About

Within the frameworks of evolutionary and developmental biology, my research focuses on maternal and grandmaternal transgenerational transmission of phenotypes, life-history patterns, and disease risk. I synthesize information from molecular, clinical, epidemiological, and anthropological research towards understanding the evolutionary context of human health and disease, family and societal structure, and addressing global health challenges.

Research topics

• Biology
• Bioinformatics
• Developmental psychology
• Psychology
• Medicine
• Ecology
• Clinical psychology
• Evolutionary biology
• Social psychology

Selected publications

• Pregnancy and breastfeeding are associated with less later‐life cognitive decline in a longitudinal, prospective cohort

  Alzheimer s & Dementia · 2026-01-01

  articleOpen access1st authorCorresponding

  INTRODUCTION: The brains of female mammals evolved to undergo structural and functional changes during pregnancy and lactation, equipping them for motherhood. However, long-term cognitive health implications of these adaptations in women are poorly understood. METHODS: In the Women's Health Initiative (WHI) Memory Study (WHIMS; n = 7427) and WHI Study of Cognitive Aging (WHISCA; n = 2304), postmenopausal women completed reproductive history interviews, annual global cognitive assessment from mean age 70 for up to 13 years, and multi-domain cognitive testing for up to 8 years. RESULTS: Each additional month pregnant was associated with higher scores of global cognition. Each additional month of breastfeeding corresponded to higher scores of global cognition, verbal memory, and visual memory. We observed equivalent results for binary formulations of gravidity and breastfeeding. DISCUSSION: Low rates of fertility and breastfeeding may have implications for postmenopausal cognitive health at the population level. Next steps include examining mechanisms linking women's reproductive history with postmenopausal cognitive health. HIGHLIGHTS: Motherhood may leave an enduring mark on women's brains, shaping cognitive health. Over 7000 women were assessed annually from approximately age 70 for up to 13 years. Ever being pregnant and cumulative time pregnant were linked with better cognition. Ever having breastfed and more time breastfeeding were linked with better cognition. These results imply that declining fertility may affect cognitive aging in future generations.

  PublisherOA PDFDOI

• Of scents and cytokines: How olfactory and food aversions relate to nausea and immunomodulation in early pregnancy

  Evolution Medicine and Public Health · 2025-01-01 · 2 citations

  articleOpen accessSenior author

  Background: During pregnancy, the maternal body undergoes extensive physiological adaptations to support embryonic growth, including whole-body remodeling, that may induce odor and food aversions, as well as nausea and vomiting. The biological mechanisms behind odor and food aversions, as well as nausea and vomiting in early pregnancy, remain largely unexplored. Our study investigated associations between these changes and cytokine profiles during pregnancy. Methodology: = 58) completed a structured questionnaire on pregnancy "morning sickness"-related symptoms and aversions. Maternal plasma cytokine levels were measured between 5 and 17 weeks' gestation. Results: About 64% of participants experienced odor or food aversions, primarily to tobacco smoke and meat; 67% reported nausea, and 66% experienced vomiting. Multivariable linear regression models revealed that odor aversions were associated with increased pro-inflammatory T-helper-cell type (Th) 1 composite cytokine levels. Women who found tobacco smoke aversive exhibited a shift toward Th1 immune responses, indicated by a higher Th1:Th2 ratio. Food aversions also showed a positive association with Th1 cytokine levels. A borderline positive association was noted between nausea and vomiting and the Th1:Th2 ratio. Conclusions: These findings are consistent with the hypothesis that gestational changes in olfactory and gustatory experience, and nausea and vomiting, reflect adaptive upregulation of behavioral prophylaxis in ways that could protect the fetus. If this elevated Th1:Th2 ratio and pro-inflammatory phenotype are part of the maternal and embryonic response to embryogenesis, the behavioral and biological markers that we explore may provide an accessible index of fetal development during early pregnancy.

  PublisherOA PDFDOI

• Regulatory B‐Cells Are Associated Negatively With Regulatory T‐Cells and Positively With Cytokines in Peripheral Blood of Pregnant Women

