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  • Completed: Obtain approvals
    Obtained necessary approvals to conduct the study: California Health and Human Services Agency Committee for the Protection of Human Subjects — assures ethical conduct of the study Office of Vital Records, Office of Statewide Health Planning and Development — birth records data Department of Developmental Services — autism diagnosis data California Biobank Program — newborn screening specimens, screening data, cross-generational linkage data
  • Ongoing: Conduct community outreach activities
    Engage community stakeholders and post research briefs and updates throughout the study.
  • Completed: Collect data from study partners
    Collected data from multiple sources, including birth records, hospital discharge, newborn screening and developmental services records, and neighborhood-level data on social context, air pollution, and walkability.
  • Completed: Link data
    Linked multigenerational data from the California Biobank Program to hospital discharge and developmental services records to identify cases with chronic hypertension or autism spectrum disorder, as well as to neighborhood-level data via geocodes. Before study exclusions, the multigenerational cohort has over 145,000 White women and 56,000 Black women born in California since 1982 who delivered a baby between 2007 and 2011.
  • Completed: Conduct sampling
    Using a case-cohort sampling, selected a small subset of Black and White mothers from the multigenerational cohort whose newborn screening specimens would be analyzed for the tobacco biomarker cotinine (~2,400 subjects total).
  • In Progress: Descriptive analysis
    While awaiting lab results, create study variables, describe sampled groups, assess representativeness, identify multigenerational predictors of the four study outcomes, and test our statistical methods.
  • In Progress: Obtain Archived Specimens
    The California Biobank Program is pulling ~2,400 archived newborn screening specimens from freezer storage and shipping them to our partnering laboratory at UCSF.
  • In Progress: Conduct laboratory analysis
    The UCSF Tobacco Biomarker Core Facility is conducting cotinine analysis and providing batches of data to study investigators.
  • Planned: Conduct data analysis
    Following linkage of laboratory results to our study samples, describe patterns of in utero exposure to prenatal smoking, and its association with later obesity and chronic hypertension, and very preterm birth and autism in the third generation. Assess the impact of in utero exposure to smoking on racial and socioeconomic health disparities.
  • Planned: Manuscript development
    Submit manuscripts for publication, covering multigenerational risk factors for study outcomes; patterns and predictors of in utero exposure to prenatal smoking; effects of in utero exposure to smoking on maternal obesity, chronic hypertension, very preterm birth, and autism, including impact on health disparities
  • Planned: Hold communication forums
    Facilitate in person and/or online communication forums to interpret and disseminate findings.

This project is funded by the Tobacco-Related Disease Research Program (award T301R0925).

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