Southern Center on Environmentally-Driven Disparities in Birth Outcomes

EPA Grant Number: R833293
Center: Southern Center on Environmentally Driven Disparities in Birth Outcomes
Center Director: Miranda , Marie Lynn
Title: Southern Center on Environmentally-Driven Disparities in Birth Outcomes
Investigators: Miranda , Marie Lynn , Ashley-Koch, Allison , Auten, Richard , Foster, W. Michael , Gelfand, Alan , Gibson-Davis, Christina , Goodall, Jonathan , James, Sherman , Reiter, Jerome , Speer, Marcy , Swamy, Geeta , Tootoo, Joshua , Williams, Redford
Current Investigators: Miranda , Marie Lynn , Ashley-Koch, Allison , Auten, Richard , Foster, W. Michael , Gelfand, Alan , Gibson-Davis, Christina , Goodall, Jonathan , James, Sherman , Keating, Martha H. , Maxson, Pamela , Reiter, Jerome , Swamy, Geeta , Williams, Redford
Institution: Duke University
EPA Project Officer: Callan, Richard
Project Period: May 1, 2007 through April 30, 2012 (Extended to April 30, 2014)
Project Amount: $7,735,620
RFA: Centers for Children’s Environmental Health and Disease Prevention Research (2005) RFA Text |  Recipients Lists
Research Category: Children's Health , Health Effects , Health

Objective:

The central mission of the Southern Center on Environmentally-Driven Disparities in Birth Outcomes is to determine how environmental, social, and host factors jointly contribute to health disparities in birth outcomes. Although it is widely agreed that maternal and fetal health and well-being are determined by multiple forces, surprisingly little is known about the interactions of those forces. For example, elevated environmental exposures often occur in communities facing multiple social stressors like deteriorating housing, inadequate access to health care, poor schools, high unemployment, high crime, and high poverty — all of which may compound the effects of environmental exposures. This phenomenon is especially severe for low income and minority pregnant mothers, with significant health implications for the fetuses they carry. In addition, despite an emerging consensus that numerous gene- environment interactions determine maternal and child health, we know little about how genetic and environmental factors combine to promote or prevent adverse outcomes. This center seeks to disentangle these complicated effects by combining rapidly evolving methods in spatial statistics, genetics, and proteomics, in complementary human and animal models of birth outcomes.

Low birthweight (LBW), preterm birth (PTB), and fetal growth restriction (FGR) all exhibit documented disparities across subpopulations. Survivors of LBW and PTB are at significant risk for both short-term neonatal morbidity as well as long-term disabilities, including respiratory distress syndrome, variable heart rate, cerebral ventriculomegaly, cerebral palsy, mental retardation, blindness, deafness, learning disabilities, behavioral disabilities, and motor impairment. Of similar importance is the impact of lower birth weight on increased risk of diabetes, obesity, cardiovascular disease and other health problems in adulthood. Thus, understanding, and eventually intervening, to prevent these adverse birth outcomes is of critical importance to the overall health of the nation.

Approach:

The Southern Center on Environmentally-Driven Disparities in Birth Outcomes will achieve the central mission and specific goals through the organization of an Administrative Core; three Research Projects (Research Project A: Mapping Disparities in Birth Outcomes; Research Project B: Healthy Pregnancy, Healthy Baby: Studying Racial Disparities in Birth Outcomes; and Research Project C: Perinatal Environmental Exposure Disparity and Neonatal Respiratory Health); one Facility Core (Geographic Information Systems and Statistical Analysis Core); and a Community Outreach and Translation Core. Synergies and complementarities exist across all research projects and cores. Overlap exists between each pair of research projects, as well as among all three research projects. The Geographic Information Systems and Statistical Analysis and Administrative Cores support all three research projects, and the Community Outreach and Translation Core serves as a bi-directional bridge between the center and all its component parts and the community.

The Center is governed through an Administrative Core that includes an Executive Committee and an External Advisory Committee. The Administrative Core provides scientific direction and leadership, coordinates and fosters interactions among research project and facility core investigators, and represents SCEDDBO to the outside community.

