Andrea L Deierlein
Andrea L. Deierlein
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Director of Public Health Nutrition
Associate Professor of Public Health Nutrition
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Professional overview
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Dr. Andrea Deierlein’s research focuses on examining how dietary, behavioral, and
environmental factors contribute to reproductive health outcomes and chronic-disease
development throughout the lifespan.Dr. Deierlein is trained as a nutritional epidemiologist. Much of her research has
examined predictors and outcomes of maternal metabolic health-related conditions during
pregnancy and the postpartum, specifically, excessive gestational weight gain,
hyperglycemia, and obesity. She contributed to a systematic evidence-based review
examining outcomes of weight gain during pregnancy at the Agency of Healthcare
Research and Quality. This review informed the development of the 2009 Institute of
Medicine Gestational Weight Gain Guidelines. Dr. Deierlein received the K99/R00
Pathway to Independence Award to expand her training to include the study of toxic
environmental chemicals and metals. She conducted research examining associations of
endocrine-disrupting toxicant exposures during childhood and changes in anthropometric
measurements through adolescence among girls. She also conducted a series of analyses
examining maternal prenatal exposures to phthalates with weight gain and biomarkers of
cardiometabolic health in women during pregnancy and throughout the postpartum.
Recently, Dr. Deierlein has expanded her research to include disability-related disparities
in nutrition and reproductive health. -
Education
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BS, Animal Science, Cornell University, Ithaca, NYMS, Health Nutrition, Columbia University, New York, NYMPH, Epidemiology, Columbia University, New York, NYPhD, Nutrition Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Honors and awards
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Travel Scholarship, Be Our Voice Childhood Obesity Prevention Advocacy Training, Robert Wood Johnson Foundation (2013)New York Academy of Sciences Education Fellowship (2012)Postdoctoral Fellowship in Pediatric Environmental Health, Icahn School of Medicine at Mount Sinai (2010)Travel Scholarship, Researching Women’s Environmental Health: Food, Nutrition, and Obesity, University of Rochester Medical Center (2010)Travel Scholarship, Childhood Obesity Symposium, University of Southern California (2010)
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Areas of research and study
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Environmental Public Health ServicesEpidemiologyMaternal and Child HealthNutritionWomen's Health
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Publications
Publications
Folic Acid Supplementation to Prevent Recurrent Neural Tube Defects : 4 Milligrams Is Too Much
AbstractDolin, C. D., Deierlein, A. L., & Evans, M. I. (n.d.).Publication year
2018Journal title
Fetal Diagnosis and TherapyVolume
44Issue
3Page(s)
161-165AbstractSome medical practices have been ingrained in custom for decades, long after "proof" that they were effective was established. It is necessary to periodically reevaluate these practices, as newer theories and research may challenge the evidence upon which they were based. An example is the decades' old practice of recommending a 4-mg (4,000-μg) supplement of folic acid to women who are at risk for recurrent neural tube defect (NTD) during pregnancy. This recommendation was based on findings from a randomized clinical trial in 1991. Since then, multiple studies have confirmed the utility of 400-800 μg of folic acid in lowering both primary and recurrent risks of NTDs, but no studies have established any further reduction in risk with doses over 1 mg. Current understanding of folic acid metabolism during pregnancy suggests that at higher doses, above ∼1 mg, there is not increased absorption. Recent evidence suggests that 4 mg folic acid supplementation may not be any more effective than lower doses for the prevention of recurrent NTDs. Thus, we recommend that it is time for clinicians to reexamine their reliance on this outdated recommendation and consider using current recommendations of 400-800 μg per day for all patients in conjunction with assessment of maternal folate status.Food assistance programs and income are associated with the diet quality of grocery purchases for households consisting of women of reproductive age or young children
AbstractLitvak, J., Parekh, N., Juul, F. C., & Deierlein, A. L. (n.d.).Publication year
2020Journal title
Preventive MedicineVolume
