About

Alison Stuebe, MD, is a distinguished scholar in infant and young child feeding within the Department of Maternal and Child Health at the UNC Gillings School of Global Public Health. She is also a maternal-fetal medicine subspecialist and a professor of Obstetrics and Gynecology at the UNC School of Medicine. Her educational background includes completing her Obstetrics and Gynecology residency at Brigham and Women’s Hospital and Massachusetts General Hospital, as well as fellowship training in Maternal Fetal Medicine at Brigham and Women’s Hospital. She earned a Masters in Epidemiology from the Harvard School of Public Health. Dr. Stuebe has published over 220 peer-reviewed articles and has received grant funding from prominent agencies such as the NIH, AHRQ, PCORI, and the American Heart Association. Her current research focuses on advancing justice, belonging, and humanity for mothers and birthing people. She actively engages in professional organizations, serving as Chair of the Orange County Board of Health, and has been recognized with awards including the Talent Identification Program Distinguished Alumnae Award and the Award of Research Excellence from the Society of Maternal-Fetal Medicine. In clinical practice, she is a board-certified Maternal Fetal Medicine physician and Medical Director of Lactation Services for UNC Health Care, leading interdisciplinary teams and directing the Breastfeeding Medicine Consult Service. Dr. Stuebe also teaches in lactation training initiatives and presents internationally and across the US.

Research topics

• Medicine
• Nursing
• Pediatrics
• Sociology
• Family medicine
• Political Science
• Psychology
• Internal medicine
• Psychiatry
• Public relations
• Virology
• Environmental health
• Social psychology
• Obstetrics
• Gender studies
• Intensive care medicine

Selected publications

• Gestational diabetes and risk of type 2 diabetes: exploring the role of the gut microbiome in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

  Diabetologia · 2026-04-30

  articleOpen access

  AIMS/HYPOTHESIS: Women with a history of gestational diabetes mellitus (GDM) have an elevated risk of type 2 diabetes in their later life, yet the underlying mechanisms of this remain unclear. We aimed to investigate the long-term impact of GDM on gut microbiota and related metabolites and to explore whether such alterations may contribute to type 2 diabetes risk. METHODS: Among parous women from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), we identified microbial species associated with a history of GDM (visit 2, 2014-2017, n=1525), and serum metabolites associated with both a history of GDM (visit 1, 2008-2011, n=2968) and GDM-related microbiota (visit 2, n=391). We further examined prospective associations of the GDM-related microbiome (visit 2, n=925) with incident type 2 diabetes over 6 years of follow-up, and of microbial-related metabolites (visit 1, n=2341) with incident type 2 diabetes over 12 years. RESULTS: Among 1525 US Hispanic/Latino parous women (median age: 58 years), seven species differed between women with and without a history of GDM, including higher abundances of four species (e.g. Parabacteroides merdae CAG:48, a proinflammatory taxon) and lower abundances of three species (e.g. Dialister sp. CAG:588, a short-chain fatty acid producer). Fifteen metabolites were associated with both a history of GDM and the GDM-related microbiome in a consistent direction, nine of which (e.g. saturated sphingomyelins and unsaturated fatty acids) were associated with glycaemic traits and incident type 2 diabetes. Using these microbial-related metabolites as proxy measures, proxy analysis suggested a positive relationship between the GDM-related microbiome and type 2 diabetes (r=0.55, p=0.036). A metabolite score derived from the nine microbial-related metabolites mediated an estimated 20% (95% CI 9%, 42%) of the association between a history of GDM and type 2 diabetes. CONCLUSIONS/INTERPRETATION: A history of GDM is associated with an unfavourable gut microbiota and related metabolites in US Hispanic/Latino women, suggesting a potential role of the gut microbiota in GDM-related type 2 diabetes.

  PublisherDOI

• Gestational diabetes and risk of type 2 diabetes: exploring the role of the gut microbiome in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

  UNC Libraries · 2026-05-07

  articleOpen access
  PublisherDOI

• Racial and Ethnic Inequities in Postpartum Pain Evaluation and Management.

