2007 Progress Report: 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 , James, Sherman , Maxson, Pamela , Reiter, Jerome , Swamy, Geeta , 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 Period Covered by this Report: May 1, 2007 through April 30,2008
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:

RD833293: Administrative Core

The Southern Center on Environmentally Driven Disparities in Birth Outcomes (SCEDDBO) is governed through an Administrative Core that includes an Executive Committee composed of the Director, the two Co-Directors and the Project Manager; an Internal Steering Committee composed of members of the Executive Committee and the Directors of the Research Projects and the Facility and Community Outreach Cores, as well as a community member and the Director of the Durham County Health Department; and an External Advisory Committee composed of senior environmental health scientists, as well as community representatives, with expertise relevant to SCEDDBO, who provide informal consultation, as well as annual formal evaluation of Center research and outreach activities.

The specific aims of the Center's Administrative Core are to:

  1. Provide scientific direction and leadership.
  2. Coordinate and foster interactions among research project and facility core investigators.
  3. Provide administrative services for the Center.
  4. Direct the Young Investigators program.
  5. Represent Duke’'s SCEDDBO to the university, the community, the NIH, other Children’'s Environmental Health Centers across the United States, and the policy and scientific community interested in children'’s environmental health more broadly.

In all activities, SCEDDBO emphasizes the importance of diversity. The decision to focus on health disparities; the gender and racial diversity of Center leadership; the incorporation of natural, social, and biomedical scientists; a commitment to community-based participatory research; and efforts to promote the careers of promising new investigators are all indicative of the importance that we place on fostering environments where all people can prosper.

RD833293C001: Project A: Mapping Disparities in Birth Outcomes

Project A utilizes the conceptual framework of the “weathering hypothesis,” which posits that chronic and persistent stressors lead to accelerated biological aging of women, which in turn accounts for adverse birth outcomes among certain subpopulations. The central objective is to determine whether and to what extent joint exposures to socioeconomic and environmental stressors contribute to racial and ethnic health disparities in fetal growth restriction. 

Using a geographically based nested study design moving from analysis of births for the entire state of North Carolina to six demographically and geographically distinct counties to a single health center and state-of-the-art geographic information systems applications with Bayesian spatial hierarchical modeling and other advanced spatial statistical approaches, the specific aims are to:

  1. Spatially link detailed birth record, fetal death certificates, socioeconomic, environmental, tax assessor, community-based, and clinical obstetric data at highly resolved scales for the state of North Carolina from 1990-–2003.
  2. Refine the concept of fetal growth restriction by (a) developing a joint distribution for birthweight and gestation using bivariate modeling for live births and fetal deaths—both separately and jointly; and (b) defining it in terms of fetal and infant mortality, rather than percentile cut points.
  3. Determine whether and to what extent differential exposures to both environmental and social stressors help explain health disparities in fetal growth restriction among (a) African American women compared to Non-Hispanic White and Hispanic women, (b) older African American women compared to younger African American women, (c) Hispanic women compared to Non-Hispanic White and African American women, and (d) foreign-born Hispanic women compared to U.S.-born Hispanic women.

This project evaluates a large number of factors in diverse populations, providing broad relevance for birth outcomes across time, space and demography. Identifying social and environmental factors contributing to fetal growth restriction will improve our understanding of disease etiology and explain the racial disparity in disease incidence, leading to effective interventions against poor outcomes in all population groups.

RD833293C002: Project B: Healthy Pregnancy, Healthy Baby: Studying Racial Disparities in Birth Outcomes

The central objective of the Healthy Pregnancy, Healthy Baby Study is to determine how the interaction of environmental, social and host factors contributes to disparities in birth outcomes between African American and White women in the American South. There are four specific aims:

  1. Conduct a cohort study of pregnant women in Durham, NC, designed to correlate birth weight, gestation and birth weight x gestation with environmental, social and host factors.
  2. Develop community-level measures of environmental and social factors by inventorying neighborhood quality and the built environment in partnership with local community groups.
  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.
  4. Determine whether and to what extent differential exposures explain health disparities in birth outcomes by applying innovative spatial and genetic statistical methods to:
    1. Identify environmental, social, and host factors that cluster to predict birth outcomes in the entire sample.
    2. Determine whether these clusters are more or less present in African American versus White populations and quantify the proportion of health disparities explained by differences in cluster frequency.
    3. Identify environmental, social, and host factors that cluster to predict birth outcomes within the African American and White subsamples and compare these clusters across racial groups.