  American Journal of Reproductive Immunology · 2025-01-24 · 3 citations

  articleOpen accessSenior authorCorresponding

  ABSTRACT Problem Regulatory B‐cells (Bregs, CD19 + CD24 hi CD38 hi ) are a specialized B‐cell subset that suppresses immune responses and potentially contribute to the maintenance of an immune‐privileged environment for fetal development during pregnancy. However, little is known about the surrounding immunological environment of Bregs in gestational physiology. The relationship of regulatory T‐cells (Tregs, CD4 + CD25 hi CD127 lo FoxP3 + ) to Bregs in coordinating immunoregulation during pregnancy is unknown. We aimed to determine whether peripheral concentrations of Bregs and/or PD‐L1‐expressing Bregs correlated with Tregs and cytokines during pregnancy. Method Peripheral blood samples were obtained from 29 pregnant women at mean 12 weeks’ gestation. Participants were age ≥ 18, self‐identified as Latina/Hispanic, and N = 12 primigravid. Peripheral blood mononuclear cells were isolated, stained, and analyzed by flow cytometry to determine percentages of Tregs from CD4 + T‐cells and five Treg subsets defined by immune checkpoint markers, and Bregs and PD‐L1 + Bregs from total B‐cells. Levels of 13 cytokines were measured on a Meso Scale Discovery multiplex platform. Results Bregs positively correlated with pro‐inflammatory cytokine interleukin (IL)‐6. PD‐L1 + Bregs positively correlated with T‐cell suppressive cytokine IL‐10. PD‐L1 + Bregs negatively correlated with Tregs and Helios + , CTLA‐4 + , PD‐1 + , TIGIT + , and TIM3 + Tregs. For primigravida, PD‐L1 + Bregs correlated positively with IL‐10 and negatively with Helios + and TIGIT + Tregs. For multigravida, PD‐L1 + Bregs correlated positively with IL‐8 and negatively with Helios + , CTLA‐4 + , PD‐1 + , and TIGIT + Tregs. Conclusions This study provides insight into the immunosuppressive role of Bregs and PD‐L1 + Bregs during human pregnancy. Our results suggest that PD‐L1 + Bregs can employ suppressive mechanisms to limit pro‐inflammatory responses in primigravida.

  PublisherOA PDFDOI

• Regulatory T‐Cells During Pregnancy Relate to Women's Own Childhood History of Microbial Exposure

  American Journal of Human Biology · 2025-02-28 · 1 citations

  articleOpen access1st authorCorresponding

  OBJECTIVES: Previous studies found that children with siblings, farm residence, and other proxies of greater microbial contacts had lower rates of hyper-responsive immune disorders. Yet, scientific debate persists regarding whether the human immune system is educated in early life primarily as a function of pathogenic or benign microbial exposures, or both. Furthermore, pregnancy relies on women's intrinsic immunosuppressive function, yet it remained unknown how immunoregulation in pregnant women relates to early-life microbial exposures. Here, we conduct a preliminary examination of whether childhood microbial exposures prime women's pregnancy-related immunoregulatory capacity. METHODS: We administered retrospective questionnaires to estimate 55 pregnant women's early-life exposure to pathogenic (e.g., illness) and benign (e.g., pets; rural residence) microbes. Tolerogenic regulatory T-cells (Tregs) and Treg subtypes were measured by flow cytometry from peripheral blood. RESULTS: Results show that proxies for both pathogenic and benign exposures were positively associated with Treg concentrations. CONCLUSIONS: These findings offer insights that may help elucidate the relative contributions of early-life pathogenic ("hygiene hypothesis") and benign ("old friends hypothesis") microbial exposures toward the expansion of the Treg compartment. Human evolutionary history is characterized by changing microbial exposures as human residency patterns, living environments, and subsistence strategies changed. In this context, our findings suggest the possibility of less gestational pathology in human evolutionary past conditions typified by richer diversity of microbial exposure.

  PublisherOA PDFDOI

• Women’s history of breastfeeding is positively associated with post‐menopausal cognitive function

  Alzheimer s & Dementia · 2024-12-01

  articleOpen access1st authorCorresponding

  Abstract Background Women’s reproductive experiences may enact reorganization of physiological systems with lifelong health consequences. We test the hypothesis that women’s history of breastfeeding will be positively associated with neurocognitive benefits in post‐menopausal women. This hypothesis is justified by breastfeeding’s well‐established benefits for mothers’ glucose homeostasis, beta‐cell function, adipose tissue mobilization, and lipid metabolism, which would plausibly be beneficial for later‐life brain health. Method The Women’s Health Initiative (WHI) was a long‐term, large, US health study in the 1990s‐early 2000s. The WHI Memory Study (WHIMS) was an ancillary study in which cognitively healthy women at baseline were annually assessed. A subset of WHIMS participants were recruited into the WHI Study of Cognitive Aging (WHISCA), which included more comprehensive annual assessments of cognitive function and mood. We use WHIMS participant scores on the Modified Mini Mental State Exam “3MS,” which measures global cognitive functioning, and WHISCA participant scores on the California Verbal Learning Test‐Long Delay (CVLT‐LD), which measures long‐term memory. We employed linear mixed‐effects models to examine the association of 3MS and CVLT‐LD scores with women’s breastfeeding history, controlling for the effects of parity, age, reproductive span, hormone therapies (HT) and duration, and time since HT cessation. Result In the WHIMS (N = 6,069) and WHISCA (N = 1,932) cohorts (Table 1 demographics), we found that the number of children a woman breastfed was positively associated with better global cognition (b = 0.059, p = 0.047) and long‐term memory (b = 0.176, p = 0.016). The cumulative number of months a woman breastfed was positively associated with better global cognition (b = 0.064, p = 0.024) and long‐term memory (b = 0.198, p = 0.005). Women who had breastfed ever for at least one month, compared to those who did not, exhibited better long‐term memory (b = 0.671, p = 0.005), and no significant effect for global cognition. Women with a higher breastfeeding‐to‐pregnancy duration ratio exhibited better long‐term memory (b = 0.962, p = 0.000), with no significant effect for global cognition (Table 2, Fig. 1). Conclusion Our findings indicate long‐term cognitive benefits of breastfeeding for women, above and beyond any effects of parity. It is possible that breastfeeding could be beneficial for women by endowing resilience against neurodegenerative disorders, consistent with our previous observations from two small cohort pilot studies.

