Publications by authors named "Shilpi S Mehta-Lee"

Prenatal organophosphate (OP) pesticide exposure may be associated with reduced fetal growth, although studies are limited and have mixed results. We investigated associations between prenatal OP pesticide exposure and fetal size and modification by fetal sex. Maternal urinary concentrations of dialkyl phosphate (DAP) metabolites were measured at three time points.

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It is important to understand the impact of consumer chemical exposure and fecundity, a couple's measure of probability of successful conception, given approximately 15% of couples experience infertility. Prior research has generally found null associations between bisphenol and phthalate exposure and fecundability, measured via time to pregnancy (TTP). However, this research has not been updated with current chemical exposures and have often lacked diversity in their study populations.

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Objective: Both psychosocial stress and gestational weight gain are independently associated with adverse maternal and fetal outcomes. Studies of the association between psychosocial stress and gestational weight gain (GWG) have yielded mixed results. The objective of this study was to evaluate the association between psychosocial stress and GWG in a large population-based cohort.

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Background: Phthalates are endocrine-disrupting chemicals with anti-androgenic qualities and studies reported associations between prenatal phthalate exposure and infant genitalia. This study investigated whether increased prenatal phthalate exposure is associated with decreased fetal penile measures.

Methods: Data was from the New York University Children's Health and Environment Study (2016-2019).

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Purpose: The objective of this study was to compare maternal and neonatal outcomes when the diagnosis of FGR was based on isolated abdominal circumference < 10th percentile for gestational age (GA) (iAC group) versus overall estimated fetal weight < 10th percentile (EFW group).

Methods: This was a retrospective cohort study of singleton gestations who underwent growth ultrasounds and delivered at a single health system from 1/1/19-9/4/20. The study group was comprised of patients with AC < 10th percentile and EFW ≥ than the 10th percentile (iAC group).

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Objective: This article assesses the application of the Royal College of Obstetricians and Gynaecologists (RCOG) venous thromboembolism (VTE) risk model on a cohort of postpartum patients with a history of systemic lupus erythematosus (SLE).

Study Design: This is a secondary analysis of an ongoing patient registry of women with SLE from 2016 to 2022. There were 49 SLE patients with 55 pregnancies using the Definitions of Remission in SLE (DORIS) criteria to determine SLE disease activity.

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Article Synopsis
  • Bisphenols and phthalates, common chemicals in plastic products, disrupt hormones and may negatively affect fetal development, prompting this study on their impact on fetal growth.
  • The research involved 855 mother-fetal pairs, measuring these chemicals in maternal urine during pregnancy and analyzing fetal growth at 20, 30, and 36 weeks using ultrasound data.
  • Results indicated minimal associations between chemical exposure and fetal growth metrics, showing some sex differences: females had reduced growth at lower weights and increased growth at higher weights from certain phthalates, while the opposite was true for males, but overall findings were not statistically strong.
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Study Objective: To study associations between nighttime sleep characteristics and time to pregnancy.

Methods: Pregnant people age ≥18 years and<18 weeks' gestation were recruited from 3 New York University Grossman School of Medicine affiliated hospitals in Manhattan and Brooklyn (n = 1428) and enrolled into the New York University Children's Health and Environment Study. Participants in the first trimester of pregnancy were asked to recall their time to pregnancy and their sleep characteristics in the 3 months before conception.

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Study Question: How did the first two coronavirus disease 2019 (COVID-19) waves affect fertility rates in the USA?

Summary Answer: States differed widely in how their fertility rates changed following the COVID-19 outbreak and these changes were influenced more by state-level economic, racial, political, and social factors than by COVID-19 wave severity.

What Is Known Already: The outbreak of the COVID-19 pandemic contributed to already declining fertility rates in the USA, but not equally across states. Identifying drivers of differential changes in fertility rates can help explain variations in demographic shifts across states in the USA and motivate policies that support families in general, not only during crises.

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Fetal exposure to environmental chemicals has been associated with adverse health outcomes in children and later into adulthood. While several studies have examined correlations and variability of non-persistent chemical exposures throughout pregnancy, many do not capture more recent exposures, particularly in New York City. Our goal was to characterize exposure to phthalates, bisphenols, polycyclic aromatic hydrocarbons, and organophosphate pesticides among pregnant women residing in New York City who enrolled in the New York University Children's Health and Environment Study (NYU CHES) between 2016 and 2018.

