The Planetary Health Alliance
My research interests lie principally, but not exclusively, in the field of reproductive and perinatal epidemiology. I have spent the last two decades focused on integrating epidemiological, biological and molecular approaches into rigorously designed clinical epidemiology research projects that have led to greater understandings of the etiology and pathophysiology of placental abruption, gestational diabetes, and preeclampsia. My research programs were developed through (1) identifying gaps in the literature; (2) constructing methodologically rigorous, versatile and robust epidemiological data capture systems and networks (epidemiology platforms) in North America, Sub-Saharan Africa, Asia, and South America; and (3) proactively and strategically integrating biochemical and molecular biomarkers onto that epidemiology platform. I have fully exploited the arsenal of epidemiology study designs (case-control, self-matched case-crossover, and prospective cohort studies) to answer important questions concerning the etiology and pathophysiology of a relatively broad spectrum of adverse reproductive and perinatal outcomes.
My overarching goal has been, and continues to be, to use biological and molecular biomarkers as objective measures of exposure (e.g., dietary intake, nutritional status) and/or as validated pre-clinical proximal determinants (e.g., oxidative stress, systemic inflammation, endothelial dysfunction) of discrete outcomes of clinical, public and global health importance. To date, much of my work has been focused on advancing knowledge of the etiology of selected highly relevant, but fairly understudied perinatal outcomes. I have also sought to expand the literature by searching for and then confirming novel/non-traditional risk factors of those outcomes. My research programs have been largely funded by a number of research awards from the National Institutes of Health. To date, I have authored or co-authored 240 original research reports.
I am Principal Investigator of three large National Institutes of Health-funded projects: (1) A Prospective Cohort Study of Migraine, Platelet Activation, and Preeclampsia, an observational study designed to identify pregnant women at high risk of preeclampsia and to assess mechanistic hypotheses to explain the co-occurrence of migraines and preeclampsia in some women; (2) A Cohort Study of Preterm Delivery in Relation to Partner Abuse, Mood and Anxiety Disorders, an observational study of 6,000 Peruvian women to determine whether the risk of preterm delivery is influenced by maternal mental health status and/or exposure to violence before and during pregnancy; and (3) Triggers of Placental Abruption: A Case Crossover Study of an Ischemic Placental Disease, another observational study designed to identify acute and chronic risk factors for placental abruption; and to search for genetic variants in both maternal and fetal genomes (900 maternal-infant pairs) that contribute to an increased risk of placental abruption.
I completed my undergraduate studies at Princeton University, receiving a BA in biology in 1984. I received an MS in civil engineering in 1986 from Tufts University, and two degrees from Harvard University, a SM in demography and population sciences, in 1988, and a ScD in epidemiology in 1991.