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Lyndsay Avalos, PhD, MPH

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Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

(510) 891-3426 (phone)
Lyndsay.A.Avalos@kp.org
Kaiser Permanente Researcher Profiles


Lyndsay Ammon Avalos, PhD, MPH, is a Research Scientist II (equivalent to associate professor academic rank) at the Kaiser Permanente Northern California Division of Research. She holds a bachelor’s degree in animal physiology and neuroscience from UC San Diego, an MPH from Boston University, and a PhD in Epidemiology from UC Berkeley. She completed an NIAAA pre-doctoral fellowship at the Alcohol Research Group in Emeryville, Calif., and UC Berkeley’s School of Public Health. She was also a Building Interdisciplinary Research Careeers in Women's Health (BIRCWH) K12 scholar at DOR and UC San Francisco. Her research is primarily focused on informing and developing innovative interventions to improve the mental health and well-being of pregnant women, new moms and their children. Her research in maternal mental health and substance use includes studies addressing prevention, evaluating screening and treatment, testing interventions, and assessing maternal and child health outcomes. She also conducts pharmacoepidemiologic studies for conditions during pregnancy.

Current Position(s):

  • Research Scientist II, Division of Research, Kaiser Permanente Northern California

Section Affiliations:

Primary Research Interests:

  • Reproductive and perinatal epidemiology
  • Maternal mental health and substance use
  • Pharmacoepidemiology
  • In utero exposures in relation to adverse maternal, fetal, and infant health

    Racial/Ethnic Disparities in Perinatal Depression Treatment Utilization

    The study will characterize racial/ethnic differences in perinatal depression treatment utilization, treatment engagement, and continued care by assembling a retrospective cohort of KPNC members entering prenatal care between 2012-2016. The study will also identify barriers to and facilitators of treatment utilization and opportunities for improvement in care delivery.

    Investigator: Avalos, Lyndsay
    Funder: Northern California Community Benefit Programs

    Maternal Marijuana Use During Pregnancy, Marijuana Legalization, and Adverse Obstetrical and Neonatal Outcomes: A 12-year Cohort Study (COVID-19 Revision)

    As of March 26, 2020, there have been more than 80,000 cases and 1,000 deaths in the US due to COVID-19. Because it attacks the lungs, COVID-19 could be an especially serious threat to those who smoke or vape tobacco or cannabis. This study will use data from the Kaiser Permanente Northern California universal prenatal substance use screening program to examine whether women who use substances before or during pregnancy are at increased risk for COVID-19 onset and progression. We will also look at whether prenatal substance use rates rise during the pandemic overall or within certain subgroups, such as women with depression, anxiety, or low socioeconomic status.


    Investigator: Young-Wolff, Kelly; Avalos, Lyndsay
    Funder: National Institute on Drug Abuse

    Impact of In Utero Marijuana Exposure on Neurodevelopment, Behavior and Mental Health: A Longitudinal Birth Cohort Study

    This study will investigate whether maternal prenatal marijuana use increases the risk of impairments in a child's executive functioning and mental health, after accounting for other factors such as tobacco, alcohol, and other drug use; socioeconomic status, and maternal mental health postpartum. We will look at both the independent effects of prenatal marijuana use and the synergistic effects of concomitant substance use as well as differential effects by infant sex. 


    Investigator: Avalos, Lyndsay
    Funder: National Institute on Drug Abuse

    Does Centering Pregnancy impact patient satisfaction with prenatal care and maternal health and behavioral outcomes?

    This longitudinal study of 350 women seeking prenatal care in Kaiser Permanente Northern California will compare patient satisfaction with prenatal care, maternal health and behavioral outcomes between women in group prenatal care (Centering Pregnancy) and traditional prenatal care
    Investigator: Avalos, Lyndsay
    Funder: TPMG Delivery Science Projects Program

    Preventing Postpartum Depression: Exercise as Medicine

    This intervention study will randomize 200 postpartum women at increased risk of postpartum depression to an eHealth physical activity intervention and assess the efficacy of the intervention on increasing physical activity and decreasing postpartum depressive symptoms. Additionally, this study will identify actionable areas for implementation of this eHealth intervention in an integrated health care delivery system.
    Investigator: Avalos, Lyndsay; Badon, Sylvia
    Funder: KP-NBA Partnership

    Prenatal Depression and Antidepressant Exposure: Effects on Child Speech and Language Disorders