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Article Synopsis
  • The study explored how pre-pandemic mental health and demographic factors affected the stress levels of pregnant women and new mothers during the early months of COVID-19.
  • Data was collected from 1,560 women in New York City between April and August 2020, focusing on their perceived stress, resilience, and various concerns.
  • Key findings showed that previous depression, financial issues, and COVID-19 infection increased stress, while being Hispanic and having strong social support helped reduce it, indicating that financial and family-related factors were the biggest contributors to stress during the pandemic.
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While racial/ethnic differences in fetal growth have been documented, few studies have examined whether they vary by exogenous factors, which could elucidate underlying causes. The purpose of this study was to characterize longitudinal fetal growth patterns by maternal sociodemographic, behavioral, and clinical factors and examine whether associations with maternal race/ethnicity varied by these other predictors. Between 2016 and 2019, pregnant women receiving prenatal care at NYU Langone Health (New York, New York) were invited to participate in a birth cohort study.

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Background/objectives: Excessive gestational weight gain (GWG) and pre-pregnancy obesity affect a significant portion of the US pregnant population and are linked with negative maternal and child health outcomes. The objective of this study was to explore associations of pre-pregnancy body mass index (pBMI) and GWG with longitudinally measured maternal urinary metabolites throughout pregnancy.

Subjects/methods: Among 652 participants in the New York University Children's Health and Environment Study, a longitudinal pregnancy cohort, targeted metabolomics were measured in serially collected urine samples throughout pregnancy.

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Article Synopsis
  • The study aimed to estimate how common cannabis use is among women before and during pregnancy, what reasons they have for using it, and what factors influence their usage patterns.
  • Conducted in six states over 2016-2018, the research involved surveying new mothers about their cannabis use habits and related characteristics, and analyzed differences between non-users, preconception users, and those who used during both periods.
  • Results showed that 5.8% of respondents used cannabis only before conception, while 4.4% used it both before and during pregnancy, with stress and nausea being the main reasons for use, highlighting significant links to factors like marital status and race/ethnicity.*
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Importance: Early evidence shows a decrease in the number of US births during the COVID-19 pandemic, yet few studies have examined individual-level factors associated with pregnancy intention changes, especially among diverse study populations or in areas highly affected by COVID-19 in the US.

Objective: To study changes in pregnancy intention following the outbreak of the COVID-19 pandemic and identify factors possibly associated with these changes.

Design, Setting, And Participants: A cross-sectional, population-based study was conducted among women who were currently pregnant or had delivered a live infant and responded to a survey emailed to 2603 women (n = 1560).

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Article Synopsis
  • * In a study of 1,325 pregnant women in New York, the average Healthy Eating Index (HEI)-2015 score was 74.9, with variation across different demographic groups and a concerning number scoring below average.
  • * Factors like Hispanic ethnicity, younger age, obesity, and other health behaviors were linked to lower diet quality scores, indicating a need for improved nutrition education both before and during pregnancy.
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Background: In October 2018, a measles (rubeola) outbreak was identified in New York City and Rockland County, and a public health campaign and hospital policy changes were made to increase awareness of the importance of vaccination and increase vaccination rates.

Objective: We describe the prevalence of rubeola immunity in pregnant women and the change in uptake of postpartum measles, mumps, and rubella vaccination before and during the measles outbreak.

Study Design: A multipronged intervention was developed by the health system with the intent of raising awareness of the outbreak, identifying patients at risk of contracting measles during pregnancy, and limiting exposure of inpatients to the disease.

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During the coronavirus disease 2019 (COVID-19) pandemic in New York City, telehealth was rapidly implemented for obstetric patients. Though telehealth for prenatal care is safe and effective, significant concerns exist regarding equity in access among low-income populations. We performed a retrospective cohort study evaluating utilization of telehealth for prenatal care in a large academic practice in New York City, comparing women with public and private insurance.

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Systemic lupus erythematosus (SLE) primarily affects women of childbearing age and is commonly seen in pregnancy. The physiologic and immunologic changes of pregnancy may alter the course of SLE and impact maternal, fetal, and neonatal health. Multidisciplinary counseling before and during pregnancy from rheumatology, maternal fetal medicine, obstetrics, and pediatric cardiology is critical.

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Objective Preterm birth is a leading cause of perinatal morbidity and mortality. Prevention strategies rarely focus on preconception care. We sought to create a preconception nomogram that identifies nonpregnant women at highest risk for preterm birth using the Pregnancy Risk Assessment Monitoring System (PRAMS) surveillance data.

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Objective: Antenatal testing has been implemented for advanced maternal age (AMA) women given their increased stillbirth risk. Our objective was to evaluate cesarean delivery and induction rates after the start of antenatal testing at our institution.

Study Design: A retrospective cohort study of AMA women (≥ 40 years) who delivered at our institution was performed.

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