Embedded in the Kaiser Permanente Northern California health plan, DOR investigators conduct studies that can rapidly translate results into changes in clinical practice to improve women’s health and health care. DOR investigators utilize high-quality pregnancy and diabetes patient registries, historical electronic health data, and real-time electronic health records to conduct high-quality, high-impact research.
Gestational Diabetes and Gestational Weight Gain
Gestational diabetes is a major topic of study, examining factors that influence risk of development the metabolic disorder of pregnancy and identifying potential methods to help patients maintain glycemic control.
This work is assisted by a robust registry of patients with gestational diabetes. Studies have examined prevalence of the disorder in the population; cardiometabolic markers and weight trajectory that can predict it; interventions that can influence lifestyle-related factors to prevent or control gestational diabetes; and racial and ethnic disparities in glycemic control.
The UPSTREAM Center, based at DOR, is focused on prevention of adiposity and diabetes by identifying risk factors and conducting interventions early in life, particularly through collaboration with clinicians.
We are also evaluating innovations in wellness coaching to determine its impact on weight outcomes in pregnancy among those with overweight or obesity.
Pregnancy in the Pandemic
Members of the women’s and children’s health section collaborated on carrying out a survey of pregnant patients during the COVID-19 pandemic, and have been harvesting the results for important insights about how pregnant people managed their health and other aspects of pregnancy during that time. Results have shown, for instance, that patients experienced more severe mental health symptoms when they were distressed about changes in prenatal care, childcare challenges, and food insecurity brought about by the pandemic.
Ongoing work from the survey examines the impact of pregnancy during the pandemic on perinatal outcomes as well as long-term maternal and child health outcomes.
Mental and Behavioral Health in Pregnancy
DOR investigators explore various aspects of mental health in pregnancy with a particular focus on prenatal depression, its treatment, and the developmental outcomes of children whose mothers have depression during pregnancy, whether treated or not. Other work is exploring racial and ethnic disparities in treatment of depression during and after pregnancy, as well as technology interventions to assist patients through techniques such as mindfulness and physical activity.
Other work focuses on women who have had adverse childhood experiences and also experience depression, to reduce perinatal depression symptoms.
Using unique access to information about pregnant patient substance use, researchers are also learning about cannabis use in pregnancy, both usage trends and potential health impacts on mothers and babies.
Women’s Health Throughout Life
Section investigators address women’s health issues throughout the life course, including reproductive health, benign gynecological conditions (such as uterine fibroids), and the menopause transition. The Autism Research Program is studying barriers to reproductive health care for women with autism spectrum disorder.