Children who are deprived socioeconomically are more susceptible than others to an array of health problems, whether it’s asthma or cardiovascular risk or behavioral function. But these differences don’t start the day children are born.
A new study that includes David Savitz, Ph.D., and other investigators from the Hassenfeld Child Health Innovation Institute will examine what’s happening during pregnancy to see whether experiences at this crucial time can affect health outcomes for these children.
The study is a collaboration with the National Institute of Child Health and Human Development (NICHD) and RTI International, which awarded Brown and Women & Infants Hospital (WIH) a contract worth nearly $7 million in October to investigate the developmental origins of child health disparities. The project will focus on mental health issues during pregnancy, ranging from depression to other stressors, to better understand mental health-related disparities that are present at birth and beyond. The goal is to identify interventions that might help women during pregnancy, thereby improving outcomes for their children.
Savitz will lead the study, alongside Melissa Clark, Ph.D., and Erika Werner, M.D., M.S. Savitz, who was just announced as the interim dean of Brown’s School of Public Health, is chair of the Department of Epidemiology, a professor of epidemiology within the School of Public Health and a professor of obstetrics and gynecology and pediatrics at the Warren Alpert Medical School of Brown. He has extensive research experience in a wide range of public health issues and reproductive health outcomes.
Dr. Werner is the director of the Division of Maternal-Fetal Medicine at WIH and a member of the executive committee of the Hassenfeld Institute. She has appointments in both Brown’s School of Public Health and the Alpert Medical School. Dr. Clark is associate dean for academic affairs and the director of the Survey Research Center at Brown’s School of Public Health.
The NICHD study will build on the Hassenfeld Study, a birth cohort study that enrolls women in the early stages of pregnancy or at the time of birth to understand crucial information about the health of mothers and children in Rhode Island. The Hassenfeld Study is led by Dr. Werner, Dr. Clark, and Crystal Ware, RN, BSN, CCRP, a research nurse who leads the study staff.
“There’s an incredibly capable staff that is engaged and familiar with these participants,” Savitz said.
The Hassenfeld Study is the perfect starting point for examining health disparities, Savitz said, because participants come from a wide range of socioeconomic backgrounds in the local community. Plus, the follow-up rate among participants is 90 percent, which is considered excellent retention.
“It’s an art to have such a challenging study that is fully community based. We are engaging a full range of participants from the area,” Savitz said.
While similar studies exist, the NICHD study’s state-of-the-art assessment of how social and psychological factors play out biologically will make it distinctive, Savitz said.
“This study is trying to take a very sophisticated approach to including all these elements and putting the whole story together. That has not been done,” Savitz said.
Ultimately, Savitz and his colleagues hope to identify determinants of these disparities that can be changed through interventions, such as health services or other programs that could be implemented during pregnancy. For example, they are examining the potential benefits of mindfulness training during pregnancy to address a range of issues, including mental health and high blood pressure.
Savitz said researchers must “think creatively and broadly about the determinants of health to make improvements.”
The Brown/WIH research team hope to enroll 2,000 women and their infants as well as 1,340 co-parents into the study, which is slated to start this fall and continue through the end of 2024.
“What’s distinctive about Rhode Island is we have the ability to study a diverse community, with rigorous research protocols,” Savitz said.
If you’re an expectant mom who wants to learn more about the Hassenfeld Study, visit us at www.brown.edu/hassenfeld/what-we-do/hassenfeld-study. If you’re a researcher who would like to work with us, find out more at www.brown.edu/hassenfeld/for-researchers.