2018 Annual Meeting
Applying Epidemiology Across the Lifespan to Improve Health Care,
Inform Health Policy and Enhance Population Health
CINCINNATI, OHIO | SEPTEMBER 23-25 2018
Agenda
Concurrent Session 2b
Location: University of Cincinnati, Medical Sciences Building (MSB), Room 5051
Oral Presentation of Best Abstracts
Chair: Michael Cook
Jessica L Irwin, Alison J Yeates, Maria S Mulhern, Emeir M McSorley, JJ Strain, Gene E Watson, Katherine Grzesik, Sally W Thurston, Tanzy M Love, Tristram H Smith, Daniel W Mruzek, Conrad F Shamlaye, Catriona Monthy, Gary J Myers, Philip W Davidson, Edwin van Wijngaarden, University of Rochester School of Medicine and Dentistry. “Maternal gestational immune response and autism spectrum disorder phenotypes at 7 years of age in the Seychelles Child Development Study”
Description: Findings from observational and experimental studies suggest that maternal inflammation during pregnancy is associated with autism spectrum disorder (ASD), but no human studies have investigated this association prospectively. We examined the association between maternal inflammatory markers and child ASD phenotype in a large prospective birth cohort of 788 mother-child pairs from the Seychelles Child Development Study (SCDS) Nutrition Cohort 2 (NC2). This presentation will provide an overview of the SCDS NC2 study design, key findings, and recommendations for future research.
Abstract: Purpose Findings from observational and experimental studies suggest that maternal inflammation during pregnancy is associated with autism spectrum disorder (ASD), but no human studies have investigated this association prospectively. We examined the association between maternal inflammatory markers and child ASD phenotype in a large prospective birth cohort. Methods We studied 788 mother-child pairs from the Seychelles Child Development Study Nutrition Cohort 2. Inflammatory markers were measured in mothers’ serum at 28 weeks gestation. The Social Communication Questionnaire (SCQ) and Social Responsiveness Scale (SRS) were administered at age 7 years to obtain information on ASD phenotype. We evaluated associations with 13 maternal inflammatory markers, as well as Th1, Th2, and Th1:Th2, and ASD phenotype using multivariable linear regression. Results For the SRS, higher concentrations of the anti-inflammatory cytokine IL-10 were associated with fewer ASD symptoms. For the SCQ, higher concentrations of MCP-1, a chemokine that is upregulated in response to pro-inflammatory cytokines, were associated with fewer ASD symptoms. Higher concentrations of IL-4, a cytokine that is typically associated with an enhanced anti-inflammatory response, were associated with more ASD symptoms. No associations were observed for other markers. Conclusions These findings suggest that a shift in the maternal immune balance during pregnancy via alterations in IL-10, MCP-1, and IL-4 concentrations may be associated with ASD symptomatology. While the use of measures that fully capture ASD phenotypic variability is a strength, measurement of immune markers only once during gestation is a limitation. Our results should be confirmed using maternal immune markers measured throughout gestation.
Brief Biography:
Edwin van Wijngaarden, PhD, is Professor of Public Health Sciences, Environmental Medicine, Pediatrics, Dentistry, and Community Health and Prevention at the University of Rochester. He is a Fellow of the American College of Epidemiology. He leads the Seychelles Child Development Study (SCDS) which for over 30 years has investigated the impact of pre- and postnatal methylmercury exposure on child development, and factors that may modify or mediate this association. Dr. van Wijngaarden holds various leadership roles at University of Rochester. He is Chief of the Division of Epidemiology in the Department of Public Health Sciences. He is director of the Doctoral and Master's Programs in Epidemiology, leads undergraduate programs in Epidemiology and Environmental Health, and co-directs the MS in Sustainability. Additionally, he directs the innovative Health and Epidemiology Advanced Learning (HEAL) program, a dual degree program in which students who are accepted as an undergraduate are also given conditional admission to the MS in Epidemiology. He is strategic director of the Clinical and Translational Sciences Institute (CTSI) research education branch, and co-directs the CTSI Biostatistics, Epidemiology and Research Design (BERD) key function. He also co-directs the Integrated Health Sciences Facility Core (IHSFC) of the Environmental Health Sciences Center of Excellence.
