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Mary Anne Armstrong, MA

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Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

(510) 891-3501 (phone)
maryanne.armstrong@kp.org
Kaiser Permanente Researcher Profiles


Mary Anne Armstrong, MA, is a biostatistician and research scientist at the Kaiser Permanente Northern California Division of Research, as well as managing director of special projects. Ms. Armstrong earned her master’s degree in statistics from the University of California, Berkeley. She has been with the Division of Research since 1980, where she has worked in a wide variety of research areas, including alcohol and health, perinatal substance abuse, and neonatology.
 
Ms. Armstrong is the chair of the Division of Research Local Research Committee, a member of the Northern California Central Research Committee. She is director of the Division of Research Biostatistical Consulting Unit, and provides statistical consultation to members of The Permanente Medical Group in Northern California. Ms. Armstrong has authored or co-authored more than 85 peer-reviewed scientific publications on a wide-variety of topics, including the relation of alcohol use to blood pressure, coronary disease, and stroke; utilization of health services before and after alcohol abuse treatment; neonatal assisted ventilation; and women's health.

Current Position(s):

  • Biostatistician and Managing Director of Special Projects, Kaiser Permanente Division of Research
  • Director, Division of Research Biostatistical Consulting Unit
  • Vice Chair, KPNC Central Research Committee
  • Local Research Chair, Kaiser Permanente Division of Research

Section Affiliations:

Primary Research Interests:

  • Biostatistics
  • Substance abuse and pregnancy
  • Fetal Alcohol Syndrome
  • Women’s health
  • Perinatal health services research

    Study on the Association of Uterine Perforation and IUD expulsion With Breastfeeding Status at the Time of IUD insertion and Postpartum Timing of IUD Insertion in Electronic Medical Record Databases - A Post-marketing Requirement for Mirena

    The Food and Drug Administration (FDA) has required Bayer AG to conduct a post-marketing study in the U.S. to determine the incidence of uterine perforation and IUD expulsion by type of intrauterine device (IUD) used. The goal of this study is to quantify the risk of uterine perforation and IUD expulsion by: (1) breastfeeding status at the time of IUD insertion, (2) time periods postpartum when the IUD was inserted (e.g., 6 weeks or less, after 6 weeks and up to 14 weeks, more than 14 weeks and up to 52 weeks, or more than 52 weeks), and (3) type of IUD.
    Investigator: Armstrong, Mary Anne
    Funder: Bayer AG

    Risk of Uterine Perforation among Women Using different types of IUDs and the Association with Timing of Insertion and Breastfeeding

    The goal of the study is to compare the incidence of uterine perforation within 12 months after IUD insertion between: (1) postpartum insertions within 12 months of delivery (with breastfeeding status), (2) post abortion or pregnancy loss IUD insertions and (3) interval IUD insertions not associated with a pregnancy, and to determine if IUD insertion immediately postpartum and/or breastfeeding are associated with an increased risk of perforation.
    Investigator: Armstrong, Mary Anne
    Funder: Bayer AG

    Are Health Plan Design and Prior Use of Long-Acting Reversible Contraception Associated with Pregnancy Intention?

    Author(s): Armstrong MA; Postlethwaite DA; Darbinian JA; McCoy M; Law A;

    ​J Womens Health (Larchmt). 2017 May;26(5):450-460. doi: 10.1089/jwh.2014.5146. Epub 2016 Oct 18.

    PubMed abstract

    Using drink size to talk about drinking during pregnancy: a randomized clinical trial of Early Start Plus

    Author(s): Armstrong MA; Kaskutas LA; Witbrodt J; Taillac CJ; Hung YY; Osejo VM; Escobar GJ

    Soc Work Health Care. 2009 Jan;48(1):90-103.

    PubMed abstract

    Perinatal substance abuse intervention in obstetric clinics decreases adverse neonatal outcomes

    Author(s): Armstrong MA; Gonzales Osejo V; Lieberman L; Carpenter DM; Pantoja PM; Escobar GJ

    J Perinatol. 2003 Jan;23(1):3-9.

    PubMed abstract

    Early Start: an obstetric clinic-based, perinatal substance abuse intervention program

    Author(s): Armstrong MA; Lieberman L; Carpenter DM; Gonzales VM; Usatin MS; Newman L; Escobar GJ

    Qual Manag Health Care. 2001 Winter;9(2):6-15.