138AbstractWomen's diet quality during reproductive years and children's diet quality during early life influence long term health. Few studies have evaluated the impact of food assistance programs and income on the diet quality of grocery purchases made by households consisting of women of reproductive age and young children. We used data from the Food Acquisition and Purchase Survey 2012–2013 (FoodAPS) to evaluate how household income, Special Supplemental Nutrition Assistance Program for Women, Infants and Children (WIC) participation, and Supplemental Nutrition Assistance Program (SNAP) participation are related to the diet quality of grocery purchases made by households that include women of reproductive age or young children (n = 2436). The diet quality of household grocery purchases was assessed with the Healthy Eating Index (HEI) 2015. HEI-2015 total score (0−100) and component scores were evaluated according to household income (eligible for WIC: income-to-poverty ratio ≤ 185%; ineligible for WIC: income-to-poverty ratio > 185%) and WIC, SNAP, and WIC + SNAP participation. Median HEI-2015 total score was lowest among SNAP households and highest among income ineligible for WIC and WIC households (47.2 and 54.1, respectively). Compared to income ineligible for WIC households, WIC + SNAP and SNAP households had lower HEI-2015 whole fruit (β = −0.30, 95% CI: −0.59, −0.01 and β = −0.41, 95% CI: −0.63, −0.20, respectively) and total vegetable scores (β = −0.58, 95% CI: −0.83, −0.32 and β = −0.27, 95% CI: −0.45, −0.08, respectively). The diet quality of grocery purchases in this population varies according to household income and food assistance participation.Food Insecurity and Health Behaviors Among a Sample of Undergraduate Students at an Urban University
AbstractHussain, B. M., Ryan, R., Deierlein, A. L., Lal, S., Bihuniak, J. D., & Parekh, N. (n.d.).Publication year
2022Journal title
Journal of Hunger and Environmental NutritionAbstractStudents at universities are experiencing food insecurity, which may be associated with health behaviors. In a pilot study to build a survey that assesses food insecurity and health behaviors among undergraduates, we distributed the survey before (Wave 1; fall 2019) and during (Wave 2; summer 2020) COVID-19. During Wave 1, 41% of students reported food insecurity and 61% met criteria for poor sleep. In Wave 2, 26% reported food insecurity and 49% met criteria for poor sleep. Students experiencing food insecurity were more likely to report poor sleep. This survey will inform recruitment and design of a scaled-up multi-campus study. (100/100 words).Food Insecurity, Associated Health Behaviors, and Academic Performance Among Urban University Undergraduate Students
AbstractRyan, R. A., Murphy, B., Deierlein, A. L., Lal, S., Parekh, N., & Bihuniak, J. D. (n.d.).Publication year
2022Journal title
Journal of Nutrition Education and BehaviorVolume
54Issue
3Page(s)
269-275AbstractObjective: To explore associations between food insecurity, health behaviors, and academic performance among undergraduates at a private, urban US university. Methods: A cross-sectional web-based survey was conducted among a convenience sample of New York University undergraduates. Multivariable logistic regression estimated associations of food security (using the 6-item US Household Food Security Survey Module) and health behaviors (fruit/vegetable, beverage and alcohol intakes, and sleep), self-rated health, and academic performance. Results: Of the 257 students who completed the survey, 41% reported food insecurity. Food insecurity was associated with approximately 2-fold higher odds of sugar-sweetened beverage consumption (adjusted odds ratio, 1.97; 95% confidence interval, 1.14–3.41) and fair/poor health (adjusted odds ratio, 2.29; 95% confidence interval, 1.23–4.25). Conclusions and Implications: Increased awareness of food insecurity and associated health behaviors among students has implications for higher education's provision of on-campus food support programs.Food Records Show Daily Variation in Diet during Pregnancy : Results from the Temporal Research in Eating, Nutrition, and Diet during Pregnancy Study
AbstractKleinberg, S., Pleuss, J. D., & Deierlein, A. L. (n.d.).Publication year
2024Journal title
Journal of NutritionVolume
154Issue
12Page(s)
3780-3789AbstractBackground: Diet is critical for pregnant individuals and their offspring, but insight into diet during pregnancy mainly comes from questionnaires and recalls. Objectives: To obtain detailed real-time dietary data during pregnancy to evaluate intra- and interindividual variation in intakes. Methods: Pregnant individuals were recruited from a New York City health system December 2020–June 2023. Participants collected dietary intakes for 14 d (mean gestational weeks = 17.6) and again roughly 4 wk later (mean gestational weeks = 24.5). Participants logged each eating occasion using a smartphone and study-developed app, and wore a smartwatch capturing physiologic data. Results: In total, 150 individuals completed ≥1 data collection round, with 134 completing both rounds. Mean daily eating window was 10.82 h, with weekends having a significantly shorter window than weekdays (P < 0.001). Eating window was correlated with energy intake (r = 0.401, P < 0.001), driven by later last eating occasions. There was high intraindividual variation in macro- and micronutrient intakes [intraclass correlation coefficient (ICC), range 0.11–0.40] and food type (ICC range: 0.08–0.34), and differences between weekdays and weekends (less protein and micronutrients on weekends). Few participants’ mean intakes met daily recommended dietary allowances for key micronutrients (under 15% for iron, magnesium, vitamin D, and vitamin E; under 30% for calcium, folate, zinc, and vitamin A). Conclusions: Dietary intakes varied substantially within and between individuals, and mean nutrient intake estimates did not capture nutrient adequacy for individuals or populations. Future work that examines individual daily dietary intakes throughout pregnancy among diverse populations is needed.Gestational weight gain and predicted changes in offspring anthropometrics between early infancy and 3 years
