toledo-Corral CM, Gilliland FD, Eckel SP, Cabison J, Naya CH, Farzan SF, Chu D, Chavez TA. Within-subject effects of environmental and social stressors on pre-and post-partum obesity-related biobehavioral responses in low-income Hispanic women:protocol of an intensive longitudinal study. BMC Public Health 2019;19(1):253. |
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Howe CG, Farzan SF, Garcia E, Jursa T, Iyer R, Berhane K, Chavez TA, Hodes TL, Grubbs BH, Funk WE, Smith DR. Arsenic and birth outcomes in a predominately lower income Hispanic pregnancy cohort in Los Angeles. Environmental Research 2020:109294. |
R836158 (2020) |
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Relevant Websites:
MADRES Center for Environmental Health Disparities Exit
Progress and Final Reports:
Original Abstract Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
R836158C001 Cumulative prenatal and infant environmental exposures and early childhood obesity risk
R836158C002 Environmental Exposures, Stress, and Maternal Pregnancy-Related Weight Outcomes
The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency.
Project Research Results
- 2020 Progress Report
- 2019 Progress Report
- 2018 Progress Report
- 2017 Progress Report
- 2016 Progress Report
- Original Abstract
10 journal articles for this center