    PubMed abstract

    Bone loss in women with BRCA1 and BRCA2 mutations

    Author(s): Powell CB; Alabaster A; Stoller N; Armstrong MA; Salyer C; Hamilton I; Raine-Bennett T

    Gynecol Oncol. 2018 Mar;148(3):535-539.

    PubMed abstract

    Trends in Self-reported and Biochemically Tested Marijuana Use Among Pregnant Females in California From 2009-2016

    Author(s): Young-Wolff KC; Tucker LY; Alexeeff S; Armstrong MA; Conway A; Weisner C; Goler N

    JAMA. 2017 12 26;318(24):2490-2491.

    PubMed abstract

    Rates and Predictors of Vaccinations Among Inflammatory Bowel Disease Patients Receiving Anti-Tumor Necrosis Factor Agents

    Author(s): Pham HV; Hasan I; Udaltsova N; Pham K; Abramson O; Armstrong MA; Postlethwaite D; Li D

    Dig Dis Sci. 2017 Aug 23.

    PubMed abstract

    Diagnosis of sessile serrated adenoma after educational training in a large, community-based, integrated healthcare setting

    Author(s): Li D; Woolfrey J; Jiang SF; Jensen CD; Zhao WK; Kakar S; Santamaria M; Rumore G; Armstrong MA; Postlethwaite D; Corley DA; Levin TR

    Gastrointest Endosc. 2017 Aug 23.

    PubMed abstract

    Are Health Plan Design and Prior Use of Long-Acting Reversible Contraception Associated with Pregnancy Intention?

    Author(s): Armstrong MA; Postlethwaite DA; Darbinian JA; McCoy M; Law A;

    ​J Womens Health (Larchmt). 2017 May;26(5):450-460. doi: 10.1089/jwh.2014.5146. Epub 2016 Oct 18.

    PubMed abstract

    Risk of cancer in Asian Americans: a Kaiser Permanente cohort study

    Author(s): Tran HN; Li Y; Udaltsova N; Armstrong MA; Friedman GD; Klatsky AL

    Cancer Causes Control. 2016 Aug 25.

    PubMed abstract

    Experience With Opportunistic Salpingectomy in a Large, Community-Based Health System in the United States

    Author(s): Garcia C; Martin M; Tucker LY; Lyon L; Armstrong MA; McBride-Allen S; Littell RD; Alabaster A; Raine-Bennett T; Powell CB

    Obstet Gynecol. 2016 Aug;128(2):277-83.

    PubMed abstract

    Risks and Predictors of Gastric Adenocarcinoma in Patients with Gastric Intestinal Metaplasia and Dysplasia: A Population-Based Study

    Author(s): Li D; Bautista MC; Jiang SF; Daryani P; Brackett M; Armstrong MA; Hung YY; Postlethwaite D; Ladabaum U

    Am J Gastroenterol. 2016 May 17.

    PubMed abstract

    Significant Racial Disparities Exist in Noncardia Gastric Cancer Outcomes Among Kaiser Permanente's Patient Population

    Author(s): Bautista MC; Jiang SF; Armstrong MA; Kakar S; Postlethwaite D; Li D

    Dig Dis Sci. 2015 Apr;60(4):984-95. Epub 2014-10-30.

    PubMed abstract

    Alcohol Intake, Beverage Choice, and Cancer: A Cohort Study in a Large Kaiser Permanente Population

    Author(s): Klatsky AL; Li Y; Nicole Tran H; Baer D; Udaltsova N; Armstrong MA; Friedman GD

    Perm J. 2015 Spring;19(2):28-34. Epub 2015-03-01.

    PubMed abstract

    Does adopting a prenatal substance use protocol reduce racial disparities in CPS reporting related to maternal drug use? A California case study

    Author(s): Roberts SC; Zahnd E; Sufrin C; Armstrong MA

    J Perinatol. 2015 Feb;35(2):146-50. Epub 2014-09-18.

    PubMed abstract

    Impact of age on clinicopathological features and survival of patients with noncardia gastric adenocarcinoma

    Author(s): Bautista MC; Jiang SF; Armstrong MA; Postlethwaite D; Li D

    J Gastric Cancer. 2014 Dec;14(4):238-45. Epub 2014-12-26.

    PubMed abstract

    Risk management options elected by women after testing positive for a BRCA mutation

    Author(s): Garcia C; Wendt J; Lyon L; Jones J; Littell RD; Armstrong MA; Raine-Bennett T; Powell CB

    Gynecol Oncol. 2014 Feb;132(2):428-33. Epub 2013-12-16.