AbstractDeierlein, A. L., Deierlein, A. L., Siega-Riz, A. M., Herring, A. H., Adair, L. S., & Daniels, J. L. (n.d.).Publication year
2012Journal title
Pediatric ObesityVolume
7Issue
2Page(s)
134-142AbstractObjective: To determine how gestational weight gain (GWG), categorized using the 2009 Institute of Medicine recommendations, relates to changes in offspring weight-for-age (WAZ), length-for-age (LAZ) and weight-for-length z-scores (WLZ) between early infancy and 3 years. Methods: Women with singleton infants were recruited from the third cohort of the Pregnancy, Infection, and Nutrition Study (2001-2005). Term infants with at least one weight or length measurement during the study period were included (n = 476). Multivariable linear mixed effects regression models estimated longitudinal changes in WAZ, LAZ and WLZ associated with GWG. Results: In early infancy, compared with infants of women with adequate weight gain, those of women with excessive weight gains had higher WAZ, LAZ and WLZ. Excessive GWG ≥ 200% of the recommended amount was associated with faster rates of change in WAZ and LAZ and noticeably higher predicted mean WAZ and WLZ that persisted across the study period. Conclusions: GWG is associated with significant differences in offspring anthropometrics in early infancy that persisted to 3 years of age. More longitudinal studies that utilize maternal and paediatric body composition measures are necessary to understand the nature of this association.Health behaviours during the coronavirus disease 2019 pandemic : Implications for obesity
AbstractParekh, N., & Deierlein, A. L. (n.d.).Publication year
2020Journal title
Public Health NutritionVolume
23Issue
17Page(s)
3121-3125AbstractObjective: Obesity is a risk factor for severe complications and death from the coronavirus disease 2019 (COVID-19). Public health efforts to control the pandemic may alter health behaviors related to weight gain, inflammation, and poor cardiometabolic health, exacerbating the prevalence of obesity, poor immune health, and chronic diseases. Design: We reviewed how the pandemic adversely influences many of these behaviors, specifically physical activity, sedentary behaviors, sleep, and dietary intakes, and provided individual level strategies that may be used to mitigate them. Results: At the community level and higher, public health and health care professionals need to advocate for intervention strategies and policy changes that address these behaviors, such as increasing nutrition assistance programs and creating designated areas for recreation and active transportation, to reduce disparities among vulnerable populations. Conclusions: The long-lasting impact of the pandemic on health behaviors, and the possibility of a second COVID-19 wave, emphasize the need for creative and evolving, multi-level approaches to assist individuals in adapting their health behaviors to prevent both chronic and infectious diseases.How can we assist women in managing gestational weight gain?
AbstractDeierlein, A. L., & Siega-Riz, A. M. (n.d.).Publication year
2012Journal title
Women's HealthVolume
8Issue
6Page(s)
603-605Abstract~Impact of metabolism-disrupting chemicals and folic acid supplementation on liver injury and steatosis in mother-child pairs
AbstractIndia-Aldana, S., Midya, V., Betanzos-Robledo, L., Yao, M., Alcalá, C., Andra, S. S., Arora, M., Calafat, A. M., Chu, J., Deierlein, A. L., Estrada-Gutierrez, G., Jagani, R., Just, A. C., Kloog, I., Landero, J., Oulhote, Y., Walker, R. W., Yelamanchili, S., Baccarelli, A. A., … Valvi, D. (n.d.).Publication year
2025Journal title
