1st annual Nine Months Matter: Walkfest for Alcohol-Free Pregnancy is held at Liberty Station in San Diego, CA with Dr. Jones, SoCal NOFAS, and the Rady Children’s Hospital Auxiliary as key organizers.
Rady Children’s Hospital offers clinical training in Genetics-Dysmorphology with Center for Better Beginnings’ leaders in the Rady Children’s Hospital Genetics/Dysmorphogy Clinic. All medical fellowships are designed to train residents in the approach to evaluation, diagnosis, and management of individuals with a wide variety of birth defects, developmental and genetic problems.
The Centers for Disease Control and Prevention (CDC) recommends MotherToBaby as a go-to resource for information on the Zika virus in pregnancy. Families can speak to an information specialist about a possible Zika virus infection or diagnosis. As part of the MotherToBaby network, our MotherToBaby California experts are available by phone, email or live-chat for free services in English or Spanish.
MotherToBaby has been a long-standing resource recommended by the CDC on medication and other exposures in pregnancy and breastfeeding, and we are proud to stand together in the fight against Zika.
The main goal of the study is to monitor planned and unplanned pregnancies exposed to apremilast and to evaluate the possible teratogenic effect of this medication relative to specified pregnancy outcomes, and to evaluate potential effects of prenatal apremilast exposure on infant health through one year of age.
This contract is to manage the ongoing surveillance program for birth defects in representative California counties as conducted by the Maternal, Child and Adolescent Health Division of the California Department of Health.
Two major goals of this program are to provide telephone information to pregnant women and healthcare providers throughout the State of California regarding the teratogenicity of various agents and investigate the pregnancy outcomes of women with prenatal exposure to various agents.
The purpose of the OTIS Autoimmune Diseases in Pregnancy Project, Certolizumab Pegol Pregnancy Exposure Registry is to follow pregnant women with or without rheumatoid conditions or Crohn’s disease who have or have not been treated with certolizumab pegol during pregnancy to evaluate the possible effect of these diseases and/or this medication on the pregnancy outcome including child development and growth up to five years of age.
The goal of this study is to establish an accurate, population-based prevalence estimate of Fetal Alcohol Spectrum Disorders in San Diego by systematically evaluating a representative sample of children in the San Diego School System, children in foster care, and children who have developmental disabilities.
This study develops a culturally tailored design for a model NOFAS program “from within” native community setting.
The major goal of this project is to evaluate children prenatally exposed to alcohol and unexposed comparison subjects. In order to train additional physicians this study will develop a training DVD to teach physicians an approach to diagnose FASD. This study will also develop a tele-communication system whereby physicians in remote areas with little or no expertise in diagnosis of FASD can consult with a remotely located expert on a physical examination of a child being evaluated for FASD.
The main goal of this project is the identification of effective methods for prevention and early intervention for Fetal Alcohol Spectrum Disorders (FASD). In this longitudinal study in Ukraine, earlier identification and prevention of FASD is being evaluated in four areas: a) the contribution of pre and postnatal nutritional factors to risk for FASD, b) development of a preschool neurobehavioral testing battery appropriate for early identification of affected children, c) the utility of a novel and objective biomarker of exposure to alcohol, and d) exploration of genetic and epigenetic factors that may modify risk for FASD in mother/child pairs.
The Western Practice and Implementation Center will develop, disseminate and evaluate discipline-specific trainings on fetal alcohol spectrum disorders for pediatricians and women’s health and perinatal nurses.
Based on data from an ongoing intervention trial in Ukraine conducted in a sample of high-alcohol consuming pregnant women, this study will follow the approximately 300 children born to those women and comparison women who have been retained in the cohort study to evaluate the contribution or effect modification of child nutritional status on neurodevelopment and growth.
The goal of this initiative is to improve maternal and fetal health outcomes by providing education, individualized counseling, improved access to resources, and advancing the knowledge base related to safety of exposures to medications and environmental agents before, during, and after pregnancy.
The main goal of this project is to evaluate the maternal and fetal risks associated with the use of the afluria influenza vaccine during pregnancy.
