Monique M. Hedderson, PhD

Monique.m.hedderson@kp.org

Monique Hedderson, PhD, is a research scientist at the Kaiser Permanente Northern California Division of Research and associate director for the women’s and children’s health section.

She received her Master’s in public health from the University of Washington in 2000 and her PhD in epidemiology from the University of Washington in 2005. Dr. Hedderson’s research interests lie principally, but not exclusively, in the field of maternal and child health. Her research portfolio investigates the influence of preconception, prenatal and early childhood exposures on maternal and child health. Specifically, she has sought to understand how potentially modifiable factors before and during early pregnancy contribute to the risk of metabolic complications in women during pregnancy and postpartum, as well as their children.

Dr. Hedderson has a long-standing interest in developing innovative targeted prevention and treatment strategies for high risk populations, especially interventions among reproductive aged women that can be implemented into clinical practice. She is also interested in the pharmacogenetics of glycemic response to metformin among patients with type 2 diabetes. This area of research has the potential to inform data-driven prescribing and precision medicine for antidiabetic drug therapy.

Current Positions

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

Section Affiliations

Associate Director, Women’s and Children’s Health

Primary Research Interests

Reproductive and perinatal epidemiology
Gestational diabetes
In utero behavioral and environmental exposures related to maternal and child health

Studies

Comparing the effects of pharmacological treatment for gestational diabetes on long-term maternal and child health outcomes

Comparing the effects of pharmacological treatment for gestational diabetes on long-term maternal and child health outcomes
This study will use real-world clinical data on pregnancies with gestational diabetes requiring pharmacological treatment to compare the risk of long-term maternal and child health outcomes associated with oral hypoglycemic agents (metformin and glyburide) in comparison to insulin. It will compare the risk of long-term effects of metformin and glyburide versus insulin on child neurodevelopmental and growth trajectory and obesity; compare the risk of long-term effects of metformin and glyburide versus insulin alone on mothers long-term cardiometabolic health (diabetes, diabetes severity and hypertension); and explore whether the risks vary by maternal race/ethnicity or obesity status.
Funder: National Institute of Diabetes and Digestive and Kidney Diseases

Investigator: Hedderson, Monique

Funder: National Institute of Diabetes and Digestive and Kidney Diseases

Early Life Exposure to Endocrine Disrupting Chemicals and Child Growth, Adiposity, and Neurodevelopment

This is a 7-year renewal of our current ECHO Cohort Study Site Early Life Exposures and Child Growth, Adiposity, and Neurodevelopment. We plan to extend the capacity of the ECHO Cohort to further investigate the roles of endocrine disruptor chemicals and health behaviors on child growth, adiposity and neurodevelopment and to follow our 2,000 children and their mothers currently enrolled in our ECHO Cohort and implement the ECHO Cohort Protocol.

Investigator: Ferrara, Assiamira; Croen, Lisa; Hedderson, Monique

Funder: National Institutes of Health

Preconception and Prenatal Health Impacting Factors and Child Health

The study will recruit a diverse cohort of 1,800 pregnant individuals, the conceiving partner, their resulting child, and will follow all of them at multiple visits after the child is born to contribute to the Environmental influences on Child Health Outcomes (ECHO) Program. We will examine the role of in utero exposure to psychological distress and substance use on child growth, adiposity, obesity, and neurodevelopment (ND) and the extent to which prenatal lifestyle factors and neighborhood factors may mitigate these associations. We will clarify the joint effects of maternal prenatal dietary patterns and the 24-hour movement and child growth, obesity, and ND and whether metabolomic signatures prenatally, at birth, and postnatally mediate these associations. There will also be a preconception pilot study to explore the role of maternal and paternal lifestyle factors on infant health to identify critical time periods to intervene on to prevent upstream risk factors for childhood obesity and ND.

Investigator: Hedderson, Monique; Zhu, Yeyi; Avalos, Lyndsay

Funder: National Institutes of Health

Evaluating patient engagement in “KP Connected Pregnancy Care” and its association with utilization, perinatal outcomes and patient satisfaction.

This cohort study evaluates a new prenatal care delivery pathway, KP Connected Pregnancy Care (KPCPC). KPCPC is an opt-in hybrid in-person and virtual care model using digital tools to expand remote patient monitoring and virtual visits for low-risk prenatal care patients. Study compares participation in KPCPC with standard in-person care pathway and patient satisfaction with prenatal care and health outcomes. It will explore if associations vary among patients at risk for health disparities due to racism or other social determinants of health.

