Erica P. Gunderson, PhD, MS, MPH

People

Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

510-891-5917 (phone)
erica.gunderson@kp.org
Kaiser Permanente Researcher Profiles

Erica P. Gunderson, PhD, MS, MPH, RD, is a senior research scientist at Kaiser Permanente Northern California Division of Research and a professor of Health Systems Science at Kaiser Permanente Bernard J. Tyson School of Medicine. Dr. Gunderson is a life-course epidemiologist studying pregnancy-related determinants of cardiometabolic health, type 2 diabetes and cardiovascular disease (CVD) in women, and the relation of infant diet and behavior to cardiometabolic health in youth. Dr. Gunderson's research studies are among the first to account for preconception and gestational metabolic profiles that distinguish antecedent metabolic factors from the effects of adverse pregnancy outcomes and lactation on future type 2 diabetes and CVD in women, and to identify metabolomic signatures predicting future diabetes in women after gestational diabetes. These studies establish a strong evidence basis supporting causal inferences for lactation's lasting benefits on women's cardiometabolic health and lower diabetes risk. As PI of several NIH-funded R01s, her research evaluates early pregnancy blood pressure patterns and prediction of hypertensive disorders of pregnancy, chronic hypertension during pregnancy, and racial disparities in severe maternal morbidity. For the Study of Women, Infant Feeding and Type 2 Diabetes after Gestational Diabetes (SWIFT), Dr. Gunderson developed a diverse, prospective cohort of 1,033 women with gestational diabetes (75% minority) enrolled from early postpartum and followed up to identify predictors of future diabetes. Her SWIFT mother-child research studies differentiate the impact of fetal exposure to maternal obesity and dysglycemia from early postnatal modifiable behaviors (e.g., breastfeeding, infant diet) as related to obesity and cardiometabolic health in children. For two decades, she has been a co-investigator on the Coronary Artery Risk Development in Young Adults (CARDIA) Study and Co-chair of the Pregnancy-Related Reproductive Exposures and Outcomes Working Group, developing and validating the pregnancy-related variables, and conducting life-course analyses of reproductive factors and CVD. In 2020-21, Dr. Gunderson was appointed a member of the Organizing Committees for the National Academy of Sciences, Engineering and Medicine, Workshop on Nutrition During Pregnancy and Lactation: Exploring New Evidence, and the Workshop on Approaches to Assessing Intake of Food and Dietary Supplements in Pregnant Women and Children 2 to 11 Years. She has authored more than 130 peer-reviewed original research papers and reviews on the preconception, pregnancy and lactation continuum and its relationship to maternal and child health. Dr. Gunderson earned her B.S. in Biological Sciences at Stanford University, and her M.P.H. and M.S. in Public Health/Nutritional Sciences and Ph.D. in Epidemiology at the University of California at Berkeley.

Current Position(s):

Research Scientist III, Division of Research, Kaiser Permanente Northern California

Section Affiliations:

Primary Research Interests:

Life course epidemiology of obesity and cardiometabolic disease in women and children
Links between the pregnancy-lactation continuum and women’s health
Early prediction of adverse pregnancy outcomes for CVD risk reduction
Fetal life exposures and early postnatal behaviors for prevention of child obesity and metabolic disease
Prospective, longitudinal studies of diverse race and ethnic groups of women across the childbearing years

Related Website(s):

Studies

Effect of reproductive history on longitudinal change in cardiac, vascular, and lipid parameters

The NHLBI NGHS enrolled 871 girls (50% Black and 50% white) in 1987 at age 9 or 10 and examined them up to 17 times, to age 27. This resulted in 7 echocardiogram reports from ages 20-27, multiple saved samples, and reproductive history questionnaires. We will conduct detailed lipoprotein sizing and functionality assessments from stored and new samples, cardiovascular imaging, and repeat echocardiograms at median age 46. Our aims are to determine the specific lipoprotein particle size distribution and function changes which occur from before to short- and long-term post-pregnancy; determine whether pregnancy-related cardiac adaptations result in long-term alterations in cardiac structure and function, thereby increasing CVD risk for women in their forties; and to test whether parity increases cardiovascular risk independently of socioeconomic status in Black and white women.
Investigator: Gunderson, Erica
Funder: National Heart, Lung, and Blood Institute

