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Croen LA, Ames JL, Qian Y, Alexeeff S, Ashwood P, Gunderson EP, Wu YW, Boghossian AS, Yolken R, Van de Water J, Weiss LA. Inflammatory Conditions During Pregnancy and Risk of Autism and Other Neurodevelopmental Disorders. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:39-50. [PMID: 38045769 PMCID: PMC10689278 DOI: 10.1016/j.bpsgos.2023.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 12/05/2023] Open
Abstract
Background Maternal inflammation can result from immune dysregulation and metabolic perturbations during pregnancy. Whether conditions associated with inflammation during pregnancy increase the likelihood of autism spectrum disorder (ASD) or other neurodevelopmental disorders (DDs) is not well understood. Methods We conducted a case-control study among children born in California from 2011 to 2016 to investigate maternal immune-mediated and cardiometabolic conditions during pregnancy and risk of ASD (n = 311) and DDs (n = 1291) compared with children from the general population (n = 967). Data on maternal conditions and covariates were retrieved from electronic health records. Maternal genetic data were used to assess a causal relationship. Results Using multivariable logistic regression, we found that mothers with asthma were more likely to deliver infants later diagnosed with ASD (odds ratio [OR] = 1.62, 95% CI: 1.15-2.29) or DDs (OR = 1.30, 95% CI: 1.02-1.64). Maternal obesity was also associated with child ASD (OR = 1.51, 95% CI: 1.07-2.13). Mothers with both asthma and extreme obesity had the greatest odds of delivering an infant later diagnosed with ASD (OR = 16.9, 95% CI: 5.13-55.71). These increased ASD odds were observed among female children only. Polygenic risk scores for obesity, asthma, and their combination showed no association with ASD risk. Mendelian randomization did not support a causal relationship between maternal conditions and ASD. Conclusions Inflammatory conditions during pregnancy are associated with risk for neurodevelopmental disorders in children. These risks do not seem to be due to shared genetic risk; rather, inflammatory conditions may share nongenetic risk factors with neurodevelopmental disorders. Children whose mothers have both asthma and obesity during pregnancy may benefit from earlier screening and intervention.
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Affiliation(s)
- Lisa A. Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, California
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Jennifer L. Ames
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Yinge Qian
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Stacey Alexeeff
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Paul Ashwood
- Department of Medical Microbiology and Immunology and the MIND Institute, University of California, Davis, Davis, California
| | - Erica P. Gunderson
- Division of Research, Kaiser Permanente Northern California, Oakland, California
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Yvonne W. Wu
- Departments of Neurology and Pediatrics, University of California San Francisco, San Francisco, California
| | - Andrew S. Boghossian
- Institute for Human Genetics, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
| | - Robert Yolken
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Judy Van de Water
- Division of Rheumatology/Allergy/Clinical Immunology, Department of Internal Medicine, University of California at Davis, Davis, California
| | - Lauren A. Weiss
- Institute for Human Genetics, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
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2
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Ferolito B, do Valle IF, Gerlovin H, Costa L, Casas JP, Gaziano JM, Gagnon DR, Begoli E, Barabási AL, Cho K. Visualizing novel connections and genetic similarities across diseases using a network-medicine based approach. Sci Rep 2022; 12:14914. [PMID: 36050444 PMCID: PMC9436158 DOI: 10.1038/s41598-022-19244-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/26/2022] [Indexed: 11/08/2022] Open
Abstract
Understanding the genetic relationships between human disorders could lead to better treatment and prevention strategies, especially for individuals with multiple comorbidities. A common resource for studying genetic-disease relationships is the GWAS Catalog, a large and well curated repository of SNP-trait associations from various studies and populations. Some of these populations are contained within mega-biobanks such as the Million Veteran Program (MVP), which has enabled the genetic classification of several diseases in a large well-characterized and heterogeneous population. Here we aim to provide a network of the genetic relationships among diseases and to demonstrate the utility of quantifying the extent to which a given resource such as MVP has contributed to the discovery of such relations. We use a network-based approach to evaluate shared variants among thousands of traits in the GWAS Catalog repository. Our results indicate many more novel disease relationships that did not exist in early studies and demonstrate that the network can reveal clusters of diseases mechanistically related. Finally, we show novel disease connections that emerge when MVP data is included, highlighting methodology that can be used to indicate the contributions of a given biobank.