Investigator: Hedderson, Monique

Funder: TPMG Delivery Science Projects Program

The Study of Women’s Health Across the Nation (SWAN)

SWAN VI aims to elucidate menopause transition characteristics and trajectories of midlife health markers (inflammation, metabolic and cardiovascular risk factors, body composition, and bone, genitourinary, and vascular health) that are related to the preservation of physical and cognitive functioning, avoidance or delay of adverse health outcomes, and enhancement of social and psychological well-being, all of which will optimize successful aging.

Investigator: Hedderson, Monique

Funder: National Institute on Aging

Can hydroxychloroquine prevent preeclampsia and preterm delivery in lupus pregnancy?

Pregnant women with lupus are at high risk to develop preeclampsia and preterm delivery. This work leverages three large population-based databases with detailed prescription and clinical data to determine whether use of hydroxychloroquine during pregnancy among women with lupus reduces the risk of preeclampsia and preterm delivery disentangling these outcomes from the effects of potential mediators. This study will provide key information on hydroxychloroquine use and prescription practices to improve the analytic paradigm and inform our clinical understanding hydroxychloroquine use in lupus pregnancy.

Investigator: Hedderson, Monique

Funder: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Understanding racial-ethnic disparities in preterm birth sub-types and prenatal care utilization

The study will examine racial-ethnic disparities in the risk of preterm birth overall and by preterm birth sub-types. It will also study whether the racial-ethnic disparities in preterm births and preterm birth sub-types are modified by the level of prenatal care received.

Investigator: Hedderson, Monique

Funder: Northern California Community Benefit Programs

Cluster-randomized Trial of a Mobile Health Intervention to Achieve Appropriate Gestational Weight Gain in Overweight and Obese Women

This randomized trial will test whether the implementation of an mHealth tool in the health-plan setting increases the proportion of overweight and obese women with appropriate total gestational weight gain, according to Institute of Medicine (IOM) guidelines in comparison to usual care. Primary outcomes include the proportion of women with total gestational weight gain meeting the IOM guidelines and the rate of gain from the first trimester to delivery (in kilograms per week).

Investigator: Hedderson, Monique

Funder: National Institute of Diabetes and Digestive and Kidney Diseases

Atopic Dermatitis Standing Cohort Using a Cohort of Kaiser Permanente Northern California Members

A cohort study of Kaiser Permanente Northern California patients with moderate-to-severe atopic dermatitis (AD) will be used to estimate baseline characteristics and background incidence rates of safety events. Data from this study will provide valuable information regarding the current incidence rates of adverse outcomes among patients with AD. Safety events of interest include: viral reactivation, malignancies, lymphoproliferative disorders, thrombocytopenia, major/minor bleeding events, major adverse cardiovascular events, alterations in lipid profiles, and thromboembolism.

Investigator: Hedderson, Monique

Funder: Pfizer Inc.

Pregravid Biomarkers and Risk of Gestational Diabetes Mellitus Risk, Fetal Growth and Progression to Diabetes

This study will examine pregravid biomarkers of metabolic risk (adiponectin, high molecular weight adiponectin, c-reactive protein, liver enzymes, fetuin-A and LDL particle size) in relation to risk of gestational diabetes mellitus among women who participated in the Kaiser Permanente Northern California (KPNC) multiphasic health check-up (1985-1996) and had a subsequent pregnancy in KPNC.

Investigator: Hedderson, Monique

Funder: National Institute of Child Health and Human Development

Iodinated Contrast Agents and Risk of Hypothyroidism in Young Children in the United States

This study will estimate the incidence of pulmonary hypothyroid in a pediatric population of children under age 4, based on data from the US-based Kaiser Permanente Northern California database, who were exposed to iodinated contrast agent through having a diagnostic procedure.

Investigator: Hedderson, Monique

Funder: Bayer AG

Glyburide Versus Insulin for the Treatment of Women with Gestational Diabetes in Kaiser Permanente Northern California

We aim to compare the effectiveness and safety of glyburide and insulin at improving neonatal and maternal outcomes among women with gestational diabetes mellitus (GDM) requiring medication therapy in Kaiser Permanente Northern California from 2007 to 2016. We will use a cohort study design including women with GDM diagnosed from 2007 to 2016 where treatment groups contrasted are defined by therapy regimens (i.e., insulin versus glyburide or early versus late initiation of glyburide). This project will overcome shortcomings of past studies conducted in this area by using modern statistical methods that allow us to take advantage of variation in treatment patterns after the implementation of the universal Perinatal Center referral policy in 2007. More specifically, our approach consists of a cohort study with time-varying exposure to insulin and glyburide during pregnancy.