Fetal and Early Postnatal Influences on Child Metabolic Health After Gestational Diabetes

This 5-year RO1 study will determine the independent contribution of fetal exposures and early postnatal lifestyle factors on subsequent development of child adiposity and metabolic health among youth (ages 9 to 13 ) exposed to gestational diabetes in utero. The research study will evaluate cardiometabolic health factors and lifestyle behaviors in youth whose mothers were diagnosed with gestational diabetes and enrolled in the prospective, longitudinal SWIFT Study from 2008 to 2011. This study will conduct an in-person research exam and will coordinate the research exams in the children with 10-year follow up exams in the SWIFT women to reclassify glucose tolerance.
Investigator: Gunderson, Erica
Funder: National Institute of Diabetes and Digestive and Kidney Diseases

Metabolites Preceding Progression to Type 2 Diabetes in Women after Gestational Diabetes

This study will identify biochemical markers that predict type 2 diabetes mellitus in women after a pregnancy complicated by gestational diabetes mellitus (GDM). Ultimately, the results of this study may lead to improved testing and more effective, personalized interventions to prevent diabetes in women after GDM pregnancy.
Investigator: Gunderson, Erica
Funder: National Institute of Diabetes and Digestive and Kidney Diseases

Gestational diabetes phenotypes, glucose tolerance transitions and lifestyle behaviors related to cardiovascular risk status

The Study of Women, Infant Feeding, and Type 2 Diabetes after GDM Pregnancy (SWIFT) is a prospective, community-based cohort of mothers aged 20-45 years of age and diagnosed with gestational diabetes mellitus (GDM) who delivered a singleton pregnancy longer than 35 weeks gestation at Kaiser Permanente Northern California in 2008-2011. The new study leverages the SWIFT cohort's rich datasets, and measures blood pressure and novel biomarkers in blood samples obtained at the NIDDK funded 10-year follow up exam. The goal of this ancillary study will evaluate the relationship of GDM phenotype and subsequent transitions in glucose tolerance after GDM pregnancy to cardiovascular disease risk profiles, inflammation, and novel lipid biomarkers as well as effect modification by lifestyle behaviors.
Investigator: Gunderson, Erica
Funder: National Heart, Lung, and Blood Institute

Prenatal Blood Pressure Patterns to Predict Pregnancy-Related Hypertension and Later-Life Cardiovascular Risk

This study utilizes clinical prenatal-care blood pressure measurements and other clinical and biochemical variables to develop models for the early prediction of hypertensive disorders of pregnancy, and evaluates the relationship of pregnancy blood-pressure patterns to new onset hypertension and cardiovascular diseases in women within more than a decade later.
Investigator: Gunderson, Erica
Funder: National Heart, Lung, and Blood Institute

Pregnancy-Related Risk Factors and Glucose Intolerance in Women during Midlife

This is an ancillary study to the CARDIA Study, a multi-center longitudinal study of 5,115 black and white women and men (18-30) enrolled in 1985-1986, and followed at in-person exams serially through 2011. The study will evaluate pregnancy-related changes in cardiometabolic risk factors and their lasting effects on progression to glucose intolerance in women from the reproductive years through midlife.
Investigator: Gunderson, Erica
Funder: National Institute of Diabetes and Digestive and Kidney Diseases

Lactation and Incidence of Diabetes Mellitus in CARDIA Women

The goals of our study are to prospectively examine whether longer duration of lactation is associated with development of type 2 diabetes in women of reproductive age during the 25-year CARDIA study period (1986-2011) and assess changes in risk factors. We will identify changes in cardiometabolic risk factors and biomarkers linked to incident type 2 DM as well as lactation, and examine duration of lactation for all pregnancies in relation visceral fat levels in mid-life.
Investigator: Gunderson, Erica
Funder: National Institute of Diabetes and Digestive and Kidney Diseases

Highlighted Publications

Pregnancy and Subsequent Glucose Intolerance in Women of Childbearing Age: Heeding the Early Warning Signs for Primary Prevention of Cardiovascular Disease in Women.

Author(s): Gunderson, Erica P EP; Jaffe, Marc G MG

JAMA internal medicine. 2017 12 01;177(12):1742-1744. Epub --.