  UNC Libraries · 2025-07-24

  articleOpen access

  OBJECTIVE: To evaluate whether the frequency of pain assessment and treatment differed by patient race and ethnicity for women after cesarean birth. METHODS: We performed a retrospective cohort study of all women who underwent cesarean birth resulting in a liveborn neonate at a single institution between July 1, 2014, and June 30, 2016. Pain scores documented and medications administered after delivery were grouped into 0-24 and 25-48 hours postpartum time periods. Number of pain scores recorded, whether any pain score was 7 of 10 or greater, and analgesic medication administered were calculated. Models were adjusted for propensity scores incorporating maternal age, body mass index, gestational age, nulliparity, primary compared with repeat cesarean delivery, classical hysterotomy, and admission to the neonatal intensive care unit. RESULTS: A total of 1,987 women were identified, and 1,701 met inclusion criteria. There were 30,984 pain scores documented. Severe pain (7/10 or greater) was more common among black (28%) and Hispanic (22%) women than among women who identified as white (20%) or Asian (15%). In the first 24 hours after cesarean birth, non-Hispanic white women had more documented pain assessments (adjusted mean 10.2) than, black, Asian, and Hispanic women (adjusted mean 8.4-9.5; P<.05). Results at 25-48 hours were similar, compared with non-Hispanic white women (adjusted mean 8.3). Black, Asian, and Hispanic women and women who were identified as other all received less narcotic medication at 0-24 hours postpartum (adjusted mean 5.1-7.5 oxycodone tablet equivalents; P<.001-.05), as well as at 25-28 hours postpartum. CONCLUSION: Racial and ethnic inequities in the experience, assessment and treatment of postpartum pain were identified. A limitation of our study is that we were unable to assess the role of patient beliefs about expression of pain, patient preferences with regards to pain medication, and beliefs and potential biases among health care providers.

  PublisherDOI

• 182-OR: Serum Metabolomic Profiles Link History of Gestational Diabetes Mellitus to Increased Type 2 Diabetes Risk in U.S. Hispanic/Latino Women

  Diabetes · 2025-06-13

  article

  Introduction and Objective: Long-term impacts of gestational diabetes mellitus (GDM) on host metabolism are unknown. We aimed to identify serum metabolites linking history of GDM to type 2 diabetes (T2D). Methods: Among 2968 parous women in the Hispanic Community Health Study/Study of Latinos, we performed a metabolome-wide association analysis to identify metabolites associated with history of GDM; constructed GDM-related metabolite modules using network analysis; created a GDM-related metabolite score using elastic net regression; and linked these metabolite signatures with incident T2D over 12 years. Results: Ninety-six metabolites differed for women with and without history of GDM, 94 of which clustered into 5 modules. Amino acid (AA) module (mostly branched-chain and aromatic AA derivatives) and phosphatidylethanolamine module were positively associated with history GDM and T2D risk, while glycerophospholipid, acyl choline, and sphingomyelin modules were inversely associated with history of GDM and T2D risk (Fig A). The GDM-related metabolite score (Fig B) was associated with higher risk of T2D (HR = 1.37 [95% CI: 1.23-1.54] per SD, Fig C). AA module and the metabolite score partially mediated the association between history of GDM and T2D (29% and 30%). Conclusion: Circulating metabolites may play a role in GDM-related T2D risk in US Hispanic/Latino women. Disclosure Y. Wang: None. C.R. Isasi: None. A. Stuebe: Other Relationship; Couplet Care. M.L. Daviglus: None. E. Boerwinkle: None. R. Burk: None. R. Kaplan: None. Q. Qi: None. B. Peters: None. Funding American Diabetes Association (11-23-PDF-60)

  PublisherDOI

• Association of Prepregnancy Cardiometabolic Markers With Early Childhood Weight in a Study of Hispanic Dyads