Research Project A, “Mapping Disparities in Birth Outcomes” uses a geographically-based nested study design and high-end Geographic Information Systems (GIS) applications in combination with Bayesian spatial hierarchical modeling and other advanced spatial statistical approaches to: (1) spatially link detailed birth record, fetal death certificate, socioeconomic, environmental exposure, tax assessor, community-based, and clinical obstetric data at highly resolved scales for the State of North Carolina from 1990-2003; (2) refine the conception of fetal growth restriction by developing a joint distribution for birthwcight and gestation using bivariate modeling for live births and fetal deaths — both separately and jointly; and (3) determine whether and to what extent differential exposures to both socioeconomic and environmental stressors help explain health disparities in fetal growth restriction among different ethnic and social groups.

Research Project B, “Healthy Pregnancy, Healthy Baby: Studying Racial Disparities in Birth Outcomes” is a cohort study of pregnant women in Durham, NC designed to: (1) correlate birthweight, gestational age, and birthweight x gestational age with individual-level measures of environmental, social, and host factors; (2) partner with local community groups to inventory neighborhood quality and the built environment in order to develop community-level measures of environmental and social factors; (3) create a comprehensive data architecture, spatially resolved at the tax parcel level, of environmental, social, and host factors affecting pregnant women by linking data from the cohort study and neighborhood assessments with additional environmental and socioeconomic data; and (4) determine to what extent differential exposures explain health disparities by applying innovative spatial and genetic statistical methods.

Research Project C, “Perinatal Environmental Exposure Disparity and Neonatal Respiratory Health” uses an animal model to: (1) determine whether maternal exposure to airborne particulates (PM) and/or ozone restricts fetal growth and/or postnatal growth, and impairs lung development/function in newborn mice; (2) determine whether PM and/or ozone exposure ‘reprograms’ maternal inflammatory responses; (3) determine whether postnatal ozone exposure further impairs postnatal somatic and lung development/function following maternal PM and/or ozone exposures; and (4) determine whether genetic or developmental susceptibility to airway hyperreactivity exacerbates maternal and/or postnatal exposure effects on postnatal somatic and lung development/function.

The Geographic Information Systems and Statistical Analysis Core: (1) provides support for the development of environmental and social data layers needed to implement the various data analyses required for the research projects and the Community Outreach and Translation Core; (2) provides statistical analysis, advice, and consulting on the broad range of statistical issues that arise in conjunction with the research projects, with a particular emphasis on data reduction methods and modeling spatial and spatio-temporal data within a Bayesian framework; and (3) provides analysis for the unique needs of genetic data arising from the clinical and animal studies of the center. This support core facilitates the development of innovative quantitative methodology for children’s environmental health research associated with the projects and cores.

The Community Outreach and Translation Core: (1) conducts environmental health outreach and education directed at low income and minority women and their children; (2) enhances the capacity of disadvantaged communities to understand threats posed by environmental contaminants; and (3) provides a bridge between campus research, communities, and policy makers. The Community Outreach and Translation Core’s activities utilize center expertise to promote the development of preventive outreach and education with the goal of enhancing the lives of those most vulnerable in our communities.

Expected Results:

The Southern Center on Environmentally-Driven Disparities in Birth Outcomes will produce important new knowledge to disentangle the complex etiology of birth outcomes. This new knowledge will point the way to effective interventions to achieve better pregnancy outcomes among all population groups.


