2018 Progress Report: Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) Center for Environmental Health Disparities

EPA Grant Number: R836158
Center: Maternal and Developmental Risks from Environmental and Social Stressors
Center Director: Gilliland, Frank D.
Title: Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) Center for Environmental Health Disparities
Investigators: Gilliland, Frank D. , Bastain, Theresa Frilund , Cockburn, Myles G , Dunton, Genevieve Frilund , Hricko, Andrea M. , Van Doren Breton, Carrie
Institution: University of Southern California
EPA Project Officer: Callan, Richard
Project Period: July 1, 2015 through June 30, 2020
Project Period Covered by this Report: July 1, 2017 through June 30,2018
Project Amount: $1,500,000
RFA: NIH/EPA Centers of Excellence on Environmental Health Disparities Research (2015) RFA Text |  Recipients Lists
Research Category: Health


The primary goal of the Administrative Core of the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) Center for Environmental Health Disparities is 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 is 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 (EHDs).

Aim 1: Coordinate a program of research that integrates state-of-the-art exposure assessment with innovative health effects research to achieve rapid advances in understanding the impacts of prenatal and postnatal environmental and social stress on infant growth, gestational weight gain and maternal weight retention in an urban environmentally and health-disparate population.

  1. Provide access to a rich institutional scientific environment, including complementary centers and an administrative infrastructure.
  2. Facilitate scientific synergy within and outside the MADRES Center.

Aim 2: Facilitate the translation and application of research findings and community engagement activities to help identify scientific and outreach opportunities for enhancing translation of Center research findings to communities, clinicians and policymakers.

Aim 3: Provide fiscal management oversight and reporting and coordinate interactions with the National Institute of Environmental Health Sciences (NIEHS) and the U.S. Environmental Protection Agency (EPA).

Aim 4: Foster the career development of junior investigators into independent contributors to environmental health disparities research.

  1. Coordinate a robust career development program in collaboration with complementary centers at the University of Southern California (USC) to promote the progress of the Career Development Investigator to research independence.
  2. Facilitate mock peer review of grant applications, review of presentation skills, and networking with other investigators within the USC research community and beyond.
  3. Provide opportunities for community engagement and to develop non-technical presentations to communicate scientific research findings to lay audiences.

Aim 5: Make important contributions to national networks that foster communication, innovation and research excellence in the area of environmental health disparities.

  1. Contribute to conference calls and annual program meetings.
  2. Develop collaborations with other Centers of Excellence in Environmental Health Disparities.
  3. Participate in national working groups, including the Environmental Public Health Network and other groups, to present the MADRES Center's most recent research findings on environmental health disparities.

Progress Summary:

Aim 1

Recruitment of our pregnancy cohort that supports both Projects 1 and 2 of the Center is well underway. Regular administrative efforts include coordination of a weekly team meeting and a monthly Executive Committee meeting, at which we discuss current progress and troubleshooting of any problems. All project and community engagement core (CEC) principal investigators (PIs) attend this meeting, including the MPIs, project PIs, the Career Development investigator, and several PIs from our NIEHS environmental health sciences center and our Children's Environmental Health Center. Therefore, we have natural cross-talk among our three Centers, creating a rich scientific environmental and opportunity for synergistic idea-sharing and advice. Lastly, we have invited external advisors to our first External Advisory Committee (EAC) meeting, which occurred on April 25, 2016, and held our second EAC meeting on March 10, 2017, to solicit feedback on directions and progress to date. Our third EAC meeting is scheduled for April 27, 2018. The EAC members include Carmen Marsit from Dartmouth College; Patrick Ryan from the University of Cincinnati; Brenda Eskenazi from the University of California (UC), Berkeley; Francine Laden from Harvard University, who also is the PI of another EHD Center; Pathik Wadhwa from UC Irvine; and Barbara Baquero from the University of Iowa.

Aim 2

The CEC held its second community advisory board meeting in fall 2017. At this meeting, the board discussed retention strategies for participants and the possible ways to communicate research results to community members. The CEC also wrapped up its focus groups of women with children under the age of 3 in our target communities to understand the level of environmental health literacy and is in the process of summarizing those results. In addition, California State University, Los Angeles (CalStateLA) interns continue to work with the CEC to conduct 1-hour community workshops on topics related to environmental health, which have been received quite well. These workshops have also been conducted at Eisner Medical Clinic (one of our recruitment sites) to patients that attend the clinic, as well as to the staff. The CEC led a community symposium entitled "Parks, Pollution and Obesity" in Los Angeles County in collaboration with six local community organizations and the USC School of Architecture, which occurred on April 17, 2017. With over 200 people in attendance, this event examined the intersectionality between parks, pollution and obesity, bringing together community organizations, urban designers, scientists and policymakers to advance a solution-oriented conversation around land-use strategies that maximize the benefits of physical activity and minimize potential exposures to air pollution and other chemicals.

