Researchers Discuss Their Work During Women’s Health Research Webinar
In her introduction to the Feb. 25 webinar, “Women’s Health: Research Between Bench and Bedside,” BUMC Provost and Dean, Chobanian & Avedisian School of Medicine Karen Antman, MD, noted that, historically, women have been underrepresented in health studies, including animal studies that only used males and studies that excluded women of childbearing age.
“Research has not focused on sex and gender-based differences,” Antman told the 120 people attending the webinar.
Antman cited Boston University’s ongoing important women’s health research at the Framingham Heart Study and the Black Women’s Health Study, plus studies on women military veterans and gender differences in PTSD, intimate partner violence and military sexual trauma, and numerous other research projects.
Emelia Benjamin, MD, ScM, BUMC associate provost for faculty development, introduced the webinar’s four speakers: Associate Professor of Medicine Kimberly Bertrand, ScD; Professor of Biomedical Engineering Catherine Klapperich, PhD; Professor of Pediatrics Elisha Wachman, MD; and Professor of Epidemiology Lauren Wise, MSc, ScD.
The Klapperich Laboratory is focused on lab- and organ-on-a-chip technologies, particularly as they apply to female reproductive tissues. Lab-on-a-chip is a miniature device that can perform lab functions like blood screens while organ-on-a-chip is a small handheld device that mimics human physiology using microchips. The Klapperich lab grows tissues, cells or organs on these small microfluidic chips.
Klapperich discussed her research on placental malaria, uterine fibroid organoids and the role of extravillous trophoblasts in preeclampsia. Her remarks mainly focused on human papillomavirus (HPV), a sexually transmitted disease that can cause cervical cancer, whose incidence has been dramatically reduced in the U.S. with an HPV vaccine, but kills upwards of 240,000 women a year worldwide, mostly in developing countries where there’s limited screening technologies.
Klapperich’s lab is working on technology, similar in design to an at-home pregnancy test, that could detect HPV quickly, avoiding the long trips to a clinic and extended wait times for lab test results.
“Cost-benefit analyses that have been done in rural settings have shown that HPV testing, even once in a lifetime, can make a measurable difference on the survivability of cervical cancers in those settings,” said Klapperich.
Wachman received her MD from BU, completed her pediatric residency in the Boston Combined Program and is now a neonatologist at Boston Medical Center. Most of her work has centered around infants exposed to opioids who develop neonatal opioid withdrawal syndrome.
“We here at BU have been innovators in the treatment of opioid use disorder in pregnancy and at the forefront of developing what is now becoming the standard of care for these pregnant people and infants,” Wachman said. Her research looks at ways to optimize treatment of these infants, but also how to make this experience more family centered.
“A lot of it is focused on non-pharmacologic measures like “rooming in” at the hospital (where the mother and baby are cared for in the same room), promoting breastfeeding and (other) models that have been shown to dramatically improve outcomes,” Wachman said.
Wise is Professor of Epidemiology at BU School of Public Health and Principal Investigator of Pregnancy Study Online (PRESTO), an internet-based study of more than 22,000 North American couples that has been funded by the National Institutes of Health since 2013. She cited statistics showing that fertility rates have been consistently below replacement levels in the U.S. since 2007. In 2023, that rate fell to the lowest in recorded history. Similar declines have been observed in semen quality worldwide and it is unclear what factors are driving these trends. Over the past two decades, the use of fertility treatments has increased substantially in the U.S.; however, these treatments are expensive and inaccessible to most Americans and there are large racial and socioeconomic disparities in treatment success rates.
“Thus, identifying modifiable determinants of infertility is an important public health goal,” Wise said.
PRESTO participants complete periodic online questionnaires during the preconception, pregnancy, and postpartum periods. PRESTO research has shown that preconception exposure to stress, depressive symptoms, poor diet and certain endocrine-disrupting chemicals may reduce fertility.
For example, a Mediterranean diet involving higher consumption of vegetables, fruits, whole grains, olive oil, and fish was associated with higher fertility while higher consumption of processed foods, red meat and foods that increase inflammation in the body was associated with reduced fertility.
In addition, preliminary PRESTO data show that exposure to selected per- and poly-fluoroalkyl substances (PFAS), the so-called “forever chemicals,” was associated with reduced fertility, consistent with previous literature.
Bertrand, a multiple principal investigator on the Black Women’s Health Study, is working to identify novel risk factors for breast and other cancers among Black women. The study began in 1995 with the recruitment of 59,000 Black women from across the United States.
Even though statistics show that, collectively, Black people have the highest death rate and the shortest survival rates of any racial and ethnic group in the US for most cancer types, and that Black women are 40% more likely to die of their breast cancer compared to non-Hispanic white women, widely used breast cancer risk prediction models are based primarily on data gathered from white women.
“It turns out that (the models) don’t perform quite as well in Black women, who are more likely to be diagnosed at younger ages and with more aggressive forms of disease,” Bertrand said.
By using data exclusively from Black women, the study was able to improve upon existing models and could be particularly useful for younger Black women to help guide decisions about when to start screening, Bertrand said.
“We are uniquely positioned to study the experiences of racism as a risk factor for disease,” said Bertrand
To watch a recording of the Women’s Health Research webinar, click here.