  Obstetrics and Gynecology · 2025-12-18

  article

  OBJECTIVE: To investigate associations between prepregnancy cardiometabolic risk factors and early childhood weight status, independent of genetic susceptibility. METHODS: The ancillary study of the HCHS/SOL (Hispanic Community Health Study/Study of Latinos) included 227 dyads consisting of Hispanic/Latina mothers who had singleton live births between baseline and visit 2 and their children, aged 3-9 years. Child outcomes included body mass index (BMI) z-scores, and weight status categories. Maternal prepregnancy biomarkers included fasting triglycerides, high-density lipoprotein cholesterol (HDL-C), glucose, insulin, blood pressure, BMI, and waist circumference. Child DNA was used to calculate a polygenic risk score for obesity. Linear and logistic regression models adjusted for confounders and child genetic risk. RESULTS: On average, 10.9 years elapsed between maternal baseline assessment and child anthropometry. At baseline, 4.8% of women reported having diabetes or hypertension, one-third had obesity (BMI 30 or higher), and more than half had elevated waist circumference or low HDL-C. Among children (mean age 7.5 years), 17.2% were categorized as having overweight and 27.8% were categorized as having obesity. Higher maternal BMI, larger waist circumference, and higher fasting insulin and diastolic blood pressure were significantly associated with higher child BMI z-scores. A 1-SD increase in maternal BMI (6.1 units) or waist circumference (13.3 cm) was linked to greater odds of child overweight or obesity. Elevated maternal insulin was associated with having a child with overweight status, and higher diastolic blood pressure with having a child in the obesity category in minimally adjusted models. CONCLUSION: Prepregnancy cardiometabolic risk factors in Hispanic/Latina women are associated with higher BMI and obesity risk in their children, independent of genetic predisposition. These findings highlight the prepregnancy period as a critical window for interventions to improve intergenerational health outcomes.

  PublisherDOI

• Preconception Diet Quality Is Associated with Birth Weight for Gestational Age Among Women in the Hispanic Community Health Study/Study of Latinos

  UNC Libraries · 2025-06-28

  articleOpen access
  PublisherDOI

• Systems Safety: Identifying Facilitators, Barriers, and Failure Modes to Quality Patient Care on a Postnatal Unit

  Journal of Patient Safety · 2025-08-12

  article

  BACKGROUND: The postpartum period is critical for safeguarding the health and well-being of birthing parents. After delivery, birthing parents will spend an average of 24 to 48 hours in the hospital during the postnatal stay where health care workers (HCWs) monitor them, identify treatment needs, assist with breastfeeding, conduct depression assessments, and provide education. Identifying clinical system factors hindering the provision of high-quality care is critical to improving care and addressing the challenges faced by HCWs and birthing parents during inpatient postpartum care. Thus, this study was to identify barriers and facilitators that impact HCWs' work and care delivery within the postnatal unit. METHODS: The study involved a secondary analysis of observational data collected in a postnatal unit of a large, academic hospital in the United States. Barriers and facilitators were identified and coded using the System Engineering and Initiative for Patient Safety 2.0 model and the Healthcare Performance Improvement Taxonomies of Individual and System Failure Modes. RESULTS: A total of 87 barriers and 18 facilitators were identified. Common barriers included challenges with communication between HCWs, insufficient and unclear patient education, space constraints, and insufficient tools and technology. Facilitators included informed consent with patients and accessible educational tools that support HCWs in the provision of care. CONCLUSIONS: The findings from this research can inform the design and improvement of postnatal units to improve patient safety and support HCWs in providing high-quality, responsive, and patient-centered care.

  PublisherDOI

• Adverse life events, psychiatric history, and biological predictors of postpartum depression in an ethnically diverse sample of postpartum women

  UNC Libraries · 2025-09-17

  articleOpen access

  BACKGROUND: Race, psychiatric history, and adverse life events have all been independently associated with postpartum depression (PPD). However, the role these play together in Black and Latina women remains inadequately studied. Therefore, we performed a case-control study of PPD, including comprehensive assessments of symptoms and biomarkers, while examining the effects of genetic ancestry. METHODS: We recruited our sample (549 cases, 968 controls) at 6 weeks postpartum from obstetrical clinics in North Carolina. PPD status was determined using the MINI-plus. Psychiatric history was extracted from medical records. Participants were administered self-report instruments to assess depression (Edinburgh Postnatal Depression Scale) and adverse life events. Levels of estradiol, progesterone, brain-derived neurotrophic factor, oxytocin, and allopregnanalone were assayed. Principal components from genotype data were used to estimate genetic ancestry and logistic regression was used to identify predictors of PPD. RESULTS: This population was racially diverse (68% Black, 13% Latina, 18% European). Genetic ancestry was not a predictor of PPD. Case status was predicted by a history of major depression (p = 4.01E-14), lifetime anxiety disorder diagnosis (p = 1.25E-34), and adverse life events (p = 6.06E-06). There were no significant differences between groups in any hormones or neurosteroids. CONCLUSIONS: Psychiatric history and multiple exposures to adverse life events were significant predictors of PPD in a population of minority and low-income women. Genetic ancestry and hormone levels were not predictive of case status. Increased genetic vulnerability in conjunction with risk factors may predict the onset of PPD, whereas genetic ancestry does not appear predictive.