Aim 3

A key task of the Core leadership and staff is responsibility for fiscal management/reporting and for coordinating interactions and reports with NIEHS/EPA. The Administrative Core continues to administer all financial aspects of the Center, purchasing, reimbursement, and progress and other reports to NIEHS and EPA.

Aim 4

Career Development Trainee Progress

Dr. Toledo-Corral continues to gain valuable experience and is on the path of becoming an independent investigator in environmental health disparities research. As outlined in her career development plan, this year Dr. Toledo-Corral has focused on the following:

  1. Perform ongoing work with the Population Core to develop written protocols for data collection, support recruitment and follow-up efforts, and manage the data cleaning and processing protocols specific to the 24-hour diet recall method and cortisol measures.
  2. Lead the internship program for CalStateLA students.
  3. Develop writing projects, manuscripts and grants.
  4. Attend and participate in seminars, retreats, career development workshops and conferences.

Training in Cohort Recruitment, Retention and Follow-Up, and Protocol Development

Dr. Toledo-Corral has continued working closely with the Population Core and aids in developing written protocols for data collection and surveys in both English and Spanish. She also leads quality assurance efforts for dietary data (using the ASA24 method) and cortisol measures. Specifically, she spends time training staff and troubleshooting problems related to the ASA24 program or with data extraction. Dr. Toledo-Corral continues to oversee the staff members that currently administer the ASA-24 and reviews the quality of the dietary data. In addition, she leads data cleaning efforts and development of finalized diet variables to be used for analytical purposes.

Leading Leadership Program for CalStateLA Students

As part of her transition to independence, Dr. Toledo-Corral has been leading efforts in developing an environmental health-focused leadership training program for students in the Public Health Department at CalStateLA. In the second year of this program, we have had a total of 10 student interns who aid the MADRES staff members on participant visits and provide aid in participant retention efforts under the guidance of our community recruitment coordinator. Other intern projects have varied and include such components as community-based education modules on environmental toxins, participation in environmental health fairs and conferences, development of research survey tools, and data entry and processing.

Writing Projects/Manuscripts and Grant Writing

Dr. Toledo-Corral's defined role in each of the projects and cores involves expertise in health disparities associated with obesity and metabolic outcomes. She has been actively publishing and producing written works, including a book chapter on the influence of ethnicity on risk factors of childhood obesity. Her work in the environmental health field has progressed, as well, which includes analyzing data in other populations where the results have implications related to the MADRES aims.

Environmental Health Research Pilot Project Grant

Dr. Toledo-Corral, along with Dr. Tanya Alderete, was awarded $50,000 to recruit 40 pregnant Hispanic women and infants from the MADRES cohort with the purpose of characterizing relationships between non-roadway air pollution (NRAP) exposure and the gut microbiome during the prenatal and infancy periods, two critical windows of development. Outcomes from this study have the potential to demonstrate meaningful relationships between NRAP exposure and the gut microbiome, possibly explaining associations between air pollutants, low birth weight and future risk for childhood obesity.

Career Development Activities

As part of our career development training program, Dr. Toledo-Corral is present 1-2 days of her week at USC and partakes in career development workshops, attends biweekly seminars and partakes in any additional opportunities available for our young investigators. She attends the executive meetings monthly, and she annually presents progress at the external advisory committee meetings. In November 2017, she attended and presented work at the Obesity Week National Meeting and Scientific Sessions on her analysis on ambient air pollution and its association with cortisol level in pre-pubertal children. In December 2017, she also presented her work involving the internship program at the National Meeting for the Environmental Health Disparities centers in Albuquerque, NM. The presentation was profiled in the NIEHS Partnerships for Environmental Public Health newsletter in January 2018: https://www.niehs.nih.gov/research/supported/translational/peph/currentissue/lists/1_18/index.cfm.