Investigator: Hedderson, Monique

Development and Testing of a Mobile-Health (m-health) Intervention tool to Help Obese Women Achieve Appropriate Gestational Weight Gain

To determine whether a mobile-health (m-health) tool (accessible via smartphone or website) intervention for obese pregnant improves patient satisfaction with their gestational weight gain, quality of life, stress and depression during pregnancy. Provider satisfaction with discussing gestational weight gain among their patients who used the m-health tool will also be assessed.

Investigator: Hedderson, Monique

Funder: The Permanente Medical Group

Discovery of Pharmacogenomic Biomarkers for Metformin Response

The primary goal of this multi-site study is to identify genetic variants that impact response to metformin in patients with diabetes from multiple ethnic groups in the U.S. and Europe

Investigator: Hedderson, Monique

Funder: National Institute of General Medical Sciences

Pharmacogenomics Study of Extreme Response to Metformin

In this collaboration with GlaxoSmithKline, University of California San Francisco and Kaiser Permanente Northern California, we propose to perform a genome-wide association study in 1,000 patients of European ancestry with extreme response phenotypes to metformin using genomewide array and human exome chip, which include rare nonsynonymous variants. Our aim is to determine whether rare variants, either acting alone or in combination, explain much of the variation in response to metformin, particularly in the extreme responder and non-responder groups.

Investigator: Hedderson, Monique

Funder: GlaxoSmithKline PLC

Publications

Longitudinal Exposure to Neighborhood Concentrated Poverty Contributes to Differences in Adiposity in Midlife Women

Authors: Schiff, Mary D;Barinas-Mitchell, Emma;Brooks, Maria M;Mair, Christina F;Méndez, Dara D;Naimi, Ashley I;Hedderson, Monique;Janssen, Imke;Fabio, Anthony

J Womens Health (Larchmt). 2024 Oct;33(10):1393-1403. Epub 2024-07-01.

Monique M. Hedderson, PhD

Current Positions

Section Affiliations

Primary Research Interests

Studies

Comparing the effects of pharmacological treatment for gestational diabetes on long-term maternal and child health outcomes

Early Life Exposure to Endocrine Disrupting Chemicals and Child Growth, Adiposity, and Neurodevelopment

Preconception and Prenatal Health Impacting Factors and Child Health

Evaluating patient engagement in “KP Connected Pregnancy Care” and its association with utilization, perinatal outcomes and patient satisfaction.

The Study of Women’s Health Across the Nation (SWAN)

Can hydroxychloroquine prevent preeclampsia and preterm delivery in lupus pregnancy?

Understanding racial-ethnic disparities in preterm birth sub-types and prenatal care utilization

Cluster-randomized Trial of a Mobile Health Intervention to Achieve Appropriate Gestational Weight Gain in Overweight and Obese Women

Atopic Dermatitis Standing Cohort Using a Cohort of Kaiser Permanente Northern California Members

Pregravid Biomarkers and Risk of Gestational Diabetes Mellitus Risk, Fetal Growth and Progression to Diabetes

Iodinated Contrast Agents and Risk of Hypothyroidism in Young Children in the United States

Glyburide Versus Insulin for the Treatment of Women with Gestational Diabetes in Kaiser Permanente Northern California

Development and Testing of a Mobile-Health (m-health) Intervention tool to Help Obese Women Achieve Appropriate Gestational Weight Gain

Discovery of Pharmacogenomic Biomarkers for Metformin Response

Pharmacogenomics Study of Extreme Response to Metformin

Publications

Longitudinal Exposure to Neighborhood Concentrated Poverty Contributes to Differences in Adiposity in Midlife Women

Neighborhood Food Access in Early Life and Trajectories of Child Body Mass Index and Obesity

Diabetes and uterine fibroid diagnosis in midlife: Study of Women’s Health Across the Nation (SWAN)

HDL-C criterion of the metabolic syndrome and future diabetes and atherosclerosis in midlife women: The SWAN Study

The Effect of City-Level Sugar-Sweetened Beverage Taxes on Longitudinal HbA1c and Incident Diabetes in Adults With Prediabetes

City-Level Sugar-Sweetened Beverage Taxes and Youth Body Mass Index Percentile

Hydroxychloroquine and Preeclampsia in a Diverse Cohort of Women with SLE

Long-Term Risk of Reintervention After Surgical Leiomyoma Treatment in an Integrated Health Care System

Group Multimodal Prenatal Care and Postpartum Outcomes

Pregnancy outcomes in a diverse US Lupus Cohort

Longitudinal Changes in Sex Hormone Binding Globulin (SHBG) and Risk of Incident Diabetes: The Study of Women’s Health Across the Nation (SWAN)

Hypertension, Cardiovascular Risk Factors, and Uterine Fibroid Diagnosis in Midlife

Behavior reallocations within 24-h movement profiles and change in cardiometabolic biomarkers during pregnancy