    The aims of this study are to 1) Assess the relationship between untreated prenatal depression and the risk of speech and language disorders of offspring; 2) Compare the effectiveness of treatment of prenatal depression on speech and language disorders of offspring; 3) Evaluate whether the timing and duration of SSRI use during pregnancy is related to child speech and language disorders; and 4) Assess the extent to which these relationships differ by infant sex.
    Investigator: Avalos, Lyndsay
    Funder: Northern California Community Benefit Programs

    Maternal Marijuana Use During Pregnancy, Marijuana Legalization, and Adverse Obstetrical and Neonatal Outcomes: A 12-year Cohort Study

    The goal of this application is to examine the association between maternal marijuana use during pregnancy and adverse obstetrical and neonatal outcomes. We aim to: 1) Examine trends in prenatal marijuana use following the legalization of marijuana for recreational purposes in California; 2) Assess whether maternal marijuana use during pregnancy is associated with the risk of adverse maternal health and pregnancy outcomes; and 3) Assess whether maternal marijuana use during pregnancy is associated with the risk of adverse fetal and neonatal outcomes.
    Investigator: Avalos, Lyndsay; Young-Wolff, Kelly
    Funder: National Institute on Drug Abuse

    Moderate Hypertension in Pregnancy: Safety and Effectiveness of Treatment

    The aims of this study are to: 1. Estimate risks of adverse pregnancy outcomes after antihypertensive medication exposure compared to a) untreated chronic or gestational hypertension, and b) healthy pregnancies with neither hypertension nor treatment. We will study: a) Maternal outcomes including cesarean delivery, postpartum hemorrhage, pre-eclampsia, and ICU admission; and b) Neonatal outcomes including preterm birth, small-for-gestational age, intensive care unit (NICU) stay, congenital malformations, and perinatal death. 2.Examine how risks vary for different antihypertensive agents. 3.Examine how risks vary according to the degree of blood pressure control achieved during treatment. 4. Examine how risks vary by obesity, GDM status and race/ethnicity.
    Investigator: Avalos, Lyndsay
    Funder: National Institute of Child Health and Human Development

    Impact of Folate, Obesity and Genetics on Maternal Depression

    Research is desperately needed to inform safe and effective interventions for the prevention and treatment of maternal depression. An important first step to understanding whether nutrition may serve as an intervention and improve maternal mental health, is to elucidate the relationship between nutrition and depression during the peripartum period (during pregnancy and after). The aims of this study will address a gap in knowledge and provide insights into the relationship between nutrition and maternal depression which will take us a few steps closer to identifying whether dietary modifications or supplements may provide an inexpensive, easily modifiable intervention for the prevention of peripartum depression.
    Investigator: Avalos, Lyndsay
    Funder: National Institute of Mental Health

    Climate Change and Health: Assessing the Risk of Preterm Delivery

    The overall objective of this study is to examine the impact of climate change on the risk of preterm delivery (PTD) by using a case-crossover study design utilizing members of KPNC. In our first aim, we will assess the relationship between apparent temperature and PTD. Estimates will be adjusted for important air pollutants. In our second aim we will determine whether maternal factors (age, race/ethnicity and SES as measured by medicaid status) impact the relationship between apparent temperature and preterm delivery. Finally, we will explore whether additional maternal factors may impact the the relationships in the first aim. These additional factors include hypertension, smoking, alcohol use, medication use, gestational diabetes, depression, and pre-pregnancy BMI.
    Investigator: Avalos, Lyndsay
    Funder: National Institute of Environmental Health Sciences

    Prenatal Depression and Diet Quality During Pregnancy

    Author(s): Avalos LA; Caan B; Nance N; Zhu Y; Li DK; Quesenberry C; Hyde RJ; Hedderson MM

    J Acad Nutr Diet. 2020 Feb 08.

    PubMed abstract

    Association of Depression, Anxiety, and Trauma With Cannabis Use During Pregnancy

    Author(s): Young-Wolff KC; Sarovar V; Tucker LY; Goler NC; Alexeeff SE; Ridout KK; Avalos LA

    JAMA Netw Open. 2020 Feb 05;3(2):e1921333. Epub 2020-02-05.

    PubMed abstract

    Trivalent inactivated influenza vaccine (IIV3) during pregnancy and six-month infant development

    Author(s): Avalos LA; Ferber J; Zerbo O; Odouli R; Li DK; et al.

    Vaccine. 2020 Feb 28;38(10):2326-2332. Epub 2020-02-05.