Journal Articles: 73 Displayed | Download in RIS Format

Other center views: All 160 publications 74 publications in selected types All 73 journal articles
Type Citation Sub Project Document Sources
Journal Article Anthopolos R, James SA, Gelfand AE, Miranda ML. A spatial measure of neighborhood level racial isolation applied to low birthweight, preterm birth, and birthweight in North Carolina. Spatial and Spatio-temporal Epidemiology 2011;2(4):235-246. R833293 (2009)
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  • Journal Article Anthopolos R, Edwards SE, Miranda ML. Effects of maternal prenatal smoking and birth outcomes extending into the normal range on academic performance in fourth grade in North Carolina, USA. Paediatric and Perinatal Epidemiology 2013;27(6):564-574. R833293 (2012)
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  • Journal Article Anthopolos R, Kaufman JS, Messer LC, Miranda ML. Racial residential segregation and preterm birth: built environment as a mediator. Epidemiology 2014;25(3):397-405. R833293 (Final)
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  • Journal Article Auten RL, Foster WM. Biochemical effects of ozone on asthma during postnatal development. Biochimica et Biophysica Acta 2011;1810(11):1114-1119. R833293 (2009)
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  • Journal Article Berrocal VJ, Gelfand AE, Holland DM. A bivariate space-time downscaler under space and time misalignment. Annals of Applied Statistics 2010;4(4):1942-1975. R833293 (2009)
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  • Journal Article Berrocal VJ, Gelfand AE, Holland DM. A spatio-temporal downscaler for output from numerical models. Journal of Agricultural, Biological, and Environmental Statistics 2010;15(2):176-197. R833293 (2009)
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  • Journal Article Berrocal VJ, Gelfand AE, Holland DM, Burke J, Miranda ML. On the use of a PM2.5 exposure simulator to explain birthweight. Environmetrics 2011;22(4):553-571. R833293 (2009)
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  • Journal Article Berrocal VJ, Gelfand AE, Holland DM. Space-time data fusion under error in computer model output: an application to modeling air quality. Biometrics 2012;68(3):837-848. R833293 (2011)
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  • Journal Article Berrocal VJ, Miranda ML, Gelfand AE, Bhattacharya S. Synthesizing categorical datasets to enhance inference. Statistical Methodology 2013;15:25-45. R833293 (2007)
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  • Journal Article Block ML, Elder A, Auten RL, Bilbo SD, Chen H, Chen J-C, Cory-Slechta DA, Costa D, Diaz-Sanchez D, Dorman DC, Gold DR, Gray K, Jeng HA, Kaufman JD, Kleinman MT, Kirshner A, Lawler C, Miller DS, Nadadur SS, Ritz B, Semmens EO, Tonelli LH, Veronesi B, Wright RO, Wright RJ. The outdoor air pollution and brain health workshop. NeuroToxicology 2012;33(5):972-984. R833293 (2011)
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  • Journal Article Bolton JL, Smith SH, Huff NC, Gilmour MI, Foster WM, Auten RL, Bilbo SD. Prenatal air pollution exposure induces neuroinflammation and predisposes offspring to weight gain in adulthood in a sex-specific manner. FASEB Journal 2012;26(11):4743-4754. R833293 (2011)
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  • Journal Article Bolton JL, Huff NC, Smith SH, Mason SN, Foster WM, Auten RL, Bilbo SD. Maternal stress and effects of prenatal air pollution on offspring mental health outcomes in mice. Environmental Health Perspectives 2013;121(9):1075-1082. R833293 (2012)
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  • Journal Article Brown JS, Graham JA, Chen LC, Postlethwait EM, Ghio AJ, Foster WM, Gordon T. Panel discussion review: session four--assessing biological plausibility of epidemiological findings in air pollution research. Journal of Exposure Science and Environmental Epidemiology 2007;17(Suppl 2):S97-S105. R833293 (2007)
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  • Journal Article Burgette LF, Reiter JP. Multiple imputation for missing data via sequential regression trees. American Journal of Epidemiology 2010;172(9):1070-1076. R833293 (2008)
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  • Journal Article Burgette LF, Reiter JP, Miranda ML. Exploratory quantile regression with many covariates: an application to adverse birth outcomes. Epidemiology 2011;22(6):859-866. R833293 (2010)
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  • Journal Article Burgette LF, Reiter JP. Nonparametric Bayesian multiple imputation for missing data due to mid-study switching of measurement methods. Journal of the American Statistical Association 2012;107(498):439-449. R833293 (2010)
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  • Journal Article Burgette LF, Reiter JP. Modeling adverse birth outcomes via confirmatory factor quantile regression. Biometrics 2012;68(1):92-100. R833293 (2010)
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  • Journal Article Buttke DE, Wolkin A, Stapleton HM, Miranda ML. Associations between serum levels of polybrominated diphenyl ether (PBDE) flame retardants and environmental and behavioral factors in pregnant women. Journal of Exposure Science & Environmental Epidemiology 2013;23(2):176-182. R833293 (2011)