Current Position(s):

Section Affiliations:

Primary Research Interests:

Related Website(s):

Studies

Effect of reproductive history on longitudinal change in cardiac, vascular, and lipid parameters

Fetal and Early Postnatal Influences on Child Metabolic Health After Gestational Diabetes

Metabolites Preceding Progression to Type 2 Diabetes in Women after Gestational Diabetes

Gestational diabetes phenotypes, glucose tolerance transitions and lifestyle behaviors related to cardiovascular risk status

Prenatal Blood Pressure Patterns to Predict Pregnancy-Related Hypertension and Later-Life Cardiovascular Risk

Pregnancy-Related Risk Factors and Glucose Intolerance in Women during Midlife

Lactation and Incidence of Diabetes Mellitus in CARDIA Women

Highlighted Publications

Pregnancy and Subsequent Glucose Intolerance in Women of Childbearing Age: Heeding the Early Warning Signs for Primary Prevention of Cardiovascular Disease in Women.

Association of Infant Temperament With Subsequent Obesity in Young Children of Mothers With Gestational Diabetes Mellitus

Longer lactation duration is associated with decreased prevalence of non-alcoholic fatty liver disease in women

Breastfeeding and growth during infancy among offspring of mothers with gestational diabetes mellitus: a prospective cohort study

Lactation Duration and Progression to Diabetes in Women Across the Childbearing Years: The 30-Year CARDIA Study

Dietary variables associated with substantial postpartum weight retention at 1-year among women with GDM pregnancy

Lactation and Progression to Type 2 Diabetes Mellitus After Gestational Diabetes Mellitus: A Prospective Cohort Study.

Lactation intensity and fasting plasma lipids, lipoproteins, non-esterified free fatty acids, leptin and adiponectin in postpartum women with recent gestational diabetes mellitus: the SWIFT cohort.

Pregnancy during adolescence has lasting adverse effects on blood lipids: A 10-year longitudinal study of black and white females

Epidemiology of peripartum cardiomyopathy: incidence, predictors, and outcomes

A 20-year prospective study of childbearing and incidence of diabetes in young women, controlling for glycemia before conception: the Coronary Artery Risk Development in Young Adults (CARDIA) Study

Long-term plasma lipid changes associated with a first birth: the Coronary Artery Risk Development in Young Adults study

Publications

Reduced cardiovascular risks in women with endometriosis or polycystic ovary syndrome carrying a common functional IGF1R variant

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

Prepregnancy weight change associated with high gestational weight gain

Early Pregnancy Blood Pressure Patterns Identify Risk of Hypertensive Disorders of Pregnancy Among Racial and Ethnic Groups

Gestational Diabetes and Hypertensive Disorders of Pregnancy by Maternal Birthplace

Adverse Pregnancy Outcomes and Incident Heart Failure in the Women's Health Initiative

Intensive lactation among women with recent gestational diabetes significantly alters the early postpartum circulating lipid profile: the SWIFT study

Gestational Diabetes and Overweight/Obesity: Analysis of Nulliparous Women in the U.S., 2011-2019

Trends in Gestational Diabetes at First Live Birth by Race and Ethnicity in the US, 2011-2019

DNA methylation GrimAge and Incident Diabetes: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Maternal weight change from prepregnancy to 18 months postpartum and subsequent risk of hypertension and cardiovascular disease in Danish women: A cohort study

Adverse Pregnancy Outcomes and Cardiovascular Disease Risk: Unique Opportunities for Cardiovascular Disease Prevention in Women: A Scientific Statement From the American Heart Association

The Association of Lactation Duration with Visceral and Pericardial Fat Volumes in Parous Women: the CARDIA Study

Adverse Childhood Experiences and Early and Continued Breastfeeding: Findings from an Integrated Health Care Delivery System

Gestational Diabetes History and Glucose Tolerance After Pregnancy Associated With Coronary Artery Calcium in Women During Midlife: The CARDIA Study

Association of infant diet with subsequent obesity at 2-5 years among children exposed to gestational diabetes: the SWIFT study

Cancer and Cardiovascular Risk in Women With Hypertensive Disorders of Pregnancy Carrying a Common IGF1R Variant