RD833293C003: Project C: Perinatal Environmental Exposure Disparity and Neonatal Respiratory Health

  1. To determine whether maternal exposure to airborne particulates (PM) and/or ozone (1st hit) restricts fetal growth and/or postnatal growth, as well as impairs lung development/function in newborn mice.
  2. To determine whether PM and/or ozone exposure “reprograms” maternal inflammatory responses.
  3. To determine whether postnatal (2nd hit) ozone exposure further impairs postnatal somatic and lung development/function following maternal PM and/or ozone exposures.
  4. To determine whether genetic or developmental susceptibility to airway hyper-reactivity exacerbates maternal and/or postnatal exposure effects on postnatal somatic and lung development/function.

Progress Summary:

RD833293: Administrative Core

Announcement. The Administrative Core (AC) served as the host for Administrator Johnson when he traveled to Durham to announce the Southern Center on Environmentally Driven Disparities in Birth Outcomes (SCEDDBO) award. AC personnel worked with the Nicholas School and Duke University Offices of Communication and Government Relations to ensure that all substantive and organizational requests from the Administrator’'s office were fulfilled. A research roundtable allowed SCEDDBO investigators to brief the Administrator on scientific goals and objectives, as well as potential policy applications. The Administrator, in turn, provided helpful comments on the direction of the Center. In addition, a formal event was held on campus, where Administrator Johnson, Stanley Meiburg (U.S. Environmental Protection Agency [EPA]), Richard Brodhead (President, Duke University), and Marie Lynn Miranda (Principal Investigator, SCEDDBO) all offered remarks, followed by questions and answers (Q&A) from the audience.

RD833293C001: Project A: Mapping Disparities in Birth Outcomes

Over the past year, the Project A research team has met weekly to discuss new research ideas, review progress of current analysis and identify next steps, and work on manuscript preparation.

We have done considerable methodological work on how to synthesize categorical data sets to enhance inference. We are particularly interested in how to deal with a collection of data sets of varying sizes that are all relevant to a particular scientific question but which include different subsets of the relevant variables, with some overlap. This work attempts to synthesize cross-classified categorical data sets drawn from a common population where many of the sets are incomplete (i.e., one or more of the classification variables is unobserved) but at least one is completely observed. This is expected to reduce uncertainty about the cell probabilities in the associated multiway contingency table as well as for derived quantities, such as relative risks and odds ratios. We have made substantial progress on the underlying modeling and have developed a simulation example as well. A manuscript on this work has been submitted for publication.

Out of efforts to develop new spatial methodologies for addressing health disparities, additional methodological work on disaggregated spatial modeling for areal unit categorical data is currently under way. This work uses innovative statistical methodology that extends spatial disease mapping techniques to model subgroups within areal units using a spatially smoothed, multilevel, log-linear model. A presentation based on this work was given at the annual meeting of the American Public Health Association in November 2007, and a related manuscript is presently in submission. We also are exploring the public health applications of this methodology to elucidate health disparities across space and subgroups.

We have spent considerable time linking the detailed birth record data to EPA monitoring data on particulate matter up to 10 μm in size (PM10), particulate matter up to 2.5 μm in size (PM2.5), and ozone in order to study the impact of maternal exposure to air pollution on birth weight. We are focused especially on refining exposure metrics to most effectively characterize meaningful exposures, as well as to capture any windows of vulnerability. Significant progress has been made on the relationship between birth outcomes and exposure to particulate matter and ozone separately, and the current focus is determining how to characterize joint exposure to both particulate matter and ozone.

Our project on racial residential segregation is in an earlier stage of development but promises to reveal key insights into how to think about the spatial aspects of the social factors influencing health disparities. We are working to determine which facets of segregation best characterize the way community-level racial residential segregation acts to promote health disparities in birth outcomes. Although our initial efforts were statewide, we have since decided that given the significantly more detailed data available for Durham County, we will focus on this area while we work to determine what variables are most important to characterizing racial residential segregation in terms of its health consequences.