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  • Journal Article Chang HH, Reich BJ, Miranda ML. Chang et al. respond to “Environmental exposures and preterm birth." American Journal of Epidemiology 2012;175(2):111-112. R833293 (2011)
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  • Journal Article Chang HH, Reich BJ, Miranda ML. Time-to-event analysis of fine particle air pollution and preterm birth: results from North Carolina, 2001-2005. American Journal of Epidemiology 2012;175(2):91-98. R833293 (2010)
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  • Journal Article Chang HH, Reich BJ, Miranda ML. A spatial time-to-event approach for estimating associations between air pollution and preterm birth. Journal of the Royal Statistical Society: Series C (Applied Statistics) 2013;62(2):167-179. R833293 (2011)
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  • Journal Article Dadabhoy FZ, Maxson PJ, Huff N, Auten RL. Perinatal exposure to air pollutants had adverse effects on behavioral outcomes in mice. International Journal on Disability and Human Development 2012;11(4):359-368. R833293 (Final)
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  • Journal Article Edwards SE, Strauss B, Miranda ML. Geocoding large population-level administrative datasets at highly resolved spatial scales. Transactions in GIS 2014;18(4):586-603. R833293 (Final)
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  • Journal Article Gray SC, Edwards SE, Miranda ML. Assessing exposure metrics for PM and birth weight models. Journal of Exposure Science and Environmental Epidemiology 2010;20(5):469-477. R833293 (2008)
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  • Journal Article Gray SC, Gelfand AE, Miranda ML. Hierarchical spatial modeling of uncertainty in air pollution and birth weight study. Statistics in Medicine 2011;30(17):2187-2198. R833293 (2010)
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  • Journal Article Gray SC, Edwards SE, Miranda ML. Race, socioeconomic status, and air pollution exposure in North Carolina. Environmental Research 2013;126:152-158. R833293 (2012)
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  • Journal Article Gray SC, Edwards SE, Schultz BD, Miranda ML. Assessing the impact of race, social factors and air pollution on birth outcomes: a population-based study. Environmental Health 2014;13(1):4. R833293 (2012)
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  • Journal Article Gregory SG, Anthopolos R, Osgood CE, Grotegut CA, Miranda ML. Association of autism with induced or augmented childbirth in North Carolina Birth Record (1990-1998) and Education Research (1997-2007) databases. JAMA Pediatrics 2013;167(10):959-966. R833293 (2012)
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  • Journal Article Gruber A, Maxson P. Disparities in psychosocial health and the built environment during pregnancy. International Journal on Disability and Human Development 2012;11(4):377-385. R833293 (Final)
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  • Journal Article Heaton MJ, Gray SC, Gelfand AE. Process modeling for contingency tables with ordered categories. Statistical Modeling 2012;12(3):211-228. R833293 (Final)
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  • Journal Article Henderson K, Maxson P. Obesity intervention strategies and the built environment in Durham, North Carolina. International Journal of Child and Adolescent Health 2009;2(3):Article 8. R833293 (Final)
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  • Journal Article Henry H, Anthopolos R, Maxson P. Traffic-related air pollution and pediatric asthma in Durham County, North Carolina. International Journal on Disability and Human Development 2013;12(4):467-471. R833293 (Final)
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  • Journal Article Kim JY, Burnett RT, Neas L, Thurston GD, Schwartz J, Tolbert PE, Brunekreef B, Goldberg MS, Romieu I. Panel discussion review:session two--interpretation of observed associations between multiple ambient air pollutants and health effects in epidemiologic analyses. Journal of Exposure Science and Environmental Epidemiology 2007;17(Suppl 2):S83-S89. R833293 (2008)
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  • Journal Article Koehrn KM, Keating MH. The regulation of agricultural pesticides in North Carolina: implications for migrant farm workers and their families. International Journal of Child and Adolescent Health 2009;2(3):Article 4. R833293 (Final)
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  • Journal Article Kroeger GL, Messer L, Edwards SE, Miranda ML. A novel tool for assessing and summarizing the built environment. International Journal of Health Geographics 2012;11:46 (13 pp.). R833293 (Final)
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  • Journal Article Lum K, Gelfand AE. Spatial quantile multiple regression using the asymmetric Laplace process. Bayesian Analysis 2012;7(2):235-258. R833293 (2011)
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  • Journal Article Martz M, Anthopolos R, Geller M, Maxson P. Pediatric obesity and food access in Durham, North Carolina. International Journal of Child Health and Human Development 2013;7(3). R833293 (Final)
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  • Journal Article Maxson PJ, Edwards SE, Ingram A, Miranda ML. Psychosocial differences between smokers and non-smokers during pregnancy. Addictive Behaviors 2012;37(2):153-159. R833293 (2011)