Progress Toward Tenure at Home University (CalStateLA)

Dr. Toledo-Corral is currently in her 4th year on a 6-year timeline toward tenure. In her most recent review, her home Department Chair, the College Dean and the Vice-Provost have unanimously recommended her for an early tenure review in her 5th year, which is 1 year ahead of a traditional schedule.

Aim 5

We have participated in the monthly EHD calls, presenting on our plan for our Center. Francine Laden serves as an EAC member to our Center, which will provide crosstalk between the Centers. We are also working with other Centers on a joint publication to profile the five Centers and highlight their unique strengths as well as common ground, and to provide a more diverse reference population for the United States. In fall 2017, Dr. Shohreh Farzan participated in an EHD-themed symposium at the International Society of Exposure Science conference with other Center members and gave a talk on metals exposures across cohorts. Lastly, eight MADRES investigators attended the second annual EHD center meeting in New Mexico, including our CDI investigator.

All of the aims for Project 1 require the babies of the cohort to have been born. To date we have had 159 births, and several infants have reached 12 months of age. Given the relatively small sample sizes, we have begun some limited pilot work in terms of analyses. For Aim 1, we have measured urinary arsenic in repeated samples from six mothers to assess general exposure patterns, we have sent 40 maternal hair samples for As and Mn analysis, and we are preparing another 140 hair samples to be sent out for more analysis in the next month. We have also mapped the residences for the currently enrolled women to get a sense for geographic distribution and in preparation for assigning air pollution estimates, and we have assigned CalEnviroScreen scores to these women. We have sent out ~150 third-trimester saliva samples for cortisol assessment, which will be used in Aim 2. We hired a medical record abstractor who has been compiling maternal pregnancy and delivery variables from the medical records, including birthweight of the babies. We have begun to analyze the birthweight data with respect to pregnancy questionnaire data and exposure data we currently have. For Aim 3, we will wait until we have more cord blood samples collected for the mitochondrial assays, and we will begin to evaluate the energy consumption data from the infant questionnaires now that we have babies who have arrived at their first birthday. Aim 4 was slated to occur in Year 4 of the grant, so we have begun pilot testing and protocol development to begin this phase of the project soon. Instead of using abdominal MRI scans, which require a baby to be still in order to image, we will instead use 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. We are currently optimizing the protocol for the EchoMRI and have been pilot testing it on babies and children of varying ages to understand the robustness and sensitivities of the measurements.

Future Activities:

During the next reporting period, the Population Core will continue to recruit pregnant women into our cohort until we reach the target of 750. We currently recruit from LAC + USC prenatal clinic, Eisner Pediatric Medical Center, and South Central Clinic. We will continue to fine tune all necessary protocols and questionnaires to support the data collection efforts of both projects. We will continue recruitment of the 60 participants for the Project 2 substudy on EMA. We will begin recruitment on the Project 1 substudy to conduct EchoMRI on 40 infants. The Administrative Core will summarize the recommendations from the EAC meeting to be held on April 27, 2018, and will work to integrate recommendations. The CEC will plan a third community advisory meeting to particularly advise on access to care concerns that may affect recruitment or retention in the target population. The Administrative Core will continue to manage administrative needs of the Center and the agenda of community engagement of the CEC.

We propose to change the contact PI to Dr. Carrie Breton. There will be no change or impact to the project.

Dr. Breton will be responsible for direct communications with and for submitting all necessary administrative documents to NIEHS/EPA, including annual progress reports. Drs. Breton and Gilliland will have joint responsibility for facilitating scientific programmatic interactions with NIEHS/EPA.

Otherwise, the MPI Leadership Plan remains the same.

We had proposed to enroll 250 pregnant women in each of Years 1-3. In the first year, the project period was only 9 months, and delays in obtaining institutional IRB approvals as well as instrument development delayed our ability to begin study recruitment. While we have worked hard to catch up and have three sites for recruitment, we will still be enrolling women into the cohort throughout Year 4.

Journal Articles: 1 Displayed | Download in RIS Format

Other center views: All 2 publications 1 publications in selected types All 1 journal articles
Type Citation Sub Project Document Sources
Journal Article 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. R836158 (2017)
R836158 (2018)
R835441 (2018)
  • Abstract from PubMed
  • Full-text: Wiley-Full Text PDF
  • Abstract: Wiley-Abstract
  • Progress and Final Reports:

    Original Abstract
  • 2016 Progress Report
  • 2017 Progress Report
  • 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