In addition, we have been working on specific analysis and manuscripts examining the impact of maternal age and birth order on birth weight, the joint distribution of birth weight and gestational age, and the etiology of racial disparities in maternal hypertensive disorders.

RD833293C002: Project B: Healthy Pregnancy, Healthy Baby: Studying Racial Disparities in Birth Outcomes

As of April 1, 2008, 933 women have been enrolled in the study, with only 46 women withdrawn or lost to follow-up. Women are recruited from Duke University Medical Center (DUMC) and Lincoln Community Health Center. Demographic data indicate that we are successfully recruiting women who are most at risk for adverse pregnancy outcomes, particularly low-income, low-educational attainment, and non-Hispanic Black women.

The following information is collected from participants in the Healthy Pregnancy, Healthy Baby Study:

  • Psychosocial measures include: CES-D, perceived stress, self-efficacy, interpersonal support, paternal support, perceived racism, perceived community standing, pregnancy intention, John Henryism Active Coping Scale, and NEO Five Factor Inventory of personality.
  • Environmental exposure survey measures include: short survey on fish consumption, smoking pattern and exposure to secondhand smoke, and drinking water source.
  • Maternal and neonatal medical record abstraction includes: detailed prepregnancy medical and social history, antepartum complications, birth outcomes, and neonatal complications.
  • Blood samples for genetic and environmental analysis to assess candidate genes related to environmental contaminant (nicotine, cotinine, cadmium, lead, mercury, arsenic, and manganese), metabolism, inflammation, vascular dysfunction, and stress response.
  • Cord blood and placental samples currently are being stored for future genetic analysis and evaluation of activity at the maternal-fetal interface.

We have been highly successful in collection of participant-level data as well as biological samples, with greater than 90 percent attainment of maternal blood sample for genetic and environmental analyses. Collection of cord blood and placental samples, which began in June 2007, also has been successful, with approximately 150 delivery samples collected.

All maternal data is georeferenced (i.e., linked to the physical address of the mother) using geographic information system (GIS) software. The Healthy Pregnancy, Health Baby Study also includes an in-depth neighborhood assessment designed to capture both built environment and community-level social stressors and community resources. The cohort study and neighborhood assessment data are spatially linked to extensive environmental and demographic data at a highly resolved spatial scale.

To date, we have generated genotypes on 624 blood samples from pregnant women for 104 single nucleotide polymorphisms (SNPs) in 16 genes, primarily involved in either metabolism of heavy metals or immune response.

RD833293C003: Project C: Perinatal Environmental Exposure Disparity and Neonatal Respiratory Health

We have determined that postnatal ozone (1 ppm x 3h/d, 3 d/week x 4 weeks) significantly impairs postnatal weight gain in C56BL/6 mice. Air pollutant exposure at a vulnerable window of postnatal development impairs growth.

Postnatal ozone increases nebulized methacholine-induced airway hyperreactivity (AHR) in C57BL/6 mice measured at 4 weeks but not 3 weeks. Ozone-induced AHR is developmentally regulated.

We have found that prenatal instillation of particulate matter (St. Louis particle, NIST#1648) twice weekly in time-mated pregnant mice augments postnatal ozone-induced AHR in mice, measured at 4 weeks postnatal. Prenatal air pollutant exposure reprograms postnatal air pollutant responses that result in AHR. A manuscript is in preparation to report these findings.

In studies just completed in collaboration with M. Ian Gilmour, U.S. EPA, we exposed time-mated C56BL/6 pregnant mice to internal combustion engine diesel exhaust (0.5, 1 and 2 mg/m3 x 6 h/d, 5 d/week, from gestation day 6–17) versus air control. Pups delivered to exposed dams were exposed postnatally to ozone, as described above. Prenatal diesel exposure dose-dependently impaired lung compliance and pressure-volume loop hysteresis versus air or prenatal air postnatal ozone controls. There were parallel effects on nebulized methacholine challenge-induced AHR. Prenatal ambient exposures to diesel particulates at doses relevant to human environmental exposure worsened postnatal ozone-induced lung function and AHR.