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  • Journal Article Maxson P, Miranda ML. Pregnancy intention, demographic differences, and psychosocial health. Journal of Women's Health 2011;20(8):1215-1223. R833293 (2010)
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  • Journal Article Maxson P. Together we can break the cycle. International Journal on Disability and Human Development 2012;11(4):307-314. R833293 (Final)
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  • Journal Article Messer LC, Maxson P, Miranda ML. The urban built environment and associations with women's psychosocial health. Journal of Urban Health 2013;90(5):857-871. R833293 (2011)
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  • Journal Article Miranda ML, Keating MH, Edwards SE. Environmental justice implications of reduced reporting requirements for the Toxics Release Inventory Burden Reduction Rule. Environmental Science & Technology 2008;42(15):5407-5414. R833293 (Final)
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  • Journal Article Miranda ML, Maxson P, Edwards S. Environmental contributions to disparities in pregnancy outcomes. Epidemiologic Reviews 2009;31(1):67-83. R833293 (2008)
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  • Journal Article Miranda ML, Edwards SE, Swamy GK, Paul CJ, Neelon B. Blood lead levels among pregnant women: historical versus contemporaneous exposures. International Journal of Environmental Research and Public Health 2010;7(4):1508-1519. R833293 (2008)
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  • Journal Article Miranda ML, Swamy GK, Edwards S, Maxson P, Gelfand A, James S. Disparities in maternal hypertension and pregnancy outcomes: evidence from North Carolina, 1994-2003. Public Health Reports 2010;125(4):579-587. R833293 (2008)
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  • Journal Article Miranda ML, Maxson P, Kim D. Early childhood lead exposure and exceptionality designations for students. International Journal of Child Health and Human Development 2010;3(1):77-84. R833293 (2008)
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  • Journal Article Miranda ML, Edwards SE, Keating MH, Paul CJ. Making the environmental justice grade: the relative burden of air pollution exposure in the United States. International Journal of Environmental Research and Public Health 2011;8(6):1755-1771. R833293 (2011)
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  • Journal Article Miranda ML, Edwards S, Maxson PJ. Mercury levels in an urban pregnant population in Durham County, North Carolina. International Journal of Environmental Research in Public Health 2011;8(3):698-712. R833293 (2010)
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  • Full-text: International Journal of Environmental Research in Public Health-Full Text PDF
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  • Journal Article Miranda ML, Edwards SE. Use of spatial analysis to support environmental health research and practice. North Carolina Medical Journal 2011;72(2):132-135. R833293 (2011)
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  • Journal Article Miranda ML, Edwards SE, Myers ER. Adverse birth outcomes among nulliparous vs. multiparous women. Public Health Reports 2011;126(6):797-805. R833293 (2010)
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  • Journal Article Miranda ML, Anthopolos R, Edwards SE. Seasonality of poor pregnancy outcomes in North Carolina. North Carolina Medical Journal 2011;72(6):447-453. R833293 (2010)
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  • Journal Article Miranda ML, Anthopolos R, Hastings D. A geospatial analysis of the effects of aviation gasoline on childhood blood lead levels. Environmental Health Perspectives 2011;119(10):1513-1516. R833293 (2011)
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  • Journal Article Miranda ML, Edwards SE, Anthopolos R, Dolinsky DH, Kemper AR. The built environment and childhood obesity in Durham, North Carolina. Clinical Pediatrics 2012;51(8):750-758. R833293 (2011)
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  • Journal Article Miranda ML, Messer LC, Kroeger GL. Associations between the quality of the residential built environment and pregnancy outcomes among women in North Carolina. Environmental Health Perspectives 2012;120(3):471-477. R833293 (2011)
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  • Journal Article Miranda ML, Edwards SE, Chang HH, Auten RL. Proximity to roadways and pregnancy outcomes. Journal of Exposure Science & Environmental Epidemiology 2013;23(1):32-38. R833293 (2011)
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  • Abstract: Nature-Abstract
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  • Journal Article Modlin E, Maxson P. Breaking the cycle of maternal depression: an initiative to improve children’s environmental health. International Journal of Child Health and Human Development 2010;3(4):405-411. R833293 (Final)
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  • Journal Article Montagna S, Tokdar ST, Neelon B, Dunson DB. Bayesian latent factor regression for functional and longitudinal data. Biometrics 2012;68(4):1064-1073. R833293 (2011)
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  • Journal Article Neelon B, Swamy GK, Burgette LF, Miranda ML. A Bayesian growth mixture model to examine maternal hypertension and birth outcomes. Statistics in Medicine 2011;30(22):2721-2735. R833293 (2010)