Journal of HepatologyAbstractBackground & Aims: Scarce knowledge about the impact of metabolism-disrupting chemicals (MDCs) on steatotic liver disease limits opportunities for intervention. We evaluated pregnancy MDC-mixture associations with liver outcomes, and effect modification by folic acid (FA) supplementation in mother-child pairs. Methods: We studied ∼200 mother-child pairs from the Mexican PROGRESS cohort, with 43 MDCs measured during pregnancy (estimated air pollutants, blood/urine metals or metalloids, urine high- and low-molecular-weight phthalate [HMWPs, LMWPs] and organophosphate-pesticide metabolites), and serum liver enzymes (ALT, AST) at ∼9 years post-parturition. Outcomes included elevated liver enzymes in children and established clinical scores for steatosis and fibrosis in mothers (i.e., AST:ALT, FLI, HSI, FIB-4). Bayesian-weighted quantile sum regression assessed MDC-mixture associations with liver outcomes. We further examined chemical-chemical interactions and effect modification by self-reported FA supplementation. Results: In children, many MDC-mixtures were associated with liver injury. Per quartile HMWP-mixture increase, ALT increased by 10.1% (95% CI 1.67%, 19.4%) and AST by 5.27% (95% CI 0.80%, 10.1%). LMWP-mixtures and air pollutant-mixtures were associated with higher AST and ALT, respectively. Air pollutant and non-essential metal/element associations with liver enzymes were attenuated by maternal cobalt blood concentrations (p-interactions 36, and odds ratio 1.62, 95% CI 1.05–2.49 for AST:ALTImplementation of the new institute of medicine gestational weight gain guidelines
AbstractSiega-Riz, A. M., Deierlein, A. L., & Stuebe, A. (n.d.).Publication year
2010Journal title
Journal of Midwifery and Women's HealthVolume
55Issue
6Page(s)
512-519AbstractIn May 2009, the Institute of Medicine (IOM) introduced revised gestational weight gain guidelines that were based on balancing the benefits and risks of weight gain for both the mother and child's health. This article provides an overview of these new recommendations, explaining the key changes made from the previous 1990 IOM recommendations. The important role of health care providers of pregnant women in the implementation of the new recommendations is detailed, and specific guidance for troubleshooting issues that may be encountered when helping women achieve appropriate gestational weight gains is provided.Is meeting the recommended dietary allowance (RDA) for protein related to body composition among older adults? : Results from the Cardiovascular Health of Seniors and Built Environment Study
AbstractDeierlein, A. L., Beasley, J. M., Deierlein, A. L., Morland, K. B., Granieri, E. C., & Spark, A. (n.d.).Publication year
2016Journal title
Journal of Nutrition, Health and AgingVolume
20Issue
8Page(s)
790-796AbstractObjective: Studies suggest protein intake may be associated with lower body weight, but protein has also been associated with preservation of lean body mass. Understanding the role of protein in maintaining health for older adults is important for disease prevention among this population. Design: Cross-sectional study of the relationship of dietary protein on body composition. Setting: New York City community centers. Participants: 1,011 Black, White, and Latino urban men and women 60-99 years of age. Measurements: Protein intake was assessed using two interviewer-administered 24-hour recalls, and body composition was assessed using bioelectrical impedance analysis (BIA) of fat mass (kg) (FM), fat free mass (kg) (FFM), and impedance resistance (Ohms). Statistical Analysis: Indices of FM and FFM were calculated by dividing BIA measurements by height squared (m2), and percent FFM was calculated by dividing FFM by the sum of FM and FFM. Log linear models adjusting for age (continuous), race/ethnicity, education, physical activity (dichotomized at the median), hypertension, diabetes, and total calories (continuous). Results: Just 33% of women and 50% of men reported meeting the RDA for protein. Both fat free mass index (FFMI) and fat mass index (FMI) were negatively associated with meeting the RDA for protein (Women: FFMI -1.78 95%CI [-2.24, -1.33], FMI -4.12 95% CI [-4.82, -3.42]; Men: FFMI -1.62 95% CI [-2.32, -0.93] FMI -1.80 95% CI [-2.70, -0.89]). After accounting for confounders, women and men consuming at least 0.8 g/kg/day had a 6.2% (95% CI: 5.0%, 7.4%) and a 3.2% (95% CI 1.1%, 5.3%) higher percent fat free mass, respectively. Conclusions: FFM, FFMI, FM, and FMI were inversely related to meeting the RDA for protein. Meeting the RDA for protein of at least 0.8g/kg/day was associated with a higher percentage of fat free mass among older adults. These results suggest meeting the protein recommendations of at least 0.8 g/kg/day may help to promote lower overall body mass, primarily through loss of fat mass rather than lean mass.Lead exposure during childhood and subsequent anthropometry through adolescence in girls
AbstractDeierlein, A. L. (n.d.).Publication year
2019Journal title
Environment internationalVolume
122Page(s)
310-315AbstractIntroduction: Cross-sectional studies suggest that postnatal blood lead (PbB) concentrations are negatively associated with child growth. Few studies prospectively examined this association in populations with lower PbB concentrations. We investigated longitudinal associations of childhood PbB concentrations and subsequent anthropometric measurements in a multi-ethnic cohort of girls. Methods: Data were from The Breast Cancer and the Environment Research Program at three sites in the United States (U.S.): New York City, Cincinnati, and San Francisco Bay Area. Girls were enrolled at ages 6–8 years in 2004–2007. Girls with PbB concentrations collected at ≤10 years old (mean 7.8 years, standard deviation (SD) 0.82) and anthropometry collected at ≥3 follow-up visits were included (n = 683). The median PbB concentration was 0.99 μg/d (10th percentile = 0.59 μg/dL and 90th percentile = 2.00 μg/dL) and the geometric mean was 1.03 μg/dL (95% Confidence Interval (CI): 0.99, 1.06). For analyses, PbB concentrations were dichotomized asLocal food environments are associated with girls' energy, sugar-sweetened beverage and snack-food intakes