This study investigates pregnancy outcomes of women with rheumatic diseases and Crohn’s Disease and prenatal exposure to adalimumab compared to unexposed disease-matched and non-diseased control groups.
The main goal of this project is to evaluate the maternal and fetal risks associated with the use of Mepolizumab during pregnancy.
The main goal of this project is to evaluate the fetal risk associated with the use of a new multiple sclerosis drug during pregnancy.
The main goal of this study is to follow pregnant women with or without rheumatoid arthritis who have or have not been treated with tofacitinib during pregnancy to evaluate the possible effect of the disease and/or this medication on pregnancy outcome including child development and growth up to one year of age.
The specific aim of this study is to monitor planned and unplanned pregnancies exposed to ustekinumab, to evaluate whether there are any teratogenic effects of this medication in pregnancy outcomes, and to evaluate potential effects of prenatal ustekinumab exposure on infant health status through one year of age.
The purpose of the OTIS Entyvio Pregnancy Exposure Registry is to monitor planned and unplanned pregnancies in UC or CD female patients exposed to vedolizumab and to evaluate any possible association between this medication and pregnancy outcome, including the health of the mother, fetus, and infant.
The major goal of this project is evaluate the fetal risk associated with the use of the generic product leflunomide, a medication used for the treatment of rheumatoid arthritis, during the first trimester of pregnancy.
In collaboration with the American Academy of Asthma, Allergy, and Immunology (AAAAI), and in conjunction with a complementary project conducted by the Slone Epidemiology Center’s Birth Defects Study (BDS), this cohort study will generate and test hypotheses related to the comparative risk (or safety) for birth defects and other adverse outcomes of pregnancy associated with asthma medications.
The goals of this study are to monitor and evaluate fetal and maternal risk with respect to H1N1 vaccine, seasonal influenza vaccine, and antiviral medications used to prevent or treat influenza.
The main goal for this project is to evaluate the fetal risk associated with the use of Actemra when used to treat rheumatoid arthritis in pregnancy.
The Center for Better Beginnings actively contributes to the understanding of birth defects and pregnancy outcomes by publishing articles in scientific journals detailing the findings of our research. We have published articles on topics that include but are not limited to:
Jones KL, Chambers C. Biomarkers of fetal exposure to alcohol: identification of at-risk pregnancies. J Pediatr. 1998;133:316-8 .
Chambers CD, Jones KL. Is genotype important in predicting the fetal alcohol syndrome? Pediatrics. 2002;141:751-2.
Jones KL, Chambers CD, Hill LL, Hull AD, Riley EP. Alcohol use in pregnancy: inadequate recommendations for an increasing problem. BJOG. 2006;113(8):967-8.
Chambers CD, Kavteladze L, Joutchenko L, Bakhireva L, Jones KL. Alcohol consumption patterns among pregnant women in the Moscow region of the Russian Federation. Alcohol. 2006;38(3):133-7.
Jones KL, Robinson L, Bakhireva L, Marintcheva G, Storojev V, Strahova A, Sergeevskaya S, Budantseva S, Mattson S, Riley E, Chambers C. Accuracy of the diagnosis of fetal alcohol syndrome by pediatricians after specialized training. Pediatrics. 2006;118(6):e1734-8.
Jones KJ, Hoyme HE, Robinson LK, del Campo M, Manning MA, Prewitt L, Chambers CD. Fetal alcohol spectrum disorders: extending the range of structural defects. Am J Med Genet A. 2010;152A:2731-5. PMCID:PMC3143840
Chambers CD, Yevtushok L, Zymak-Zakutnya N, Korzhynskyy Y, Ostapchuk L, Akhmedzhanova D, Chan PR, Xu R, Wertelecki W. Prevalence and predictors of maternal alcohol consumption in 2 regions of Ukraine. Alcohol Clin Exp Res. 2014;38(4):1012-9.
Chambers CD, Johnson KA, Dick LM, Felix RJ, Jones KL. Birth outcomes in pregnant women taking fluoxetine. New Engl J Med. 1996;335:1010-5 .