  PublisherOA PDFDOI

• Prenatal psychological distress is associated with altered placental extracellular vesicle quantity among pregnant women

  Research Square · 2024-01-25

  preprintOpen accessSenior author
  PublisherOA PDFDOI

• Exploring the impact of maternal early life adversity on interoceptive sensibility in pregnancy: implications for prenatal depression

  Archives of Women s Mental Health · 2024-08-19 · 5 citations

  articleOpen access

  PURPOSE: Pregnancy is a sensitive period of development in adult life characterized by massive changes in physical, emotional, and cognitive function. Such changes may be adaptive, e.g., facilitating adjustment to physical demands, but they may also reflect or contribute to risks inherent to this stage of life, e.g., prenatal depression. One cognitive ability that may undergo change during pregnancy and contribute to mental wellness is interoception - the ability to perceive, integrate, and model sensory information originating from the body. Strong interoceptive abilities are associated with lower rates of depression in non-pregnant adult populations, and interoception is generally weaker in individuals at higher risk for depression, for example, exposure to early life adversity (ELA). In the present online, cross-sectional study, we investigated whether interoception in pregnant women differed based on histories of ELA, in ways that increased their relative risk for prenatal depression symptoms. METHODS: The pregnant individuals were in the second trimester of their first pregnancy and were compared to a group of nulliparous, non-parenting women. RESULTS: Previous exposure to ELA significantly moderated pregnancy-related differences in self-reported interoception (interoceptive sensibility). A further moderated-mediation analysis revealed that the extent to which interoceptive sensibility buffered against depressive symptoms was conditional on ELA exposure, suggesting more ELA is associated with lower interoceptive sensibility during pregnancy, which increased prenatal depression risk. CONCLUSIONS: Together this work suggests that levels of interoception during pregnancy are sensitive to previous adversity exposure. It also suggests that interoceptive-focused interventions for preventing/treating prenatal depressive symptoms in high-risk women may be worth exploring.

  PublisherOA PDFDOI

• Interoception in pregnancy: Implications for peripartum depression

  Neuroscience & Biobehavioral Reviews · 2024-09-06 · 8 citations

  reviewOpen access

  "In this perspective piece, we propose a novel mechanistic framework for peripartum depression in which improved interoceptive functioning in pregnancy and postpartum typically protects against depressive symptoms, but when there is a failure to improve interoception, the result is an inability to maintain metabolic efficiency, which ultimately poses risk for depression. First, we will review an emerging theory that links the modeling and predictive regulation of metabolic resources as central to the expression of many depressive symptoms. Then, focusing on the period of pregnancy to articulate the framework, we will discuss the physiological changes induced by pregnancy that place an increased metabolic demand on the pregnant mother. Following, we will address the neural and physiological changes of pregnancy that may enable enhanced interoception during this period of life. We will then review factors (e.g., childhood adversity) that may modulate pregnancy related changes in interoception. To demonstrate how the framework just described in pregnancy extends to the postpartum period, we will then discuss how the unique neurobiology and psychological features of the postpartum period, relative to during pregnancy, act to maintain high metabolic demands on the mother, as well as impact interoception in ways that can lead to resilience or risk for postpartum depression. We end by highlighting potential treatment targets suggested by our framework."