AbstractDeierlein, A. L., Galvez, M. P., Yen, I. H., Pinney, S. M., Biro, F. M., Kushi, L. H., Teitelbaum, S., & Wolff, M. S. (n.d.).Publication year
2013Journal title
Public Health NutritionVolume
17Issue
10Page(s)
2194-2200AbstractObjective: To describe availability and frequency of use of local snack-food outlets and determine whether reported use of these outlets was associated with dietary intakes. Design: Data were cross-sectional. Availability and frequency of use of three types of local snack-food outlets were reported. Daily dietary intakes were based on the average of up to four 24 h dietary recalls. Multivariable linear regression models estimated average daily intakes of energy, sugar-sweetened beverages (SSB) and snack foods/sweets associated with use of outlets. Setting: Multi-site, observational cohort study in the USA, 2004-2006. Subjects: Girls aged 6-8 years (n 1010). Results: Weekly frequency of use of local snack-food outlets increased with number of available types of outlets. Girls with access to only one type of outlet reported consuming food/beverage items less frequently than girls with access to two or three types of outlets (P < 0·001). Girls' daily energy, SSB and snack foods/sweets intakes increased with greater use of outlets. Girls who reported using outlets > 1 to 3 times/week consumed 0·27 (95 % CI 0·13, 0·40) servings of SSB more daily than girls who reported no use. Girls who reported using outlets > 3 times/week consumed 449·61 (95 % CI 134·93, 764·29) kJ, 0·43 (95 % CI 0·29, 0·58) servings of SSB and 0·38 (95 % CI 0·12, 0·65) servings of snack foods/sweets more daily than those who reported no use. Conclusions: Girls' frequency of use of local snack-food outlets increases with the number of available types of outlets and is associated with greater daily intakes of energy and servings of SSB and snack foods/sweets.Longitudinal associations of phthalate exposures during childhood and body size measurements in young girls
AbstractDeierlein, A. L., Wolff, M. S., Pajak, A., Pinney, S. M., Windham, G. C., Galvez, M. P., Silva, M. J., Calafat, A. M., Kushi, L. H., Biro, F. M., & Teitelbaum, S. L. (n.d.).Publication year
2016Journal title
EpidemiologyVolume
27Issue
4Page(s)
492-499AbstractBackground: Phthalates are environmental chemicals that may play a role in the development of obesity. Few studies have investigated longitudinal associations between postnatal phthalate exposures and subsequent anthropometric measurements in children. Methods: We collected data as part of The Breast Cancer and Environment Research Program at three US sites. A total of 1,239 girls, aged 6-8 years, were enrolled in 2004-2007. We categorized baseline phthalate exposures, assessed from creatinine-corrected urinary concentrations of low-molecular weight phthalate metabolites, as low,Long–term consequences of obesity in pregnancy for the mother
AbstractDeierlein, A. L., & Siega-Riz, A. M. (n.d.).Publication year
2012Page(s)
81-86AbstractCurrent knowledge argues that pregnancy serves as a preview of a woman’s long-term health. The numerous physiological changes during pregnancy, which stress the metabolic system [1], can reveal subclinical disease states as well as identify new ones [2,3]. Evidence for this assertion exists in studies that have examined the association between gestational diabetes mellitus (GDM) and subsequent type 2 diabetes mellitus (T2DM) [4], as well as hypertensive disorders during pregnancy and subsequent cardiovascular disease risk factors [5]. Whether pregnancy is on the causal pathway or simply a time period that allows these chronic diseases to be unmasked remains yet to be determined. Obese women are more likely to be at higher risk of developing complications such as GDM, hypertensive disorders, and pre-eclampsia during pregnancy [6–9]. In this chapter we will focus on the evidence for the association between gestational weight gain and postpartum weight retention among obese women, as well as the association between obesity and lack of breastfeeding, and how these associations are potentially interrelated to cause further disease in obese women. Postpartum weight retention. Pregnancy and its associated weight gain may be potential “triggers” for the development of obesity in women [10,11]. Pooled estimates of average absolute postpartum weight retention in units of body mass index (BMI) (kg/m2) are 2.42 (95% CI: 2.32–2.52) at six weeks, 1.14 (95% CI: 1.04–1.25) at six months, and 0.46 (95% CI: 0.38–0.54) at twelve months postpartum [12]. These estimates suggest that most women will lose the majority of weight that is associated with pregnancy within one year postpartum. However, many studies have observed a wide range of variation in postpartum weight retention [13,14], with as many as 20% of women having substantial postpartum weight retention ranging over 5kg (11lbs) [13].Maternal Glucose and Child BMI in the Young
