Lyndsay A. Avalos, PhD, MPH

People

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 III 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 III, 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

Studies

The Impact of Racial Residential Segregation on the Mental Health of Pregnant Women

We will create a large diverse cohort of more than 360,000 pregnant Black, Hispanic, Asian and white women to: examine the relationship between racial residential segregation and prenatal depression, anxiety and trauma (Aim 1); and prenatal depressive severity (Aim 2). Analyses will be stratified by race/ethnicity. This study has important public health, clinical and policy implications for addressing racial/ethnic mental health inequities in a vulnerable population, pregnant women.
Investigator: Avalos, Lyndsay
Funder: Northern California Community Benefit Programs

Treatment Initiation for New Episodes of Depression in Pregnant Women

This study will use rigorous methods and rich health care data from a diverse, multi-site study population to study psychotherapy and antidepressant treatments for new episodes of depression during pregnancy. Analyses will include examination of infant outcomes and breastfeeding.
Investigator: Avalos, Lyndsay
Funder: National Institute of Child Health and Human Development

mHealth Mindfulness Intervention for Pregnant Black and Latina Women at Risk of Postpartum Depression

This randomized controlled trial of an mHealth mindfulness intervention designed for Black and Latinx pregnant women at risk of developing postpartum depression will compare outcomes (depression, stress, sleep) of participants in the intervention with those in the control arm.
Investigator: Avalos, Lyndsay; Kubo, Ai
Funder: National Institute of Mental Health

Comparing the Effects of Prenatal Depression and its Treatment on Developmental Outcomes of the Offspring

This study will test the hypothesis that the underlying prenatal depression and use of SSRIs are independent risk factors for adverse neurodevelopmental outcomes. The aims of this study are: 1) evaluate the effect of untreated prenatal depression, compared to no prenatal depression, on neurodevelopmental outcomes of the offspring, after adjustment for confounders; 2) evaluate the effect of treatment for prenatal depression with SSRIs on neurodevelopmental outcomes of the offspring; 3) on a subsample of 2,000 children, evaluate prenatal depression and its treatment in parental interviews to identify less severe neurodevelopmental outcomes.
Investigator: Avalos, Lyndsay
Funder: National Institute of Child Health and Human Development

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; Young-Wolff, Kelly
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

Highlighted Publications

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 06;120(6):972-984. Epub 2020-02-13.

Current Position(s):

Section Affiliations:

Primary Research Interests:

Studies

The Impact of Racial Residential Segregation on the Mental Health of Pregnant Women

Treatment Initiation for New Episodes of Depression in Pregnant Women

mHealth Mindfulness Intervention for Pregnant Black and Latina Women at Risk of Postpartum Depression

Comparing the Effects of Prenatal Depression and its Treatment on Developmental Outcomes of the Offspring

Racial/Ethnic Disparities in Perinatal Depression Treatment Utilization

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

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

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

Preventing Postpartum Depression: Exercise as Medicine

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

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

Moderate Hypertension in Pregnancy: Safety and Effectiveness of Treatment

Impact of Folate, Obesity and Genetics on Maternal Depression

Climate Change and Health: Assessing the Risk of Preterm Delivery

Highlighted Publications

Prenatal Depression and Diet Quality During Pregnancy

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

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

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

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

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

Publications

The effect of the COVID-19 pandemic on prenatal cannabis use by pre-conception depression and anxiety status

Changes in 24-Hour Movement Behaviors From Early to Late Pregnancy in Individuals With Prepregnancy Overweight or Obesity

COVID-19 Pandemic Experiences and Symptoms of Pandemic-Associated Traumatic Stress Among Mothers in the US

Prenatal Antidepressant Exposures and Autism Spectrum Disorder or Traits: A Retrospective, Multi-Cohort Study

Association of serum folate levels during pregnancy and prenatal depression

Geographic Accessibility of Retail Cannabis in Northern California and Prenatal Cannabis Use During the COVID-19 Pandemic

Patterns of Substance Use During Early Pregnancy and Associations With Behavioral Health Characteristics

Racial-Ethnic Differences in Treatment Initiation for New Diagnoses of Perinatal Depression

Association of cannabis use during pregnancy with severe acute respiratory syndrome coronavirus 2 infection: a retrospective cohort study

In-utero cannabis exposure and long-term psychiatric and neurodevelopmental outcomes: The limitations of existing literature and recommendations for future research

Cardiometabolic Pregnancy Complications in Association with Autism-Related Traits as Measured by the Social Responsiveness Scale in ECHO

Coping strategies for COVID-19 pandemic-related stress and mental health during pregnancy

Association Between Prenatal Cannabis Use and Psychotropic Medication Use in Pregnant Patients With Depression and Anxiety

Perinatal Complications in Individuals in California With or Without SARS-CoV-2 Infection During Pregnancy

Prenatal Cannabis Use Before and During the COVID-19 Pandemic-Reply

Contributions of COVID-19 Pandemic-Related Stressors to Racial and Ethnic Disparities in Mental Health During Pregnancy

Associations of COVID-19-Related Health, Healthcare and Economic Factors With Prenatal Depression and Anxiety

Maternal and neonatal outcomes of antihypertensive treatment in pregnancy: A retrospective cohort study

Identifying hypertensive disorders of pregnancy, a comparison of two epidemiologic definitions

Rates of Prenatal Cannabis Use Among Pregnant Women Before and During the COVID-19 Pandemic

Disparities in Risks of Inadequate and Excessive Intake of Micronutrients during Pregnancy

Lifestyle-related education and counseling resource utilization and cardiovascular biomarkers in midlife women with low physical activity

Engagement in perinatal depression treatment: a qualitative study of barriers across and within racial/ethnic groups

Perceived Barriers and Motivators for Physical Activity in Women With Perinatal Depression

Dual trajectories of physical activity and blood lipids in midlife women: The Study of Women's Health Across the Nation

mHealth Mindfulness Intervention for Women with Moderate-to-Moderately-Severe Antenatal Depressive Symptoms: a Pilot Study Within an Integrated Health Care System

Association of Cannabis Retailer Proximity and Density With Cannabis Use Among Pregnant Women in Northern California After Legalization of Cannabis for Recreational Use

COVID-19 prevalence, symptoms, and sociodemographic disparities in infection among insured pregnant women in Northern California

A Mobile Health Mindfulness Intervention for Women With Moderate to Moderately Severe Postpartum Depressive Symptoms: Feasibility Study

Gestational weight gain, birthweight and early-childhood obesity: between- and within-family comparisons

Prenatal Depression and Diet Quality During Pregnancy

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

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

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

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

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

Understanding periviable birth: A microeconomic alternative to the dysregulation narrative

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

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

Association of Nausea and Vomiting in Pregnancy With Prenatal Marijuana Use

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

Predictors of Breastfeeding Initiation and Maintenance in an Integrated Healthcare Setting

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

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

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

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

Perinatal Obstetric Office Depression Screening and Treatment: Implementation in a Health Care System

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

Factors Associated with Seasonal Influenza Vaccination in Pregnant Women

Antidepressant medication use, depression, and the risk of preeclampsia

Genital herpes and its treatment in relation to preterm delivery

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

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

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