Future Activities:

RD833293C001: Project A: Mapping Disparities in Birth Outcomes

We recently began the process of linking participants in Project B with their associated birth certificate record. We are excited to begin exploring the additional insights into the detailed birth record data that can be gleaned by linking these data with the rich dataset collected in Project B. This linkage not only will allow us to explore issues of data accuracy in the detailed birth record, but also will allow us to begin implementing the methods of synthesizing categorical data, discussed above.

RD833293C002: Project B: Healthy Pregnancy, Healthy Baby: Studying Racial Disparities in Birth Outcomes

In the upcoming year, we will continue to enroll study participants with our target sample size of 1,500 pregnant women.

We will begin preliminary analyses on approximately 700 to 800 participants with complete pregnancy data, genetic results and environmental results. Analyses will look at the joint impact of environmental, social, and host factors on birth outcomes, especially as they differ by race. Identification of such co-exposures could lead to development and implementation of strategies to prevent adverse birth outcomes, ultimately decreasing or eliminating the racial disparity.

Maternal blood samples will be analyzed for both protein and genetic associations with adverse birth outcomes. Maternal samples collected at 24 to 28 weeks gestation will be analyzed for protein levels involving markers of inflammation, vascular dysfunction and stress response. DNA analysis is well under way, with genotyping completed for several genetic polymorphisms regarding environmental contaminant metabolism, as well as inflammatory cytokines and chemokines. Genotyping will continue and include genes involved in the maternal stress response and vascular/endothelial cell dysfunction. Statistical analysis regarding candidate gene polymorphisms will begin in June 2008. We will continue to genotype SNPs in the candidate genes we had proposed, as well as genotyping new, pertinent genes, as the literature suggests (i.e., GRK2/GRK5 as described by Liggett, et al., 2008). In addition, during Year 2, we will begin genotyping functional polymorphisms such as the 5HTTLPR in the serotonin transporter.

RD833293C003: Project C: Perinatal Environmental Exposure Disparity and Neonatal Respiratory Health

We have developed a recent collaboration with M. Ian Gilmour, U.S. EPA, Research Triangle Park, NC, to enable us to perform prenatal diesel particle exposures at concentrations and doses that more closely resemble human environmental exposures. Because the thrust of our project is to determine combined exposure effects on pregnancy and postnatal somatic and lung development, we are working on developing a system to perform simultaneous or alternating diesel and ozone exposures. This novel exposure scheme now is being developed and will begin early in Year 2 of the project.

Major mechanistic questions underlie the link between prenatal exposure(s) and adverse neonatal outcomes. Because maternal inflammation is a mechanism central to many exposures implicated in fetal growth restriction, postnatal development and postnatal morbidities, our plan is to test the concept by performing the single and combined pre- and postnatal exposures using inbred mouse strains with genetically determined but differing inflammatory repertoires in Year 2.


Journal Articles: 75 Displayed | Download in RIS Format

Other center views: All 162 publications 76 publications in selected types All 75 journal articles
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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, Potts EN, Mason SN, Fischer B, Huang Y, Foster WM. Maternal exposure to particulate matter increases postnatal ozone-induced airway hyperreactivity in juvenile mice. American Journal of Respiratory and Critical Care Medicine 2009;180(12):1218-1226. 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 Modelling 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)
    R829213 (Final)
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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 2014;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 PJ. 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 Maxson PJ, Edwards SE, Valentiner EM, Miranda ML. A multidimensional approach to characterizing psychosocial health during pregnancy. Maternal and Child Health Journal 2016;20(6):1103-1113. R833293 (Final)
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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 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)
    R833293 (Final)
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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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    R833293C001 (2009)
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  • Abstract: International Journal of Child Health and Human Development-Abstract
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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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  • 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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  • Abstract: Public Health Reports-Abstract
  • 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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  • Full-text: NC Medical Journal-Full Text HTML
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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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  • Abstract: Wiley-Abstract
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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, 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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  • Abstract: Sage Publications-Abstract
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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 Societ--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 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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  • Abstract: Taylor and Francis-Abstract
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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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  • 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. R833293 (Final)
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  • Supplemental Keywords:

    Pregnancy, preterm birth, low birth weight, racial disparity, African American, environmental stressors, gene-environment interactions, psychosocial stressors, genes, single nucleotide polymorphisms, airway hyperreactitivity, diesel exhaust particles, air pollution, lung function

    Progress and Final Reports:

    Original Abstract
  • 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