AbstractDeierlein, A. L. (n.d.).Publication year
2012Abstract~Maternal Phthalates Exposure and Blood Pressure during and after Pregnancy in the PROGRESS Study
AbstractWu, H., Kupsco, A., Just, A., Calafat, A. M., Oken, E., Braun, J. M., Sanders, A. P., Mercado-Garcia, A., Cantoral, A., Pantic, I., Téllez-Rojo, M. M., Wright, R. O., Baccarelli, A. A., & Deierlein, A. L. (n.d.).Publication year
2021Journal title
Environmental health perspectivesVolume
129Issue
12AbstractBACKGROUND: Phthalate exposure is ubiquitous and may affect biological pathways related to regulators of blood pressure. Given the profound changes in vasculature during pregnancy, pregnant women may be particularly susceptible to the potential effects of phthalates on blood pressure. OBJECTIVES: We examined associations of phthalate exposure during pregnancy with maternal blood pressure trajectories from mid-pregnancy through 72 months postpartum. METHODS: Women with singleton pregnancies delivering a live birth in Mexico City were enrolled during the second trimester (n = 892). Spot urine samples from the second and third trimesters were analyzed for 15 phthalate metabolites. Blood pressure and covariate data were collected over nine visits through 72 months postpartum. We used linear, logistic, and linear mixed models; latent class growth models (LCGMs); and Bayesian kernel machine regression to estimate the relationship of urinary phthalate biomarkers with maternal blood pressure. RESULTS: As a joint mixture, phthalate biomarker concentrations during pregnancy were associated with higher blood pressure rise during mid-to-late gestation. With respect to individual biomarkers, second trimester concentrations of monobenzyl phthalate (MBzP) and di(2-ethylhexyl) phthalate bio-markers (∑DEHP) were associated with higher third trimester blood pressure. Two trajectory classes were identified by LCGM, characterized by increasing blood pressure through 72 months postpartum (“increase–increase”) or decreased blood pressure through 18 months postpartum with a gradual increase thereafter (“decrease–increase”). Increasing exposure to phthalate mixtures during pregnancy was associated with higher odds of being in the increase–increase class. Similar associations were observed for mono-2-ethyl-5-carboxypentyl terephthalate (MECPTP) and dibutyl phthalate (∑DBP) biomarkers. When specific time periods were examined, we observed specific temporal relationships were observed for ∑DEHP, MECPTP, MBzP, and ∑DBP. DISCUSSION: In our cohort of pregnant women from Mexico City, exposure to phthalates and phthalate biomarkers was associated with higher blood pressure during late pregnancy, as well as with long-term changes in blood pressure trajectories.Mental health outcomes across the reproductive life course among women with disabilities : a systematic review
AbstractDeierlein, A. L., Park, C., Patel, N., Gagnier, R., & Thorpe, M. (n.d.).Publication year
2024Journal title
Archives of Women's Mental HealthAbstractPurpose: This systematic review examined literature on mental health outcomes among women with disabilities living in high-income countries within the context of reproductive health, spanning menstruation through menopause. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched MEDLINE, CINAHL, and PsycINFO databases for studies published through June 2023. Eligible studies were observational, quantitative, and included a comparison group without disabilities. Results: A total of 2,520 studies were evaluated and 27 studies met inclusion criteria. These studies assessed mental health during prepregnancy, pregnancy, postpartum, and parenting among women with and without disabilities. None of the studies examined reproductive health time periods related to menstruation, fertility, or menopause. Women of reproductive age with disabilities were more likely to have poor mental health outcomes compared to women without disabilities. During pregnancy and the postpartum, women with disabilities were at greater risk of diagnosed perinatal mental disorders and psychiatric-related healthcare visits. Findings also suggested mental distress and inadequate emotional and social support related to parenting among women with disabilities. The greatest risks of poor mental health outcomes were often observed among women with intellectual and developmental disabilities and among women with multiple types of disabilities, compared to women without disabilities. Conclusions: Routine reproductive healthcare visits provide significant prevention and treatment opportunities for poor mental health among women with disabilities. Further research examining mental health outcomes within the context of reproductive health, especially understudied areas of menstruation, fertility, parenting, and menopause, among women with disabilities is needed.Outcomes of maternal weight gain.