    PubMed abstract

    Prevalence and Neonatal Factors Associated with Autism Spectrum Disorders in Preterm Infants

    Author(s): Kuzniewicz MW; Wi S; Qian Y; Walsh EM; Armstrong MA; Croen LA

    J Pediatr. 2014 Jan;164(1):20-5. Epub 2013-10-22.

    PubMed abstract

    Risk of Coronary Disease in South Asian Americans

    Author(s): Hajra A; Li Y; Siu S; Udaltsova N; Armstrong MA; Friedman GD; Klatsky AL

    J Am Coll Cardiol. 2013 Aug 13;62(7):644-5. Epub 2013 Jun 13.

    PubMed abstract

    Neisseria gonorrhea and Chlamydia trachomatis Screening at Intrauterine Device Insertion and Pelvic Inflammatory Disease

    Author(s): Sufrin CB; Postlethwaite D; Armstrong MA; Merchant M; Wendt JM; Steinauer JE

    Obstet Gynecol. 2012 Dec;120(6):1314-21.

    PubMed abstract

    The value of additional pathology comments indicating suspicion of adenocarcinoma among women diagnosed preoperatively with complex atypical endometrial hyperplasia

    Author(s): Suh-Burgmann E; Hung YY; Armstrong MA

    Int J Gynecol Pathol. 2012 May;31(3):222-6.

    PubMed abstract

    Provision of Contraceptive Services to Women with Diabetes Mellitus

    Author(s): Schwarz EB; Postlethwaite D; Hung YY; Lantzman E; Armstrong MA; Horberg MA

    J Gen Intern Med. 2012 Feb;27(2):196-201. Epub 2011 Sep 16.

    PubMed abstract

    Early start: a cost-beneficial perinatal substance abuse program

    Author(s): Goler NC; Armstrong MA; Osejo VM; Hung YY; Haimowitz M; Caughey AB

    Obstet Gynecol. 2012 Jan;119(1):102-10.

    PubMed abstract

    Postacute care and ischemic stroke mortality: findings from an integrated health care system in northern california

    Author(s): Wang H; Sandel ME; Terdiman J; Armstrong MA; Klatsky A; Camicia M; Sidney S

    PM R. 2011 Aug;3(8):686-94.

    PubMed abstract

    Coffee, caffeine, and risk of hospitalization for arrhythmias

    Author(s): Klatsky AL; Hasan AS; Armstrong MA; Udaltsova N; Morton C

    Perm J. 2011 Summer;15(3):19-25.

    PubMed abstract

    Pregnancy outcomes by pregnancy intention in a managed care setting

    Author(s): Postlethwaite D; Armstrong MA; Hung YY; Shaber R

    Matern Child Health J. 2010 Mar;14(2):227-34. Epub 2009 Jan 19.

    PubMed abstract

    Complex atypical endometrial hyperplasia: the risk of unrecognized adenocarcinoma and value of preoperative dilation and curettage

    Author(s): Suh-Burgmann E; Hung YY; Armstrong MA

    Obstet Gynecol. 2009 Sep;114(3):523-9.

    PubMed abstract

    Using drink size to talk about drinking during pregnancy: a randomized clinical trial of Early Start Plus

    Author(s): Armstrong MA; Kaskutas LA; Witbrodt J; Taillac CJ; Hung YY; Osejo VM; Escobar GJ

    Soc Work Health Care. 2009 Jan;48(1):90-103.

    PubMed abstract

    Substance abuse treatment linked with prenatal visits improves perinatal outcomes: a new standard

    Author(s): Goler NC; Armstrong MA; Taillac CJ; Osejo VM

    J Perinatol. 2008 Sep;28(9):597-603. Epub 2008 Jun 26.

    PubMed abstract

    Documentation of contraception and pregnancy when prescribing potentially teratogenic medications for reproductive-age women

    Author(s): Schwarz EB; Postlethwaite DA; Hung YY; Armstrong MA

    Ann Intern Med. 2007 Sep 18;147(6):370-6.

    PubMed abstract

    Predictors of hysterectomy after uterine artery embolization for leiomyoma

    Author(s): Gabriel-Cox K; Jacobson GF; Armstrong MA; Hung YY; Learman LA

    Am J Obstet Gynecol. 2007 Jun;196(6):588.e1-6.

    PubMed abstract

    Changes in rates of hysterectomy and uterine conserving procedures for treatment of uterine leiomyoma

    Author(s): Jacobson GF; Shaber RE; Armstrong MA; Hung YY

    Am J Obstet Gynecol. 2007 Jun;196(6):601.e1-5; discussion 601.e5-6.

