Institut Pasteur de Bangui
The Women’s Health Group—headed by Donna D. Baird, Ph.D.—uses the tools of reproductive epidemiology to address women's reproductive health issues. It combines epidemiologic methods development with research of public health concern. This research has focused on: fertility and early pregnancy epidemiology of uterine fibroids The Early Pregnancy Study, a longstanding collaboration between Baird, Clarice Weinberg, Ph.D., and Allen Wilcox, M.D., Ph.D., was a prospective cohort study conducted in the 1980s that was designed to determine the risk of early loss of pregnancy among healthy women. Participants collected daily urine specimens during the menstrual cycles when they were trying to conceive and also during the first eight weeks of gestation for those who became pregnant. Urine was analyzed for human chorionic gonadotropin (hCG), estrogen and progesterone metabolites and luteinizing hormone (LH) to identify ovulation and implantation. These markers served as benchmarks for studying fertility and corpus luteum rescue, and length of pregnancy. The researchers have collaborated with the Centers for Disease Control to measure urinary biomarkers of exposure to bisphenol A and phthalates in order to investigate associations with fertility and the reproductive events of early pregnancy as well as pregnancy outcomes. We conducted the NIEHS Uterine Fibroid Study (UFS) which screened randomly selected participants, 35-49 years of age, for fibroids using transvaginal ultrasound. We described the prevalence of these benign tumors in black and white women (Baird et al., 2003) and have analyzed the data to identify risk factors. As in laboratory animal studies of fibroids (Walker et al., 2001), parity is protective. As an explanation, we hypothesized that postpartum uterine remodeling could clear existing lesions from the myometrium (Baird et al, 2003). To test this hypothesis, a collaborative study was designed with Right From The Start, a prospective pregnancy study that screens for fibroids in very early pregnancy; findings are consistent with the hypothesized mechanism. Also, confirming laboratory animal studies, the UFS data revealed an increased risk associated with prenatal diethystilbestrol (DES) exposure (Baird and Newbold, 2005). Study participants were followed to assess the health consequences of fibroids, with a final follow-up completed in 2005, and the initial ultrasound data on size of fibroid(s) was associated with surgical treatment during follow-up, suggesting that a single ultrasound exam is strongly predictive of adverse health consequences of fibroids.
Epidemiology of Reproductive