Chambers CD1, Hernandez-Diaz S, Van Marter LJ, Werler MM, Louik C, Jones KL, Mitchell AA. Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn. N Engl J Med. 2006 Feb 9;354(6):579-87.
Chambers CD, Moses-Kolko E, Wisner KL. Antidepressant use in pregnancy: new concerns, old dilemmas. Expert Rev Neurother. 2007;7(7):761-4.
Chambers CD. Selective serotonin reuptake inhibitors and congenital malformations. BMJ. 2009;339:b3525.
Chambers C. Safety of asthma and allergy medications in pregnancy. Immunol Allergy Clin North Am. 2006;26:13-28.
Bakhireva LN, Schatz M, Jones KL, Chambers CD. Asthma control during pregnancy and the risk of preterm delivery or impaired fetal growth. Ann Allergy Asthma Immunol. 2008;101:137-43.
Chambers CD, Tutuncu ZN, Johnson D, Jones KL. Human pregnancy safety for agents used to treat rheumatoid arthritis: adequacy of available information and strategies for developing post-marketing data. Arthritis Res Ther. 2006;8(4):215.
Chambers CD, Johnson DL, Robinson LK, Braddock SR, Xu R, Lopez-Jimenez J, Mirrasoul N, Salas E, Luo YJ, Jin S, Jones KL, OTIS Collaborative Research Group. Birth outcomes in women who have taken leflunomide during pregnancy. Arthritis Rheum. 2010;65(5):1494-1503.
Cassina M, Johnson D, Robinson L, Braddock S, Xu R, Lopez-Jimenez J, Mirrasoul N, Salas E, Luo Y, Jones KL, Chambers CD; the Organization of Teratology Information Specialists Collaborative Research Group. Pregnancy outcome in women exposed to leflunomide before or during pregnancy. Arthritis and Rheum. 2012;64(7):2085-94.
Chambers CD, Johnson DL. Emerging data on the use of anti-tumor necrosis factor-alpha medications in pregnancy. Birth Defects Res A Clin Molec Teratol. 2012;94(8):607-11.
Chambers CD, Jones KL, Lammer EJ, Van Bennekom CM, Mitchell AA. Accutane-exposed pregnancies – California, 1999. MMWR. 2000;49:28-31 .
Jones KL, Johnson KA, Dick LM, Felix RJ, Kao KK, Chambers CD. Pregnancy outcomes after first trimester exposure to phentermine/fenfluramine. Teratology. 2002;65:125-30.
Chambers CD, Jones KL. Risk for fetal death after fever in pregnancy. Lancet. 2002;360:1526. http://www.ncbi.nlm.nih.gov/pubmed/12443593
Chambers CD, Johnson D, Xu R, Luo Y, Louik C, Mitchell AA, Schatz M, Jones KL; OTIS Collaborative Research Group. Risks and safety of pandemic H1N1 influenza vaccine in pregnancy: birth defects, spontaneous abortion, preterm delivery, and small for gestational age infants. Vaccine. 2013;31(44):5026-32.
Chambers CD, Castilla EE, Orioli I, Jones KL. Intrauterine growth restriction in like-sex twins discordant for structural defects. Birth Defects Res Part A Clin Mol Teratol. 2006;76(4):246-8.
Chambers CD, Chen BH, Kalla K, Jernigan L, Jones KL. Novel risk factor for gastroschisis: change in paternity. Am J Med Ge net. 2007;143(7):653-9.
Jones KL, Benirschke K, Chambers CD. Gastroschisis: etiology and developmental pathogenesis. Clin Genet. 2009;75(4):322-5.
Jones KL, Jones MC. 50 years ago in the J Pediatr: The no.18 trisomy syndrome. J Pediatr. 2012; 160(4):566.
Jones KL, Weiss LA, Hagey LR, Gonzalez V, Benirschke K, Chambers CD. Altered lipid metabolism in gastroschisis: a novel hypothesis.Am J Med Genet A. 2013;161A(8):1860-5.
Chambers C. The role of teratology information services in screening for teratogenic exposures: challenges and opportunities. Am J Med Genet C Semin Med Genet. 2011;157C(3):195-200.
