Through the Center for Better Beginnings, the Division of Dysmorphology and Teratology continues to conduct cutting-edge local, national and international epidemiologic and biomedical research focused on the identification and prevention of birth defects, miscarriage, preterm birth, pre and post-natal growth abnormalities and longer term neurodevelopmental and functional impairments.
Medications and Vaccines in Pregnancy
A major research theme is based on the premise that a substantial number of birth defects which presently have an unknown etiology are the result of drugs, chemicals and/or environmental agents to which the fetus is exposed. Follow-up through systematic post-marketing surveillance of prenatally exposed infants whose mothers were ascertained though MotherToBaby California provides a wealth of research material.
In addition, our Division is the coordinating center for MotherToBaby Pregnancy Studies, which consist of multiple national post-marketing surveillance studies of medication and vaccine safety in pregnancy. These studies are conducted through the Organization of Teratology Information Specialists (OTIS). Our Division provides the research infrastructure that allows for proper study design, subject ascertainment, follow-up, collection of data, statistical analysis and interpretation of data. Some of these studies are done in collaboration with the American Academy of Allergy Asthma and Immunology and Boston University as part of the Vaccines and Medications in Pregnancy Surveillance System (VAMPSS).
Our ongoing studies on medications and vaccines in pregnancy include:
- Medications used to treat autoimmune diseases such as Crohn's Disease, Rheumatoid Arthritis, Psoriasis, Psoriatic Arthritis, Ankylosing Spondylitis, and Multiple Sclerosis
- the Seasonal Flu Vaccine
- the Pertussis Vaccine
- Medications used to treat Asthma
Fetal Alcohol Spectrum Disorders
A second major research theme relates to the prenatal effects of alcohol. Research efforts in this area are both local and international and include: estimating the prevalence of Fetal Alcohol Spectrum Disorders (FASD); examining a variety of risk factors for FASD; cross-cultural comparisons of the dysmorphic features of children exposed to alcohol; and testing intervention strategies to reduce risky alcohol consumption among women of reproductive age.
Birth Defects Etiology and Prevention
The Division currently runs the State of California Birth Defects Monitoring Program, a long-standing public health surveillance program for birth defects that monitors 15 counties in California and is linked to a State biorepository for maternal serum samples and infant blood spots. Additionally, the Division has partnered with the newly founded Rady Genomic and Systems Medicine Institute to develop a program for better understanding the genetic underpinnings of some birth defects. Collaborations have been established with CDC's SMART collaborative program to evaluate assisted reproductive technology birth outcomes in California; the Department of Medicine to evaluate a metabolomics signature in children with specific types of heart defects; and with researchers state wide to study the etiology of gastroschisis
Research Only Human Breast Milk Repository
In collaboration with UCSD's Clinical and Translational Research Institute, Rady Children's Hospital-San Diego, Sharp Mary Birch Hospital for Women and Newborns and San Diego State University's School of Public Health, in 2014 we opened a human milk repository dedicated to research. This will enable scientists from diverse fields to answer a multitude of questions about human milk, including its unique biochemical properties and the extent to which pharmaceuticals and substances to which nursing mothers are exposed can be passed to the infant during breastfeeding and their effects on the infant both while nursing and long term.