Diminished Sphingolipid Metabolism, a Hallmark of Future Type 2 Diabetes Pathogenesis, Is Linked to Pancreatic β Cell Dysfunction

Underlying dyslipidemia postpartum in women with a recent GDM pregnancy who develop type 2 diabetes

Life Course Changes in Cardiometabolic Risk Factors Associated With Preterm Delivery: The 30-Year CARDIA Study

Changes in Cardiometabolic Risk Factors Before and After Gestational Diabetes: A Prospective Life-Course Analysis in CARDIA Women

Amino acid and lipid metabolism in post-gestational diabetes and progression to type 2 diabetes: A metabolic profiling study

Pregnancy and Subsequent Glucose Intolerance in Women of Childbearing Age: Heeding the Early Warning Signs for Primary Prevention of Cardiovascular Disease in Women.

Life-Course Reproductive History and Cardiovascular Risk Profile in Late Mid-Life: The CARDIA Study

Non-alcoholic fatty liver disease in pregnancy is associated with adverse maternal and perinatal outcomes

A longitudinal study of pre-pregnancy antioxidant levels and subsequent perinatal outcomes in black and white women: The CARDIA Study

Links Between Childhood Obesity, Gestational Diabetes, and Infant Temperament-Reply

Fasting glucose variability in young adulthood and incident diabetes, cardiovascular disease and all-cause mortality

Association of Infant Temperament With Subsequent Obesity in Young Children of Mothers With Gestational Diabetes Mellitus

Association of breastfeeding and gestational diabetes mellitus with the prevalence of prediabetes and the metabolic syndrome in offspring of Hispanic mothers

Pre-pregnancy kidney function and subsequent adverse pregnancy outcomes

The discovery of novel predictive biomarkers and early-stage pathophysiology for the transition from gestational diabetes to type 2 diabetes

Longer lactation duration is associated with decreased prevalence of non-alcoholic fatty liver disease in women

Duration and stability of metabolically healthy obesity over 30 years

Breastfeeding and later maternal risk of hypertension and cardiovascular disease - The role of overall and abdominal obesity

Breastfeeding and Future Maternal Health-No Causal Evidence-Reply

Blood Pressure Patterns and Subsequent Coronary Artery Calcification in Women Who Delivered Preterm Births

Breastfeeding and growth during infancy among offspring of mothers with gestational diabetes mellitus: a prospective cohort study

Pre-Pregnancy Fitness and Risk of Gestational Diabetes: A Longitudinal Analysis.

Pre-pregnancy endothelial dysfunction and birth outcomes: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Elevated Medium Chain-Acylcarnitines are Associated with Gestational Diabetes, and Early Progression to Type-2 Diabetes, and Induce Pancreatic β-Cell Dysfunction

Cardiorespiratory Fitness, Exercise Hemodynamics and Birth Outcomes: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Lactation Duration and Progression to Diabetes in Women Across the Childbearing Years: The 30-Year CARDIA Study

Risk of Type 2 Diabetes Mellitus following Gestational Diabetes Pregnancy in Women with Polycystic Ovary Syndrome

Association Between Gestational Diabetes and Incident Maternal CKD: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Gravidity is not associated with telomere length in a biracial cohort of middle-aged women: The Coronary Artery Risk Development in Young Adults (CARDIA) study

Dietary variables associated with substantial postpartum weight retention at 1-year among women with GDM pregnancy

Hospital Supplementation Differentially Impacts the Association Between Breastfeeding Intention and Duration Among Women With and Without Gestational Diabetes Mellitus History

In-Hospital Breastfeeding Experiences Among Women with Gestational Diabetes

Testosterone Levels in Pre-Menopausal Women are Associated With Nonalcoholic Fatty Liver Disease in Midlife

Genome-wide analysis identifies 12 loci influencing human reproductive behavior

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

A Predictive Metabolic Signature for the Transition from Gestational Diabetes to Type 2 Diabetes

Preterm Delivery and Metabolic Syndrome in Women Followed From Prepregnancy Through 25 Years Later

The Comparative Effectiveness of Diabetes Prevention Strategies to Reduce Postpartum Weight Retention in Women With Gestational Diabetes Mellitus; The Gestational Diabetes' Effects on Moms (GEM) Cluster Randomized Controlled Trial.