AbstractViswanathan, M., Siega-Riz, A. M., Moos, M. K., Deierlein, A. L., Mumford, S., Knaack, J., Thieda, P., Lux, L. J., & Lohr, K. N. (n.d.).Publication year
2008Journal title
Evidence report/technology assessmentIssue
168Page(s)
1-223AbstractOBJECTIVES: The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) systematically reviewed evidence on outcomes of gestational weight gain and their confounders and effect modifiers, outcomes of weight gain within or outside the 1990 Institute of Medicine (IOM) guidelines, risks and benefits of weight gain recommendations, and anthropometric measures of weight gain. DATA SOURCES: We searched MEDLINE Cochrane Collaboration resources, Cumulative Index to Nursing & Allied Health Literature, and Embase. REVIEW METHODS: We included studies published in English from 1990 through October 2007. We excluded studies with low sample size (based on study design: case seriesPatterns of weight change one year after delivery are associated with cardiometabolic risk factors at six years postpartum in Mexican women
AbstractSoria-Contreras, D. C., Trejo-Valdivia, B., Cantoral, A., Pizano-Zárate, M. L., Baccarelli, A. A., Just, A. C., Colicino, E., Deierlein, A. L., Wright, R. O., Oken, E., Téllez-Rojo, M. M., & López-Ridaura, R. (n.d.).Publication year
2020Journal title
NutrientsVolume
12Issue
1AbstractPregnancy is a contributor to the obesity epidemic in women, probably through postpartum weight retention (PPWR), weight gain (PPWG), or a combination of both (PPWR + WG). The contribution of these patterns of postpartum weight change to long-term maternal health remains understudied. In a secondary analysis of 361 women from the prospective cohort PROGRESS, we evaluated the associations between patterns of weight change one year after delivery and cardiometabolic risk factors at six years postpartum. Using principal component analysis, we grouped cardiometabolic risk factors into: (1) body mass index (BMI), waist circumference (WC), homeostatic model assessment of insulin resistance (HOMA-IR), high-density lipoprotein cholesterol (HDL-c), triglycerides (TG), and glucose; (2) systolic (SBP) and diastolic blood pressure (DBP); and (3) low-density lipoprotein cholesterol and total cholesterol. Using path analysis, we studied direct (patterns of weight change-outcomes) and indirect associations through BMI at six years postpartum. Around 60% of women returned to their pregestational weight (reference) by one year postpartum, 6.6% experienced PPWR, 13.9% PPWG, and 19.9% PPWR + WG. Women with PPWR + WG, vs. the reference, had higher BMI and WC at six years (2.30 kg/m2, 95% CI [1.67, 2.93]; 3.38 cm [1.14, 5.62]). This was also observed in women with PPWR (1.80 kg/m2 [0.80, 2.79]; 3.15 cm [−0.35, 6.65]) and PPWG (1.22 kg/m2 [0.53, 1.92]; 3.32 cm [0.85, 5.78]). PPWR + WG had a direct association with HOMA-IR (0.21 units [0.04, 0.39]). The three patterns of weight change, vs. the reference, had significant indirect associations with HOMA-IR, glucose, TG, HDL-c, SBP, and DBP through BMI at six years. In conclusion, women with PPWR + WG are at high-risk for obesity and insulin resistance. Interventions targeting women during pregnancy and the first year postpartum may have implications for their long-term risk of obesity and cardiovascular disease.Persistent Endocrine-Disrupting Chemicals and Fatty Liver Disease
AbstractDeierlein, A. L., Rock, S., & Park, S. (n.d.).Publication year
2017Journal title
Current environmental health reportsVolume
4Issue
4Page(s)
439-449AbstractPurpose of Review: Non-alcoholic fatty liver disease (NAFLD) is the most prominent chronic liver disease in Western countries, affecting approximately 25% of the population worldwide. Sex-specific differences in the development of NAFLD are apparent. While obesity and insulin resistance are major contributors to the increasing prevalence of NAFLD, a growing body of literature suggests that exposure to persistent endocrine-disrupting chemicals (pEDCs) may also play a role. This review summarizes recent (2011 and later) scientific literature investigating exposures to pEDCs, specifically persistent organic pollutants (POPs), and NAFLD, with a focus on sex-specific associations. Recent Findings: The overwhelming majority of studies were conducted in single-sex animal models and provide biological evidence that exposures to 2,3,7,8-tetrachlorodibenzo-p-dioxin polychlorinated biphenyls, and other POPs or POP mixtures are negatively associated with liver health. There were four cross-sectional epidemiological studies in humans that reported associations for several POPs, including polychlorinated biphenyls and perfluorinated chemicals, with elevated liver enzymes. Only one of these studies, using a sample of gastric bypass surgery patients, examined sex-specific associations of POPs and liver enzymes, finding adverse associations among women only. The noticeable lack of studies investigating how differences (i.e., biochemical, physiological, and behavioral) between men and women may influence associations of pEDCs and NAFLD represents a large research gap in environmental health. Sexual dimorphism in metabolic processes throughout the body, including the liver, is established but often overlooked in the designs and analyses of studies. Other factors identified in this review that may also act to modulate associations of environmental chemicals and NAFLD are reproductive status and dietary nutrient intakes, which also remain understudied in the literature. Summary: Despite knowledge of sexual dimorphism in the actions of pEDCs, as well as in metabolic processes related to NAFLD development, few experimental or epidemiological studies have investigated sex-dependent associations. Future studies, especially those in humans, should be designed to address this research need. Consideration of other factors, such as reproductive status, dietary intakes, and mixtures of chemicals with varying endocrine-disrupting capabilities, should be explored.Personal Care and Household Cleaning Product Use among Pregnant Women and New Mothers during the COVID-19 Pandemic