    PubMed abstract

    Preventing Perinatal Depression to Improve Maternal and Child Health-a Health Care Imperative

    Author(s): Avalos LA; Flanagan T; Li DK

    JAMA Pediatr. 2019 Feb 12.

    PubMed abstract

    Improved Perinatal Depression Screening, Treatment, and Outcomes With a Universal Obstetric Program

    Author(s): Avalos LA; Raine-Bennett T; Chen H; Adams AS; Flanagan T

    Obstet Gynecol. 2016 May;127(5):917-25.

    PubMed abstract

    Do multivitamin supplements modify the relationship between prenatal alcohol intake and miscarriage?

    Author(s): Ammon Avalos L; Kaskutas LA; Block G; Li DK

    Am J Obstet Gynecol. 2009 Dec;201(6):563.e1-9. Epub 2009 Oct 20.

    PubMed abstract

    Family Environment, Neurodevelopmental Risk, and the Environmental Influences on Child Health Outcomes (ECHO) Initiative: Looking Back and Moving Forward

    Author(s): Bush NR; Avalos LA; Posner J; et al.

    Front Psychiatry. 2020;11:547. Epub 2020-06-19.

    PubMed abstract

    Prenatal Depression and Diet Quality During Pregnancy

    Author(s): Avalos LA; Caan B; Nance N; Zhu Y; Li DK; Quesenberry C; Hyde RJ; Hedderson MM

    J Acad Nutr Diet. 2020 Feb 08.

    PubMed abstract

    Association of Depression, Anxiety, and Trauma With Cannabis Use During Pregnancy

    Author(s): Young-Wolff KC; Sarovar V; Tucker LY; Goler NC; Alexeeff SE; Ridout KK; Avalos LA

    JAMA Netw Open. 2020 Feb 05;3(2):e1921333. Epub 2020-02-05.

    PubMed abstract

    Trivalent inactivated influenza vaccine (IIV3) during pregnancy and six-month infant development

    Author(s): Avalos LA; Ferber J; Zerbo O; Odouli R; Li DK; et al.

    Vaccine. 2020 Feb 28;38(10):2326-2332. Epub 2020-02-05.

    PubMed abstract

    Identifying hypertension in pregnancy using electronic medical records: The importance of blood pressure values

    Author(s): Chen L; Avalos LA; Neugebauer R; Nance N; Badon SE; Dublin S; et al.

    Pregnancy Hypertens. 2020 Jan 03;19:112-118. Epub 2020-01-03.

    PubMed abstract

    Pre- and Early Pregnancy Onset Depression and Subsequent Rate of Gestational Weight Gain

    Author(s): Badon SE; Hedderson MM; Hyde RJ; Quesenberry CP; Avalos LA

    J Womens Health (Larchmt). 2019 May 07.

    PubMed abstract

    Preventing Perinatal Depression to Improve Maternal and Child Health-a Health Care Imperative

    Author(s): Avalos LA; Flanagan T; Li DK

    JAMA Pediatr. 2019 Feb 12.

    PubMed abstract

    Trends in marijuana use among pregnant women with and without nausea and vomiting in pregnancy, 2009-2016

    Author(s): Young-Wolff KC; Sarovar V; Tucker LY; Avalos LA; Alexeeff S; Conway A; Armstrong MA; Weisner C; Campbell CI; Goler N

    Drug Alcohol Depend. 2019 Mar 01;196:66-70. Epub 2019-01-18.

    PubMed abstract

    Association of Nausea and Vomiting in Pregnancy With Prenatal Marijuana Use

    Author(s): Young-Wolff KC; Sarovar V; Tucker LY; Avalos LA; Conway A; Armstrong MA; Goler N

    JAMA Intern Med. 2018 Aug 20.

    PubMed abstract

    Understanding periviable birth: A microeconomic alternative to the dysregulation narrative

    Author(s): Catalano R; Bruckner T; Avalos LA; Stewart H; Karasek D; Kariv S; Gemmill A; Saxton K; Casey J

    Soc Sci Med. 2017 Dec 12.

    PubMed abstract

    Intimate Partner Violence, Smoking, and Pregnancy: What Can We Do to Help?

    Author(s): Young-Wolff KC; McCaw B; Avalos LA

    J Womens Health (Larchmt). 2017 Sep 22.