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  • Journal Article Neelon B, Gelfand AE, Miranda ML. A multivariate spatial mixture model for areal data: examining regional differences in standardized test scores. Journal of the Royal Statistical Society:Series C (Applied Statistics) 2014;63(5):737-761. R833293 (Final)
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  • Other: University of Minnesota-Prepublication PDF
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  • Journal Article Neelon B, Anthopolos R, Miranda ML. A spatial bivariate probit model for correlated binary data with application to adverse birth outcomes. Statistical Methods in Medical Research 2014;23(2):119-133. R833293 (Final)
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  • Journal Article Ouyang R. The relationship between the built environment and birthweight. Reviews on Environmental Health 2011;26(3):181-186. R833293 (Final)
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  • Journal Article Sanders A, Smeester L, Rojas D, DeBussycher T, Wu M, Wright F, Zhou Y-H, Laine J, Rager J, Swamy G, Ashley-Koch A, Miranda ML, Fry R. Cadmium exposure and the epigenome: exposure-associated patterns of DNA methylation in leukocytes from mother-baby pairs. Epigenetics 2014;9(2):212-221. R833293 (Final)
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  • Journal Article Schwartz SL, Gelfand AE, Miranda ML. Joint Bayesian analysis of birthweight and censored gestational age using finite mixture models. Statistics in Medicine 2010;29(16):1710-1723. R833293 (2008)
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  • Journal Article Schwartz S, Li F, Reiter JP. Sensitivity analysis for unmeasured confounding in principal stratification settings with binary variables. Statistics in Medicine 2012;31(10):949-962. R833293 (2010)
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  • Journal Article Stapleton HM, Eagle S, Anthopolos R, Wolkin A, Miranda ML. Associations between polybrominated diphenyl ether (PBDE) flame retardants, phenolic metabolites, and thyroid hormones during pregnancy. Environmental Health Perspectives 2011;119(10):1454-1459. R833293 (2011)
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  • Journal Article Swamy GK, Garrett ME, Miranda ML, Ashley-Koch AE. Maternal vitamin D receptor genetic variation contributes to infant birthweight among black mothers. American Journal of Medical Genetics Part A 2011;155A(6):1264-1271. R833293 (2009)
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  • Journal Article Swamy GK, Edwards S, Gelfand A, James SA, Miranda ML. Maternal age, birth order, and race: differential effects on birthweight. Journal of Epidemiology and Community Health 2012;66(2):136-142. R833293 (2009)
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  • Journal Article Tassone EC, Miranda ML, Gelfand AE. Disaggregated spatial modelling for areal unit categorical data. Journal of the Royal Statistical Society: Series C (Applied Statistics) 2010;59(1):175-190. R833293 (2007)
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  • Abstract: Wiley Online-Abstract
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  • Journal Article Vinikoor-Imler LC, Gray SC, Edwards SE, Miranda ML. The effects of exposure to particulate matter and neighbourhood deprivation on gestational hypertension. Paediatric and Perinatal Epidemiology 2012;26(2):91-100. R833293 (2011)
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  • Journal Article Zhou X, Reiter JP. A note on Bayesian inference after multiple imputation. The American Statistician 2010;64(2):159-163. R833293 (2008)
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  • Journal Article Zhu B, Dunson DB, Ashley-Koch AE. Adverse subpopulation regression for multivariate outcomes with high-dimensional predictors. Statistics in Medicine 2012;31(29):4102-4113. R833293 (2011)
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  • Journal Article Zhu B, Ashley-Koch AE, Dunson DB. Generalized admixture mapping for complex traits. G3: Genes, Genomes, Genetics 2013;3(7):1165-1175. R833293 (2012)
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  • Journal Article Miranda ML, Anthopolos R, Wolkin A, Stapleton HM. Associations of birth outcomes with maternal polybrominated diphenyl ethers and thyroid hormones during pregnancy. Environment International 2015;85:244-253. R833293C002 (Final)
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  • Supplemental Keywords:

    Low Birthweight, Preterm Birth, Fetal Growth Restriction, Bayesian Statistics, Gene-Environment Interactions,

    Progress and Final Reports:

    2007 Progress Report
    2008 Progress Report
    2009 Progress Report
    2010 Progress Report
    2011 Progress Report
    2012 Progress Report
    Final Report

    Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
    R833293C001 Research Project A: Mapping Disparities in Birth Outcomes
    R833293C002 Research Project B: Healthy Pregnancy, Healthy Baby: Studying Racial Disparities in Birth Outcomes
    R833293C003 Research Project C: Perinatal Environmental Exposure Disparity and Neonatal Respiratory Health
    R833293C004 Community Outreach and Translation Core
    R833293C005 Geographic Information System and Statistical Analysis Core