AbstractDeierlein, A. L., Grayon, A. R., Zhu, X., Sun, Y., Liu, X., Kohlasch, K., & Stein, C. R. (n.d.).Publication year
2022Journal title
International journal of environmental research and public healthVolume
19Issue
9AbstractThis study examined product use among pregnant women and new mothers in New York City during the COVID-19 pandemic (July 2020–June 2021). Women reported use of personal care and household cleaning products within the previous month, changes in antibacterial product use, receipt of healthcare provider advice, and opinions on environmental chemicals (n = 320). On average, women used 15 personal care products and 7 household cleaning products. Non-Hispanic Black women used nearly two more personal care products; non-Hispanic Black women, those with a college degree, and essential workers used 1–3 more household cleaning products. Compared to non-Hispanic White women, those who were Hispanic or reported their race and ethnicity as Other were two times more likely to use antibacterial personal care products. Non-Hispanic Black, Hispanic, and women who reported their race and ethnicity as Other were 1.5 times more likely to increase antibacterial product use during the pandemic. Nearly all women agreed that environmental chemicals pose health risks and are impossible to avoid, while less than one quarter received advice regarding product use. Product use is a modifiable source of chemical exposures. Results from this study suggest that women may have increased their product use during the pandemic. Healthcare providers may use the current focus on health hygiene to promote discussion and assessment of environmental chemical exposures with patients.Phenol concentrations during childhood and subsequent measures of adiposity among young girls
AbstractDeierlein, A. L., Wolff, M. S., Pajak, A., Pinney, S. M., Windham, G. C., Galvez, M. P., Rybak, M., Calafat, A. M., Kushi, L. H., Biro, F. M., & Teitelbaum, S. L. (n.d.).Publication year
2017Journal title
American Journal of EpidemiologyVolume
186Issue
5Page(s)
581-592AbstractPhenolic compounds represent a class of environmental chemicals with potentially endocrine-disrupting capabilities. We investigated longitudinal associations between childhood exposure to phenols, from both manmade and natural sources, and subsequent measures of adiposity among girls enrolled in the Breast Cancer and the Environment Research Program between 2004 and 2007. Baseline (ages 6-8 years) urinary concentrations were obtained for creatinine and phenol metabolites: enterolactone, genistein, daidzein, benzophenone-3, bisphenol A, the sum of parabens (methyl, ethyl, and propyl parabens), 2,5-dichlorophenol, and triclosan. Body mass index (weight (kg)/height (m)2), waist circumference, and percent body fat were measured at annual or semiannual examinations through 2015 (n = 1,017). Linear mixed-effects regression was used to estimate how baseline concentrations of phenols (tertile groups) were related to changes in girls' adiposity measurements from ages 7 through 15 years. Enterolactone was inversely associated with body mass index, waist circumference, and percent body fat, while 2,5-dichlorophenol was positively associated with these measurements. A nonmonotonic association was observed for triclosan and girls' adiposity; however, it was due to effect modification by baseline overweight status. Triclosan was positively associated with adiposity only among overweight girls. These results suggest that exposure to specific phenols during childhood may influence adiposity through adolescence.Physical activity during pregnancy and risk of hyperglycemia
AbstractDeierlein, A. L., Siega-Riz, A. M., & Evenson, K. R. (n.d.).Publication year
2012Journal title
Journal of Women's HealthVolume
21Issue
7Page(s)
769-775AbstractObjective: To determine the association between moderate and vigorous physical activities (MVPA) during midpregnancy and the risk of hyperglycemia. Methods: Data were from 1437 pregnant women. Frequency, duration, and intensity of MVPA during the previous 7 days were collected via questionnaire at 17-22 weeks' gestation. Modes of MVPA included work, recreation, transportation, caregiving, and indoor and outdoor household activities. Hyperglycemia was defined as a glucose concentration ≥130 mg/dL on a 1-hour, 50-g glucose challenge test or gestational diabetes mellitus (GDM) assessed at ∼27 weeks' gestation. Multivariable Poisson regression estimated risks of hyperglycemia associated with total and mode-specific MVPA. Results: There were 269 women (18.7%) with hyperglycemia. Any metabolic equivalent (MET) hours/week of recreational MVPA was associated with a 27% lower risk of hyperglycemia (adjusted relative risk, [aRR] 0.73, 95% confidence interval [95%CI] 0.54-0.99). Multiplicative interaction terms were significant for prepregnancy body mass index (BMI) and recreational MVPA (p=0.01). Among women with prepregnancy BMIPostpartum Weight Retention, Chronic Disease, and Optimal Inter-Pregnancy Interval
AbstractGillman, M. W., Poston, L., & Deierlein, A. L. (n.d.).Publication year
2012Abstract~