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Affiliation(s)
- Brian Ferolito
- VA Boston Healthcare System, Massachusetts Veterans Epidemiology and Research Information Center, (MAVERIC), 150 S. Huntington Avenue, Boston, 02130, USA.
| | - Italo Faria do Valle
- VA Boston Healthcare System, Massachusetts Veterans Epidemiology and Research Information Center, (MAVERIC), 150 S. Huntington Avenue, Boston, 02130, USA
- Center for Complex Network Research, Department of Physics, Northeastern University, Boston, 02115, USA
| | - Hanna Gerlovin
- VA Boston Healthcare System, Massachusetts Veterans Epidemiology and Research Information Center, (MAVERIC), 150 S. Huntington Avenue, Boston, 02130, USA
| | - Lauren Costa
- VA Boston Healthcare System, Massachusetts Veterans Epidemiology and Research Information Center, (MAVERIC), 150 S. Huntington Avenue, Boston, 02130, USA
| | - Juan P Casas
- VA Boston Healthcare System, Massachusetts Veterans Epidemiology and Research Information Center, (MAVERIC), 150 S. Huntington Avenue, Boston, 02130, USA
- Brigham and Women's Hospital, Division of Aging, Department of Medicine, Harvard Medical School, Boston, 02115, USA
| | - J Michael Gaziano
- VA Boston Healthcare System, Massachusetts Veterans Epidemiology and Research Information Center, (MAVERIC), 150 S. Huntington Avenue, Boston, 02130, USA
- Brigham and Women's Hospital, Division of Aging, Department of Medicine, Harvard Medical School, Boston, 02115, USA
| | - David R Gagnon
- VA Boston Healthcare System, Massachusetts Veterans Epidemiology and Research Information Center, (MAVERIC), 150 S. Huntington Avenue, Boston, 02130, USA
- School of Public Health, Department of Biostatistics, Boston University, Boston, 02215, USA
| | - Edmon Begoli
- Oak Ridge National Laboratory, Oak Ridge, 37830, USA
| | - Albert-László Barabási
- Center for Complex Network Research, Department of Physics, Northeastern University, Boston, 02115, USA
| | - Kelly Cho
- VA Boston Healthcare System, Massachusetts Veterans Epidemiology and Research Information Center, (MAVERIC), 150 S. Huntington Avenue, Boston, 02130, USA
- Brigham and Women's Hospital, Division of Aging, Department of Medicine, Harvard Medical School, Boston, 02115, USA
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Gunderson EP, Greenberg M, Nguyen-Huynh MN, Tierney C, Roberts JM, Go AS, Tao W, Alexeeff SE. Early Pregnancy Blood Pressure Patterns Identify Risk of Hypertensive Disorders of Pregnancy Among Racial and Ethnic Groups. Hypertension 2022; 79:599-613. [PMID: 34963295 PMCID: PMC9004135 DOI: 10.1161/hypertensionaha.121.18568] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hypertensive disorders of pregnancy are a leading cause of severe maternal morbidity and mortality and confer 4-fold higher perinatal mortality in Black women. Early pregnancy blood pressure patterns may differentiate risk of hypertensive disorders of pregnancy. METHODS This study identified distinct blood pressure trajectories from 0 to 20 weeks' gestation to evaluate subsequent pregnancy-related hypertension in a retrospective cohort of 174 925 women with no prior hypertension or history of preeclampsia, prenatal care entry ≤14 weeks, and a stillborn or live singleton birth delivered at Kaiser Permanente Northern California hospitals in 2009 to 2019. We used electronic health records to obtain clinical outcomes, covariables, and longitudinal outpatient blood pressure measurements ≤20 weeks' gestation (mean 4.1 measurements). Latent class trajectory modeling identified 6 blood pressure groups: ultra-low-declining(referent), low-declining, moderate-fast-decline, low-increasing, moderate-stable, and elevated-stable. Multivariable logistic regression evaluated trajectory group-associations with the odds of preeclampsia/eclampsia and gestational hypertension' and effect modification by race-ethnicity and prepregnancy body size. RESULTS Compared with ultra-low-declining, adjusted odds ratios (95% confidence intervals [CIs]) for low-increasing, moderate-stable, and elevated-stable groups were 3.25 (2.7-3.9), 5.3 (4.5-6.3), and 9.2 (7.7-11.1) for preeclampsia/eclampsia' and 6.4 (4.9-8.3), 13.6 (10.5-17.7), and 30.2 (23.2-39.4) for gestational hypertension. Race/ethnicity, and prepregnancy obesity modified the trajectory-group associations with preeclampsia/eclampsia (interaction P<0.01), with highest risks for Black, then Hispanic and Asian women for all blood pressure trajectories, and with increasing obesity class. CONCLUSIONS Early pregnancy blood pressure patterns revealed racial and ethnic differences in associations with preeclampsia/eclampsia risk within equivalent levels and patterns. These blood pressure patterns may improve individual risk stratification permitting targeted surveillance and early mitigation strategies.
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Affiliation(s)
- Erica P. Gunderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA,Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA
| | - Mara Greenberg
- Department of Obstetrics and Gynecology, Kaiser Permanente, Oakland Medical Center, CA
| | - Mai N. Nguyen-Huynh
- Division of Research, Kaiser Permanente Northern California, Oakland, CA,Department of Neurology, Kaiser Permanente Walnut Creek Medical Center, Walnut Creek, CA
| | - Cassidy Tierney
- Department of Obstetrics and Gynecology, Kaiser Permanente, Oakland Medical Center, CA
| | - James M. Roberts
- Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, Epidemiology and Clinical and Translational Research, University of Pittsburgh, PA
| | - Alan S. Go
- Division of Research, Kaiser Permanente Northern California, Oakland, CA,Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA,Departments of Epidemiology, Biostatistics and Medicine, University of California
| | - Wei Tao
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Stacey E. Alexeeff
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
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Feigelson HS, Clarke CL, Van Den Eeden SK, Weinmann S, Burnett-Hartman AN, Rowell S, Scott SG, White LL, Ter-Minassian M, Honda SAA, Young DR, Kamineni A, Chinn T, Lituev A, Bauck A, McGlynn EA. The Kaiser Permanente Research Bank Cancer Cohort: a collaborative resource to improve cancer care and survivorship. BMC Cancer 2022; 22:209. [PMID: 35216576 PMCID: PMC8876075 DOI: 10.1186/s12885-022-09252-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/21/2022] [Indexed: 12/04/2022] Open
Abstract
Background The Kaiser Permanente Research Bank (KPRB) is collecting biospecimens and surveys linked to electronic health records (EHR) from approximately 400,000 adult KP members. Within the KPRB, we developed a Cancer Cohort to address issues related to cancer survival, and to understand how genetic, lifestyle and environmental factors impact cancer treatment, treatment sequelae, and prognosis. We describe the Cancer Cohort design and implementation, describe cohort characteristics after 5 years of enrollment, and discuss future directions. Methods Cancer cases are identified using rapid case ascertainment algorithms, linkage to regional or central tumor registries, and direct outreach to KP members with a history of cancer. Enrollment is primarily through email invitation. Participants complete a consent form, survey, and donate a blood or saliva sample. All cancer types are included. Results As of December 31, 2020, the cohort included 65,225 cases (56% female, 44% male) verified in tumor registries. The largest group was diagnosed between 60 and 69 years of age (31%) and are non-Hispanic White (83%); however, 10,076 (16%) were diagnosed at ages 18–49 years, 4208 (7%) are Hispanic, 3393 (5%) are Asian, and 2389 (4%) are Black. The median survival time is 14 years. Biospecimens are available on 98% of the cohort. Conclusions The KPRB Cancer Cohort is designed to improve our understanding of treatment efficacy and factors that contribute to long-term cancer survival. The cohort’s diversity - with respect to age, race/ethnicity and geographic location - will facilitate research on factors that contribute to cancer survival disparities.
