Research

Research Projects

1.             Associations between perinatal complications and long term offspring morbidities, (publications no 11, 13-19, 21-23, 25-45, 47-54, 56-65). These studies were based on the OBGYN database which includes >250,000 live births, linked with the Pediatric units databases and were conducted in close collaboration with experienced OBGYNs and pediatricians at SUMC, involving MD and MPH students (including: Adva Shaked Bugaisky; Ahmad Essa, Mor Marziano, Vera Zolotabera).

As a co-advisor I work with MD and MPH students on preparation of their research proposals, advise about study design, perform the statistical analysis (MPH perform the analysis independently), interpretation of data, and evaluation of the written thesis or the manuscript for publication, and address methodological comments of journal reviewers when needed.

Future studies on long term offspring health outcomes will include perinatal and early life environmental exposures.

Following IRB approval, a connection has been made with the Israeli Center of Disease Control, and the Soroka perinatal database has been linked with National Cancer Registry. Data has been combined and will allow studying perinatal complications and offspring malignancies risk.

2.            A prospective study of environmental exposures and long term offspring and maternal outcomes- The Negev Pregnancy cohort.  Besides working on existing databases, I lead a pilot study of the Negev Pregnancy Cohort, in collaborations with Prof.Eyal Sheiner (OBGYN, SUMC), Prof. Amalya Levy (Public Health, BGU), Dr. Daniella Landau (Neonatologist, SUMC) and Dr. Doron Dukler (OBGYN, SUMC).  This study will lay the groundwork for a larger cohort, which will address several objectives, including associations between early life exposures and morbidities throughout life. The aim is to study prospectively possible associations between perinatal environmental exposures and pregnancy outcomes as well as long term offspring health. Thus far, 200 women have been recruited and have participated in several levels, including detailed questionnaires, urine and blood collection, and anthropometric measurements. Three MPH students are working on their thesis based on data completed on this pilot (Maya Tabachnik- graduated; Yonatan Finkelstein, Illit Furman) based on data collected in this study, including the associations between digit ratio and reproductive characteristics, and the stability of non-persistent pollutants levels during pregnancy. The pilot study is funded by the Environment and Health Fund, Jerusalem, and it is part of the Israeli Birth Cohorts Consortium.  

Two grants have been received, based on this pilot, one is to study the associations between prenatal air pollution exposure and Autism risk factors (Drexel- Ben Gurion University Collaborative grant, in collaboration with Dr. Rachel Golan). The other grant is for comparison of levels of non-persistent organic pollutants between first and third trimester levels, and the possible association between pregnancy outcomes and the exposure to these chemicals measured at the two different times during pregnancy (Environmental Epidemiology Research Center grant, Ben Gurion University).

3.         Preconception exposures and fertility. As one of the outcomes frequently associated with environmental exposures is infertility, I initiated a research group in collaboration with Dr. Avi Harlev (OBGYN) working on a prospective cohort study among women treated at the In-Vitro- Fertilization (IVF) unit of the SUMC. The aim of this  research group is to study the associations between selected environmental exposures, fertility characteristics and treatment outcomes. The study protocol includes questionnaire completion and anthropometric measurements, including digit ratio and ano-genital distance (these measurements have been shown the represent early life hormonal environment). A MPH student (Naama Sagi) is working under my supervision on this cohort, and thus far more than 210 women have been recruited. Initial results of her thesis was presented at the Environment and Health Fund meeting, Jerusalem, 2017.

To further develop this line of research I am leading efforts to summarize and computerize records in the IVF unit, of all offspring conceived at the unit (approximately 2500 offspring were conceived following treatment at this unit). Once a database is created, it will lay the ground for retrospective cohort studies on the associations between the different treatment technologies used, and pregnancy outcomes, offspring malignancy risk (based on cross-linking the data collected and the National Cancer Registry), Autism risk (based on cross-linking data collected with the Social Security records), and more.  An MPH student (Maayan Baal) and two MD students (Noa Ben David and Noga Shahor) are working on these projects. Thus far nearly 1100 offspring files have been abstracted and summarized.

4.            Recurrent preterm deliveries. The main preterm birth (PTB) risk factor is a history of PTB. In cooperation with Dr. Shimrit Salem- Yaniv, Dr. Israel Yoles and Professor Ilana Shoham- Vardi, environmental risk factors will be studied in association with recurrent PTB risk. The pilot study will take place at the delivery ward, where women with a current PTB will be recruited, in order to evaluate risks for recurrent PTB. This study will include a detailed questionnaire, and whole blood collection for heavy metals analysis. Future studies on this subject will include DNA analysis, which will be carried by Professor Ruti Parvari.

5.            Recurrent pregnancies losses (RPL). In cooperation with Professor Asher Bashiri, several studies (retrospective and clinical trials) on different treatment protocols and success rate in RPL prevention. Two MD students are currently working on these projects: Dalia Jbaren and Gabi Halperin.

6.            In Vitro Fertilization (IVF) Technologies, In cooperation with Professor Iris Har- Vardi and the IVF laboratory. Comparing different treatment protocols and new technologies, to study their effects on implantation rates and pregnancy outcomes.  Nitzan Goldberg, an MD students is currently working on this project, besides other studies in cooperation with Professor Har- Vardi and other laboratory scientists. 

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