  PublisherDOI

• More Cumulative Time Spent Pregnant is Associated with Thicker Cerebral Cortex in Postmenopausal Women

  Alzheimer s & Dementia · 2024-12-01

  articleOpen accessSenior author

  Abstract Background Matrescence, like adolescence, is a critical period for neurodevelopment characterized by hormonal changes that reshape the brain in preparation for new experiences and subsequent learning. Women exhibit greater age‐matched Alzheimer’s disease (AD) risk than men, yet little is known about long‐term neurological health consequences of reproduction (Buckley, 2019), the defining biological difference between the sexes. We tested the hypothesis that greater number of months pregnant would be positively associated with cortical thickness (CT), particularly in regions within the default mode network (DMN). DMN disruption is well‐established in AD pathology (Dennis, 2014). Research also indicates that synaptic pruning within the DMN during pregnancy is related to improved maternal attachment and reduced hostility toward the infant, with these changes persisting post‐partum (Hoekzema, 2017; Garcia, 2021). Moreover, in late life, beneficial changes due to motherhood have been shown in the DMN (Orchard, 2021). Method We used data from 1004 older women from the Women’s Health Initiative Magnetic Resonance Imaging (MRI) study (Coker, 2009) ( Table 1 ). CT was estimated from T1‐weighted MRI using FreeSurfer. The effect of cumulative pregnancy duration on mean CT was assessed using a linear mixed model, controlling for parity (number of complete pregnancies), breastfeeding duration, age, reproductive span, estrogen, and progestogen hormone therapies (HT) and duration, and time since HT cessation. Cortical surface analyses used linear regression, accounting for the same confounders, and were corrected for multiple comparisons using cluster‐wise probability. Results The number of months a woman was pregnant was positively associated with global cortical thickness (b = 0.002, p = 0.002). Cortical surface analysis revealed only positive regional associations with CT, including most regions of the DMN ( Figure 1; Table 2 ), as well as several clusters outside the DMN. Notably, the anterior cingulate (ACG) did not show a significant association. Conclusions This work supports the hypothesis that pregnancy may be beneficial for late‐life brain health, particularly in regions important to AD‐pathology such as the DMN, with benefits extending beyond the effect of parity and breastfeeding. Future directions of this work include subcortical analysis and examining whether genetic risk for AD (such as APOE) modifies the relationship between pregnancy and cortical atrophy.

  PublisherOA PDFDOI

• Lonely, stressed-out moms

  Evolution Medicine and Public Health · 2024-01-01 · 3 citations

  reviewOpen accessSenior author

  Perinatal mood and anxiety disorders (PMADs) are estimated to affect as many as 17.7% of mothers in agricultural and postindustrial societies. Various lines of research converge to suggest that PMADs may be 'diseases of modernity', arising from a mismatch between the environments in which humans evolved over hundreds of thousands of years and contemporary postindustrial lifestyles. Here we highlight the social context of childrearing by focusing on three sources of mismatch associated with PMADs: closer interbirth spacing, lack of allomaternal support and lack of prior childcare experience. The transitions to agriculture and industrialization disrupted traditional maternal support networks, allowing closer birth spacing without compromising infant survival but increasing maternal isolation. Caring for closely spaced offspring is associated with high levels of parenting stress, and poses a particular challenge in the context of social isolation. The mother's kin and community play a critical role in allomothering (childcare participation) in all contemporary hunter-gatherer societies, facilitating a system of simultaneous care for children of a range of ages with unique age-specific needs. The absence of social support and assistance from allomothers in postindustrial societies leaves mothers at increased risk for PMADs due to elevated caregiving burdens. Furthermore, the traditional system of allomothering that typified human evolutionary history afforded girls and women experience and training before motherhood, which likely increased their self-efficacy. We argue that the typical postindustrial motherhood social experience is an evolutionary anomaly, leading to higher rates of PMADs.

  PublisherOA PDFDOI

Recent grants

• Social adversity, gestational stress physiology, and birth outcomes in Hispanic Americans

  NIH · $234k · 2020–2023

• Effects of Acculturation on Gestational Biology in Mexican-American Pregnant Women

  NIH · $782k · 2015–2022

Frequent coauthors

• Kyle S. Wiley

  University of California, Los Angeles

  30 shared

• Laura M. Glynn

  Chapman University

  16 shared

• Delaney A. Knorr

  University of California, Los Angeles

  14 shared

• Pathik D. Wadhwa

  National Heart Lung and Blood Institute

  14 shared

• Leslie A. Knapp

  Agilent Technologies (United States)

  12 shared

• Venu Lagishetty

  University of California, Los Angeles

  8 shared

• Curt A. Sandman

  University of California, Irvine

  8 shared

• Jonathan P. Jacobs

  University of California, Los Angeles

  8 shared

Labs

• Biological Anthropology of Motherhood LabPI

Education

• Ph.D., Biological Anthropology

  Yale University

• B.A., Biological Anthropology

  Yale University

• M.A., Biological Anthropology

  University of Cambridge

Awards & honors

• Gates Cambridge Scholar