Katherine Bowers, Hong Ji, Lili Ding, Robert Ammerman, Judith Van Ginkel, Kimberly Yolton, Alonzo (Ted) Folger, Cincinnati Children's Hospital Medical Center.“Intergenerational effects of maternal early life adversity on infant DNA methylation of NR3C1”
Abstract: Purpose. Emerging research has identified DNA methylation (DNAm) as one mechanism by which maternal experiences may be transmitted to her offspring. While an abundance of research has demonstrated the association between a woman’s early life adversity and later health outcomes, emerging evidence suggests these effects may also be transmitted to her offspring. The purpose of this study was to evaluate the association between maternal ACEs and infant newborn DNAm of NR3C1, a glucocorticoid receptor gene. Methods. Analyses were conducted within the PRegnancy and Infant Development (PRIDE) Study, a cohort of mother-infant pairs participating in Every Child Succeeds, a home visiting program in Cincinnati, Ohio. Fifty-two healthy pregnant mothers completed a battery of psychologic and stress measures, including the ACEs. Infant newborn (3-5 weeks) buccal cells were collected for EWAS analysis. DNA was modified by sodium bisulfite (BS) and assayed using the Infinium Human Methylation850 BeadChip. Quality control was assessed at the sample and CpG level. Linear models determined the association between maternal ACE scores with M values (logit transformation of methylation percentage) of 56 CpG sites in NR3C1 adjusting for covariates. Results. Adjusting for race, child sex, maternal age, smoking, and surrogate variables (capturing epigenetic variation caused by confounding factors), four CpG sites reached statistical significance (<0.05), three of which were located in the proximal promotor region (1F, 1C, and 1H). An additional significantly associated CpG was located in the untranslated region. Conclusions. Results suggest that early maternal adversity may be transmitted to her infant through DNA methylation.
Brief Biography:
Katherine Bowers, PhD, is an associate professor in the Division of Biostatistics and Epidemiology at Cincinnati Children’s Hospital Medical Center. She received training in epidemiology at The Johns Hopkins University and NICHD. Her research interests include understanding how maternal exposures and conditions prior to and during pregnancy, for example psychosocial exposures and pregnancy complications, affect child development.
Sara A. Miller-Archie, Sungwoo Lim, Sarah Walters, Tejinder Singh, New York City Department of Health and Mental Hygiene, Division of Epidemiology, Bureau of Epidemiology Services. “Impact of supportive housing on substance use healthcare utilization and treatment among homeless persons who are active substance users”
Description: Substance use is highly prevalent among homeless populations. Supportive housing initiatives, by providing both stable, permanent housing and access to substance use treatment, may reduce the number of emergency department visits and hospitalizations for drug and alcohol use. This presentation discusses the findings from a New York City-based supportive housing program.
Abstract: Homeless persons with co-occurring substance use issues are at high risk of emergency department (ED) visits and hospitalizations for a substance use-related condition. We aimed to evaluate the impact of supportive housing on the rate of substance use-related ED visits and hospitalizations among chronically homeless adults who were active substance users by comparing those placed into supportive housing with those who were eligible but not placed. Methods: This evaluation matched 1,558 homeless adults who were active substance users and eligible for a New York City supportive housing program (2007-2012) to Medicaid claims data. The main outcomes were rates of substance use hospitalizations and ED visits for two years post-eligibility. We calculated inverse probability of treatment weights using baseline demographic and clinical characteristics and performed doubly robust marginal structural models to compare the rates of substance use-related hospitalizations and ED visits between persons placed into supportive housing and their counterparts. We also examined referrals to and initiation of outpatient substance use treatment. Results: Persons placed into supportive housing were hospitalized and visited EDs for substance use at significantly lower rates than persons not placed into housing (adjusted rate ratio (ARR) = 0.73, 95% CI=0.55-0.98 and ARR=0.49, 95% CI=0.29-0.81, respectively) during the two years post-eligibility. Placed persons had increased odds of receiving a referral for outpatient substance use treatment and initiating treatment within 14 days.Conclusions: Placement into supportive housing was associated with decreases in substance use-related hospitalizations and ED visits among chronically homeless persons who are active substance users.
Brief Biography:
Sara Miller-Archie, MPH, has over a decade of experience conducting epidemiologic surveillance and research with the New York City Department of Health and Mental Hygiene. She is currently a researcher and program evaluation analyst with the Bureau of Epidemiology Services. Much of her work focuses on evaluating the impact of large-scale, multi-agency supportive housing initiatives in New York City. Prior to this, she worked at the World Trade Center Health Registry, where she conducted surveillance into chronic and emerging health conditions related to the 9/11 disaster. She received her MPH in Epidemiology from the George Washington University Milken Institute School of Public Health.