    PubMed abstract

    Predictors of Breastfeeding Initiation and Maintenance in an Integrated Healthcare Setting

    Author(s): Henninger ML; Irving SA; Kauffman TL; Kurosky SK; Rompala K; Thompson MG; Sokolow LZ; Avalos LA; Ball SW; Shifflett P; Naleway AL; Pregnancy and Influenza Project Workgroup

    J Hum Lact. 2017 May;33(2):256-266. Epub 2017-03-23.

    PubMed abstract

    The impact of high apparent temperature on spontaneous preterm delivery: a case-crossover study

    Author(s): Avalos LA; Chen H; Li DK; Basu R

    Environ Health. 2017 Feb 01;16(1):5. Epub 2017-02-01.

    PubMed abstract

    The impact of maternal factors on the association between temperature and preterm delivery

    Author(s): Basu R; Chen H; Li DK; Avalos LA

    Environ Res. 2017 Jan 02;154:109-114. Epub 2017-01-02.

    PubMed abstract

    The Kaiser Permanente Northern California research program on genes, environment, and health (RPGEH) pregnancy cohort; study design, methodology and baseline characteristics.

    Author(s): Hedderson MM; Ferrara A; Avalos LA; Van den Eeden SK; Gunderson EP; Li DK; Altschuler A; Woo S; Rowell S; Choudhary V; Xu F; Flanagan T; Schaefer C; Croen LA;

    ​BMC Pregnancy Childbirth. 2016 Nov 29;16(1):381.

    PubMed abstract

    Improved Perinatal Depression Screening, Treatment, and Outcomes With a Universal Obstetric Program

    Author(s): Avalos LA; Raine-Bennett T; Chen H; Adams AS; Flanagan T

    Obstet Gynecol. 2016 May;127(5):917-25.

    PubMed abstract

    Formal and informal substance use treatment utilization and alcohol abstinence over seven years: Is the relationship different for blacks and whites?

    Author(s): Avalos LA; Mulia N

    Drug Alcohol Depend. 2012 Feb 1;121(1-2):73-80. Epub 2011 Sep 21.

    PubMed abstract

    Factors Associated with Seasonal Influenza Vaccination in Pregnant Women

    Author(s): Henninger ML; Irving SA; Thompson M; Avalos LA; Ball SW; Shifflett P; Naleway AL

    J Womens Health (Larchmt). 2015 Apr 15.

    PubMed abstract

    Antidepressant medication use, depression, and the risk of preeclampsia

    Author(s): Avalos LA; Chen H; Li DK

    CNS Spectr. 2015 Feb;20(1):39-47.

    PubMed abstract

    The Association Between Influenza Vaccination and Other Preventative Health Behaviors in a Cohort of Pregnant Women

    Author(s): Scheminske M; Henninger M; Irving SA; Thompson M; Williams J; Shifflett P; Ball SW; Avalos LA; Naleway AL; for The Pregnancy and Influenza Project Workgroup

    Health Educ Behav. 2014 Dec 12.

    PubMed abstract

    Genital herpes and its treatment in relation to preterm delivery

    Author(s): Li DK; Raebel MA; Cheetham TC; Hansen C; Avalos L; Chen H; Davis R

    Am J Epidemiol. 2014 Dec 1;180(11):1109-17. Epub 2014-11-12.

    PubMed abstract

    Feasibility and acceptability of a novel, computerized screening and brief intervention (SBI) for alcohol and sweetened beverage use in pregnancy

    Author(s): Nayak MB; Korcha RA; Kaskustas LA; Avalos LA

    BMC Pregnancy Childbirth. 2014;14:379. Epub 2014-11-25.

    PubMed abstract

    Trends in Elective Labor Induction for Six United States Health Plans, 2001-2007

    Author(s): Dublin S; Johnson KE; Walker RL; Avalos LA; Andrade SE; Beaton SJ; Davis RL; Herrinton LJ; Pawloski PA; Raebel MA; Smith DH; Toh S; Caughey AB

    J Womens Health (Larchmt). 2014 Nov;23(11):904-11. Epub 2014-10-20.

    PubMed abstract

    Volume and Type of Alcohol During Early Pregnancy and the Risk of Miscarriage

    Author(s): Avalos LA; Roberts SC; Kaskutas LA; Block G; Li DK

    Subst Use Misuse. 2014 Sep;49(11):1437-45. Epub 2014-05-08.