  PublisherDOI

• Telehealth to provide prenatal genetics services: Feasibility and importance revealed during global pandemic

  UNC Libraries · 2025-07-11

  articleOpen access1st authorCorresponding

  Traditionally, prenatal genetic counseling is performed with face to face counseling in a prenatal diagnosis center. However, alternative forms of genetic counseling are available including use of telephone counseling, group counseling, and use of decision aids. Telegenetics services can benefit patients living in rural areas where there is limited access to providers with genetics expertise. Many women in the United States do not have access to prenatal genetic counseling and receive limited access to standard aneuploidy and carrier screening options because of insurance status even though these options should be offered to all pregnant women. Prenatal telegenetics services can address these inequalities but thus far have not been used broadly due to limited reimbursement and hospital unwillingness to provide the necessary start-up costs to implement prenatal genetics telehealth services.

  PublisherDOI

• Bridges to treatment satisfaction: the roles of trauma, social support, race and ethnicity among perinatal women receiving behavioural activation therapy

  BMC Medicine · 2025-08-20

  articleOpen access

  BACKGROUND: High treatment satisfaction is related to improved treatment adherence and outcomes in psychotherapy research. Satisfaction with psychotherapy treatment among racially and ethnically diverse perinatal populations with post-traumatic stress (PTS) remains understudied. The aims of this study are to examine the relations between PTS symptoms, perceived social support, and race and ethnicity, and treatment satisfaction among perinatal women receiving behavioural activation (BA) psychotherapy. METHODS: This is a mixed-methods study of the Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) trial-a large, multi-site, non-inferiority trial for perinatal women with depressive and anxiety symptoms (NCT04153864). A two-sample t-test compared baseline PTS symptoms, social support, and treatment satisfaction between participants from white and racial and ethnic minority groups. Hierarchical multiple linear regression examined whether PTS symptoms, perceived social support, race and ethnicity predicted treatment satisfaction. Content analysis of open-ended responses explored facilitators and modifications for improving treatment satisfaction across PTS symptom severity and race and ethnicity. RESULTS: Of 1230 women, 1119 (90.98%) had ≥ 1 BA session. Compared to their white counterparts, baseline PTS symptom severity was higher (t(1087) = - 4.98; p < 0.001; 95% CI = - 2.23, - 0.97), and social support lower (t(1087) = 8.05; p < 0.001; 95% CI = 0.43, 0.71) among racial and ethnic minority women. Lower baseline PTS symptom severity (β = - 0.009; 95% CI = - 0.016, - 0.002) and higher perceived social support (β = 0.042; 95% CI = 0.013, 0.072) were associated with higher post-treatment satisfaction across the sample. Descriptive analysis revealed no differences in treatment satisfaction across race and ethnicity; treatment satisfaction was higher for racial and ethnic minority women when social support was added to the regression model (β = 0.077; 95% CI = 0.005, 0.149). Content analysis (n = 807) revealed no differences by PTS symptoms severity or race and ethnicity across reported facilitators and modifications. BA as a treatment modality (n = 446, 55.27%) was a key facilitator; modifications included more sessions (n = 202, 25.03%). CONCLUSIONS: PTS symptom severity and social support predict treatment satisfaction among racially and ethnically diverse perinatal populations and should be considered when delivering psychotherapy. TRIAL REGISTRATION: ClinicalTrials.gov NCT04153864. Registered on November 6, 2019.

  PublisherOA PDFDOI

Recent grants

• NIH Grant R21DK092750

  NIH · $401k · 2015

• Mood, mother and infant: The psychobiology of impaired dyadic development

  NIH · $2.9M · 2013–2019

Frequent coauthors

• Valery A. Danilack-Fekete

  Yale University

  128 shared

• Ian J. Saldanha

  128 shared

• Kenneth K. Chen

  Kaiser Permanente Oakland Medical Center

  128 shared

• Alex Peahl

  University of Michigan–Ann Arbor

  127 shared

• Michael L. Zahradnik

  Brown University

  127 shared

• Gaelen P. Adam

  Providence College

  127 shared

• Ghid Kanaan

  Providence College

  127 shared

• Ethan M. Balk

  Brown University

  127 shared

Awards & honors

• Talent Identification Program Distinguished Alumnae Award 20…
• Award of Research Excellence 2016, Society of Maternal-Fetal…
• Jefferson Pilot Faculty Scholar 2013, University of North Ca…