    PubMed abstract

    Early start: an integrated model of substance abuse intervention for pregnant women

    Author(s): Taillac C; Goler N; Armstrong MA; Haley K; Osejo V

    Perm J. 2007 Summer;11(3):5-11.

    PubMed abstract

    Intrauterine contraception: evaluation of clinician practice patterns in Kaiser Permanente Northern California

    Author(s): Postlethwaite D; Shaber R; Mancuso V; Flores J; Armstrong MA

    Contraception. 2007 Mar;75(3):177-84. Epub 2007 Jan 16.

    PubMed abstract

    Using drink size to talk about drinking during pregnancy: Early start plus

    Author(s): Witbrodt J; Armstrong MA; Diehl S; Kaskutas LA; Taillac C; Osejo VM; Escobar GJ

    J Addict Nurs. 2007;18(4):199-206.

    PubMed abstract

    Unstudied infants: outcomes of moderately premature infants in the neonatal intensive care unit

    Author(s): Escobar GJ; McCormick MC; Zupancic JA; Coleman-Phox K; Armstrong MA; Greene JD; Eichenwald EC; Richardson DK

    Arch Dis Child Fetal Neonatal Ed. 2006 Jul;91(4):F238-44. Epub 2006 Apr 12.

    PubMed abstract

    Hysterectomy rates for benign indications

    Author(s): Jacobson GF; Shaber RE; Armstrong MA; Hung YY

    Obstet Gynecol. 2006 Jun;107(6):1278-83.

    PubMed abstract

    Risk of hemorrhagic stroke in Asian American ethnic groups

    Author(s): Klatsky AL; Friedman GD; Sidney S; Kipp H; Kubo A; Armstrong MA

    Neuroepidemiology. 2005;25(1):26-31. Epub 2005 Apr 25.

    PubMed abstract

    Rehospitalisation after birth hospitalisation: patterns among infants of all gestations

    Author(s): Escobar GJ; Greene JD; Hulac P; Kincannon E; Bischoff K; Gardner MN; Armstrong MA; France EK

    Arch Dis Child. 2005 Feb;90(2):125-31.

    PubMed abstract

    Alcohol and in-patient utilization: what is the shape of the relationship?

    Author(s): Armstrong MA

    Addiction. 2005 Jan;100(1):30; author reply 30-2.

    PubMed abstract

    Using chart reviews to assess postpartum substance abuse. A pilot study

    Author(s): Midanik LT; Armstrong MA; Lieberman L; Osejo VG

    Soc Work Health Care. 2004;38(4):25-35.

    PubMed abstract

    Wine, liquor, beer, and mortality

    Author(s): Klatsky AL; Friedman GD; Armstrong MA; Kipp H

    Am J Epidemiol. 2003 Sep 15;158(6):585-95.

    PubMed abstract

    The early repolarization normal variant electrocardiogram: correlates and consequences

    Author(s): Klatsky AL; Oehm R; Cooper RA; Udaltsova N; Armstrong MA

    Am J Med. 2003 Aug 15;115(3):171-7.

    PubMed abstract

    Traits of persons who drink decaffeinated coffee

    Author(s): Kubo Shlonsky A; Klatsky AL; Armstrong MA

    Ann Epidemiol. 2003 Apr;13(4):273-9.

    PubMed abstract

    Perinatal substance abuse intervention in obstetric clinics decreases adverse neonatal outcomes

    Author(s): Armstrong MA; Gonzales Osejo V; Lieberman L; Carpenter DM; Pantoja PM; Escobar GJ

    J Perinatol. 2003 Jan;23(1):3-9.

    PubMed abstract

    The effect of coronary disease on changes in drinking in an older population

    Author(s): Klatsky AL; Armstrong MA; Landy C; Udaltsova N

    Alcohol Res. 2003;8:211-13.

    PubMed abstract

    Alcohol drinking and risk of hemorrhagic stroke

    Author(s): Klatsky AL; Armstrong MA; Friedman GD; Sidney S

    Neuroepidemiology. 2002 May-Jun;21(3):115-22.

    PubMed abstract

    Rehospitalization for neonatal dehydration: a nested case-control study

    Author(s): Escobar GJ; Gonzales VM; Armstrong MA; Folck BF; Xiong B; Newman TB

    Arch Pediatr Adolesc Med. 2002 Feb;156(2):155-61.