    PubMed abstract

    The Prevalence and Trends of Antiviral Medication Use During Pregnancy in the US: A Population-Based Study of 664,297 Deliveries in 2001-2007

    Author(s): Avalos LA; Chen H; Yang C; Andrade SE; Cooper WO; Cheetham CT; Davis RL; Dublin S; Hammad TA; Kaplan S; Pawloski PA; Raebel MA; Scott PE; Smith DH; Toh S; Li DK

    Matern Child Health J. 2014 Jan;18(1):64-72.

    PubMed abstract

    Effectiveness of seasonal trivalent influenza vaccine for preventing influenza virus illness among pregnant women: a population-based case-control study during the 2010-2011 and 2011-2012 influenza seasons

    Author(s): Thompson MG; Li DK; Shifflett P; Sokolow LZ; Ferber JR; Kurosky S; Bozeman S; Reynolds SB; Odouli R; Henninger ML; Kauffman TL; Avalos LA; Ball S; Williams JL; Irving SA; Shay DK; Naleway AL; Pregnancy and Influenza Project Workgroup

    Clin Infect Dis. 2014 Feb;58(4):449-57. Epub 2013-11-26.

    PubMed abstract

    Prevalence and trends in the use of antipsychotic medications during pregnancy in the U.S., 2001-2007: a population-based study of 585,615 deliveries

    Author(s): Toh S; Li Q; Cheetham TC; Cooper WO; Davis RL; Dublin S; Hammad TA; Li DK; Pawloski PA; Pinheiro SP; Raebel MA; Scott PE; Smith DH; Bobo WV; Lawrence JM; Dashevsky I; Haffenreffer K; Avalos LA; Andrade SE

    Arch Womens Ment Health. 2013 Apr;16(2):149-57. Epub 2013 Feb 7.

    PubMed abstract

    Prevalence, Trends, and Patterns of Use of Antidiabetic Medications Among Pregnant Women, 2001-2007

    Author(s): Lawrence JM; Andrade SE; Avalos LA; Beaton SJ; Chiu VY; Davis RL; Dublin S; Pawloski PA; Raebel MA; Smith DH; Toh S; Wang JQ; Kaplan S; Amini T; Hampp C; Hammad TA; Scott PE; Cheetham TC; Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP) Study Group

    Obstet Gynecol. 2013 Jan;121(1):106-14.

    PubMed abstract

    Trends in the Use of Antiepileptic Drugs among Pregnant Women in the US, 2001-2007: A Medication Exposure in Pregnancy Risk Evaluation Program Study

    Author(s): Bobo WV; Davis RL; Toh S; Li DK; Andrade SE; Cheetham TC; Pawloski P; Dublin S; Pinheiro S; Hammad T; Scott PE; Epstein RA Jr; Arbogast PG; Morrow JA; Dudley JA; Lawrence JM; Avalos LA; Cooper WO

    Paediatr Perinat Epidemiol. 2012 Nov;26(6):578-88.

    PubMed abstract

    Alcohol, tobacco and drug use as reasons for abortion

    Author(s): Roberts SC; Avalos LA; Sinkford D; Foster DG

    Alcohol Alcohol. 2012 Nov-Dec;47(6):640-8. Epub 2012 Aug 22.

    PubMed abstract

    A systematic review to calculate background miscarriage rates using life table analysis

    Author(s): Ammon Avalos L; Galindo C; Li DK

    Birth Defects Res A Clin Mol Teratol. 2012 Jun;94(6):417-23. Epub 2012 Apr 18.

    PubMed abstract

    Does Lack of Multinutrient Supplementation During Early Pregnancy Increase Vulnerability to Alcohol-Related Preterm or Small-for-Gestational-Age Births?

    Author(s): Avalos LA; Kaskutas L; Block G; Abrams B; Li DK

    Matern Child Health J. 2011 Nov;15(8):1324-32.

    PubMed abstract

    Stress, substance use and sexual risk behaviors among primary care patients in Cape Town, South Africa

    Author(s): Avalos LA; Mertens JR; Ward CL; Flisher AJ; Bresick GF; Weisner CM

    AIDS Behav. 2010 Apr;14(2):359-70. Epub 2009 Feb 10.

    PubMed abstract

    Do multivitamin supplements modify the relationship between prenatal alcohol intake and miscarriage?

    Author(s): Ammon Avalos L; Kaskutas LA; Block G; Li DK

    Am J Obstet Gynecol. 2009 Dec;201(6):563.e1-9. Epub 2009 Oct 20.

    PubMed abstract