Association Between Neighborhood Deprivation in Early Pregnancy and Gestational Diabetes Mellitus

Risk of postpartum readmission after hypertensive disorder of pregnancy and variation by discharge antihypertensive medication prescription

Intrinsic motivation for physical activity, healthy eating, and self-weighing in association with corresponding behaviors in early pregnancy

Weight loss, stability and low weight gain during pregnancy among individuals with obesity: associations with adverse perinatal outcomes: an observational study

Opportunities for Examining Child Health Impacts of Early-Life Nutrition in the ECHO Program: Maternal and Child Dietary Intake Data from Pregnancy to Adolescence

Prenatal depression and risk of child autism-related traits among participants in the Environmental influences on Child Health Outcomes program

Genome-Wide Association Study Identifies Pharmacogenomic Variants Associated With Metformin Glycemic Response in African American Patients With Type 2 Diabetes

Prenatal Weight Change Trajectories and Perinatal Outcomes among Twin Gestations

Prenatal Health Care Outcomes Before and During the COVID-19 Pandemic Among Pregnant Individuals and Their Newborns in an Integrated US Health System

Longitudinal profiles of neighborhood socioeconomic vulnerability influence blood pressure changes across the female midlife period

The association between intrauterine exposure to opioids, tobacco, alcohol, and cannabis and length of birth hospitalization among neonates without NOWS

Novel approaches to examining weight changes in pregnancies affected by obesity

Prenatal exposure to per- and polyfluoroalkyl substances and childhood autism-related outcomes

The prospective association of hyperandrogenism, oligomenorrhea and polycystic ovary syndrome with incident gestational diabetes: The coronary artery risk development in young adults women’s study

Changes in Body Mass Index Among School-Aged Youths Following Implementation of the Healthy, Hunger-Free Kids Act of 2010

Rates of malignancies among patients with moderate to severe atopic dermatitis: a retrospective cohort study

Using Peer Support to Prevent Diabetes: Results of a Pragmatic RCT

Perinatal Outcomes After Bariatric Surgery Compared With a Matched Control Group

Accuracy of diagnostic codes for prenatal opioid exposure and neonatal opioid withdrawal syndrome

Dietary Quality Indices in Early Pregnancy and Rate of Gestational Weight Gain among a Prospective Multi-Racial and Ethnic Cohort

Trends in Screen Time Use Among Children During the COVID-19 Pandemic, July 2019 Through August 2021

Impact of the COVID-19 pandemic on children’s sleep habits: an ECHO study

Placental Histopathologic Findings of a Large Cohort of Patients With SARS-CoV-2 Infection During Pregnancy

Pregnancy post-bariatric surgery: Improved outcomes with telephonic nutritional management program

Association of maternal education, neighborhood deprivation, and racial segregation with gestational age at birth by maternal race/ethnicity and United States Census region in the ECHO cohorts

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

Fibroids and vitamin D: another piece of the puzzle

Urinary Phenols in Early to Mid-Pregnancy and Risk of Gestational Diabetes: A Longitudinal Study in a Multiracial Cohort

Efficacious lifestyle interventions for appropriate gestational weight gain in women with overweight or obesity set in the health care system: a scoping review

Association of serum folate levels during pregnancy and prenatal depression

Reconciling Between Medication Orders and Medication Fills for Lupus in Pregnancy

Gestational diabetes mellitus, prenatal maternal depression, and risk for postpartum depression: an Environmental influences on Child Health Outcomes (ECHO) Study

Changes in BMI During the COVID-19 Pandemic

Health Behavior Changes during the COVID-19 Pandemic: A Longitudinal Analysis among Children

Sociodemographic Variation in Children’s Health Behaviors During the COVID-19 Pandemic

Reach, acceptability, and perceived success of a telehealth diabetes prevention program among racially and ethnically diverse patients with gestational diabetes: the GEM cluster-randomized trial

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

Impaired fasting glucose in pregnancy: improved perinatal outcomes with active glycemic management

A Web-Based mHealth Intervention With Telephone Support to Increase Physical Activity Among Pregnant Patients With Overweight or Obesity: Feasibility Randomized Controlled Trial

Uptake of guideline-recommended postpartum diabetes screening among diverse women with gestational diabetes: associations with patient factors in an integrated health system in USA

Contribution of Maternal Cardiometabolic Risk Factors to Racial-Ethnicity Disparities in Preterm Birth Subtypes

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

Association of Glyburide and Subcutaneous Insulin With Perinatal Complications Among Women With Gestational Diabetes

Rates of cardiovascular events among patients with moderate-to-severe atopic dermatitis in an integrated health care system: A retrospective cohort study

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

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