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Affiliation(s)
- Heather Spencer Feigelson
- Institute for Health Research, Kaiser Permanente, 2550 S. Parker Rd, Suite 200, Aurora, CO, 80014, USA.
| | - Christina L Clarke
- Institute for Health Research, Kaiser Permanente, 2550 S. Parker Rd, Suite 200, Aurora, CO, 80014, USA
| | | | - Sheila Weinmann
- Center for Health Research, Kaiser Permanente, 3800 N. Interstate Ave, Portland, OR, 97227, USA
| | - Andrea N Burnett-Hartman
- Institute for Health Research, Kaiser Permanente, 2550 S. Parker Rd, Suite 200, Aurora, CO, 80014, USA
| | - Sarah Rowell
- Kaiser Permanente Program Office, 1800 Harrison, 16th floor, Oakland, CA, 94612, USA
| | - Shauna Goldberg Scott
- Institute for Health Research, Kaiser Permanente, 2550 S. Parker Rd, Suite 200, Aurora, CO, 80014, USA
| | - Larissa L White
- Institute for Health Research, Kaiser Permanente, 2550 S. Parker Rd, Suite 200, Aurora, CO, 80014, USA
| | - Monica Ter-Minassian
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente, 2101 East Jefferson St, 3 West, Rockville, MD, 20852, USA
| | - Stacey A A Honda
- Center for Integrated Healthcare Research and Hawai'i Permanente Medical Group, Kaiser Permanente, 501 Alakawa St Suite 201, Honolulu, HI, 96817, USA
| | - Deborah R Young
- Department of Research and Evaluation, Kaiser Permanente, 100 S. Los Robles Avenue, Pasadena, CA, 91101, USA
| | - Aruna Kamineni
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave Suite 1600, Seattle, WA, 98101, USA
| | - Terrence Chinn
- Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA, 94612, USA
| | - Alexander Lituev
- Kaiser Permanente Research Bank, Kaiser Permanente, 1795 A Second St, Berkeley, CA, 94710, USA
| | - Alan Bauck
- Center for Health Research, Kaiser Permanente, 3800 N. Interstate Ave, Portland, OR, 97227, USA
| | - Elizabeth A McGlynn
- Kaiser Permanente Research & Quality Measurement and Kaiser Permanente Research Bank, 100 S. Los Robles, 3rd floor, Pasadena, CA, 91101, USA
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Park A, Alabaster A, Shen H, Mell LK, Katzel JA. Undertreatment of women with locoregionally advanced head and neck cancer. Cancer 2019; 125:3033-3039. [DOI: 10.1002/cncr.32187] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 04/02/2019] [Accepted: 04/04/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Annie Park
- Department of Internal Medicine Scripps Mercy San Diego California
| | - Amy Alabaster
- Division of Research Kaiser Permanente Oakland California
| | - Hanjie Shen
- Center for Precision Radiation Medicine La Jolla California
| | - Loren K. Mell
- Center for Precision Radiation Medicine La Jolla California
- Department of Radiation Medicine and Applied Sciences University of California San Diego San Diego California
| | - Jed A. Katzel
- Department of Oncology Kaiser Permanente Santa Clara California
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