    PubMed abstract

    Utilization of health services among patients referred to an alcohol treatment program

    Author(s): Armstrong MA; Midanik LT; Klatsky AL; Lazere A

    Subst Use Misuse. 2001 Dec;36(13):1781-93.

    PubMed abstract

    Early Start: an obstetric clinic-based, perinatal substance abuse intervention program

    Author(s): Armstrong MA; Lieberman L; Carpenter DM; Gonzales VM; Usatin MS; Newman L; Escobar GJ

    Qual Manag Health Care. 2001 Winter;9(2):6-15.

    PubMed abstract

    Alcohol drinking and risk of hospitalization for ischemic stroke

    Author(s): Klatsky AL; Armstrong MA; Friedman GD; Sidney S

    Am J Cardiol. 2001 Sep 15;88(6):703-6.

    PubMed abstract

    Sex-based differences in causes of hospitalization for coronary heart disease

    Author(s): Klatsky A; Armstrong MA

    Perm J. 2000 Fall;4(4):15-20.

    PubMed abstract

    Neonatal sepsis workups in infants /=2000 grams at birth: A population-based study

    Author(s): Escobar GJ; Li DK; Armstrong MA; Gardner MN; Folck BF; Verdi JE; Xiong B; Bergen R

    Pediatrics. 2000 Aug;106(2 Pt 1):256-63.

    PubMed abstract

    Risk of pulmonary embolism and/or deep venous thrombosis in Asian-Americans

    Author(s): Klatsky AL; Armstrong MA; Poggi J

    Am J Cardiol. 2000 Jun 1;85(11):1334-7.

    PubMed abstract

    Neonatal assisted ventilation: predictors, frequency, and duration in a mature managed care organization

    Author(s): Wilson A; Gardner MN; Armstrong MA; Folck BF; Escobar GJ

    Pediatrics. 2000 Apr;105(4 Pt 1):822-30.

    PubMed abstract

    Frequency of neonatal bilirubin testing and hyperbilirubinemia in a large health maintenance organization

    Author(s): Newman TB; Escobar GJ; Gonzales VM; Armstrong MA; Gardner MN; Folck BF

    Pediatrics. 1999 Nov;104(5 Pt 2):1198-203.

    PubMed abstract

    Rehospitalization for respiratory syncytial virus among premature infants

    Author(s): Joffe S; Escobar GJ; Black SB; Armstrong MA; Lieu TA

    Pediatrics. 1999 Oct;104(4 Pt 1):894-9.

    PubMed abstract

    Rehospitalization in the first two weeks after discharge from the neonatal intensive care unit

    Author(s): Escobar GJ; Joffe S; Gardner MN; Armstrong MA; Folck BF; Carpenter DM

    Pediatrics. 1999 Jul;104(1):e2.

    PubMed abstract

    Alcohol consumption and utilization of health services in a health maintenance organization

    Author(s): Armstrong MA; Midanik LT; Klatsky AL

    Med Care. 1998 Nov;36(11):1599-605.

    PubMed abstract

    Structured review of neonatal deaths in a managed care organisation

    Author(s): Escobar GJ; Yanover M; Gardner MN; Golembeski D; Armstrong MA; Shum F; Kipnis P

    Paediatr Perinat Epidemiol. 1998 Oct;12(4):422-36.

    PubMed abstract

    Developmentally supportive care in a neonatal intensive care unit: a research utilization project

    Author(s): Gray K; Dostal S; Ternullo-Retta C; Armstrong MA

    Neonatal Netw. 1998 Mar;17(2):33-8.

    PubMed abstract

    Monitoring women at risk for preterm labor

    Author(s): Dyson DC; Danbe KH; Bamber JA; Crites YM; Field DR; Maier JA; Newman LA; Ray DA; Walton DL; Armstrong MA

    N Engl J Med. 1998 Jan 1;338(1):15-9.

    PubMed abstract

    Cataract extraction. Risk factors in a health maintenance organization population under 60 years of age

    Author(s): Schwab IR; Armstrong MA; Friedman GD; Wong IG; Carpentieri AC; Dawson CR

    Arch Ophthalmol. 1988 Aug;106(8):1062-5.

    PubMed abstract

    Precursors of essential hypertension: body weight, alcohol and salt use, and parental history of hypertension

    Author(s): Friedman GD; Selby JV; Quesenberry CP Jr; Armstrong MA; Klatsky AL

    Prev Med. 1988 Jul;17(4):387-402.

    PubMed abstract