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.