Chambers CD, Braddock SR, Briggs GG, Einarson A, Johnson YR, Miller RK, Polifka JE, Robinson LK, Stepanuk K, Jones KL. Post marketing surveillance for human teratogenicity: a model approach. Teratology. 2 001;64:252-61.
Chambers CD. Value of the small cohort study including a physical examination for minor structural defects in identifying new human teratogens. Congenit Anom (Kyoto). 2011;51(1):16-20
To view a complete list of publications from each of our faculty, click on the author’s name below:
What can we do to reach women at risk of drinking alcohol during pregnancy?
Annika Montag, PhD, a postdoctoral scholar at UC San Diego’s Center for Better Beginnings, published a paper on this topic in the International Journal of Women’s Health. According to Dr. Montag, “This review explores the pros and cons of three common approaches used to identify women at risk for having a child with Fetal Alcohol Spectrum Disorder (FASD). We found that a combination of two approaches was most effective to reach at-risk women: a self-assessment to obtain a report from the woman about her alcohol consumption plus biomarker screenings to pinpoint genetic predisposition to alcohol’s harmful effects.”
The Center for Better Beginnings at UC San Diego is a medical division of the Department of Pediatrics. We bring together multiple specialty programs that work together to promote maternal health and child development. Running throughout our work is the mission to advance the identification, prevention, and treatment of preventable birth defects.
Pregnancy is typically a 40-week journey, characterized by rapid fetal development. During this time, a pregnancy is susceptible to multiple outside influences. Even after entering into the world, a baby’s development can continue to be influenced a parent’s exposures if they are chestfeeding. We examine how maternal and infant health can be impacted by the conditions, exposures and treatments a woman is exposed to during pregnancy and while breastfeeding.
By the time you count to 10 more than 60 people will become pregnant worldwide. Only in partnership with parents, health care providers, and community and government leaders can we improve the health of our future generations. Our Center acts as a central hub to bring these key players together. Our focus is on a person’s health before they become pregnant, during pregnancy and childbirth, and during lactation to explore how maternal and other environmental exposures impact a baby’s development.
The Center for Better Beginnings focuses on four major areas of maternal and infant health:
(1) clinical care of patients with birth defects and developmental disabilities;
(2) conducting pregnancy research to better understand the causes, prevention and treatment of birth defects and developmental disabilities;
(3) teaching future generations of professionals in the fields of epidemiology, pediatrics, dysmorphology, genetics, pharmacology, and health behavior; and
(4) educating the public about prenatal exposures and exposures during breastfeeding and their impact on child development and health.
Threaded throughout these four major focus areas is our dedication to reducing disparities in the field of maternal and child health.
Expectant and new parents rely on medical professionals and trained staff to recognize problems and provide advanced care. The Center for Better Beginnings offers professional training to medical fellows and pre- and post-doctoral research scholars in the fields of dysmorphology, genetics, epidemiology and teratology.
To complement our higher education offerings, we also provide educational workshops to health care providers, social service professionals, and the general community to educate them about the causes and impact of birth defects and how they may prevented. Our workshops are expertly crafted to educate the public by promoting maternal health and child development.
By understanding the reason why certain birth defects occur, we are in a better position to prevent them. The Center for Better Beginnings is driving scientific advancement through our innovative research, addressing the gaps in knowledge related to exposures during pregnancy and while breastfeeding that could impact baby’s development. Find out how we are making research come to life, and impacting the health of future moms and babies.
We want every baby to have the best start in life—and if there are challenges to overcome, we’re here to provide superb clinical services. Medical staff at the Center for Better Beginnings evaluate, diagnose, and treat children with birth defects. The seamless integration of our medical staff holding dual privileges at Rady Children’s Hospital-San Diego (RCHSD) and UC San Diego Health allows for the best patient care and access to the largest possible network of specialists. In addition, our Fetal Alcohol Spectrum Disorders program enables experts to screen and refer patients to RCHSD for evaluation, and also provides counseling and support to families affected by these disorders.
