Examining Environmental Exposure and Birth Outcomes

Posted on June 1, 2016 by


The article titled “Mechanisms of the Maternal Exposome and Implications for Health Outcomes” is now featured on the ANS website.  In this article the authors, Michelle L. Wright, PhD, RN; Angela R. Starkweather, PhD, ACNP-BC, CNRN and Timothy P. York, PhD examine environmental exposures in women that may effect the health of their offspring.  Dr. Wright shared this message for ANS readers:


Michelle Wright

My mentors, Drs. Starkweather and York, and I are thrilled to have our manuscript featured on the ANS blog. This paper was a labor of love and I hope it will come to motivate nurses to reconsider how we evaluate our environment and genomic signature related to health.  The information presented in this manuscript are foundational to the program of research I have been building and will likely become commonplace within healthcare as the initiative for precision medicine marches forward.

Have you ever wondered why some people who seem to be living a healthy lifestyle become gravely ill and others are perfectly healthy against all odds? Of course, some of it is genetic but many times there is no identifiable genetic cause for an illness. Our bodies have the fascinating ability to respond to, and are sometimes changed by, environmental exposures. Perhaps more mind-boggling, is that some of these changes can be potentially passed from one generation to the next that are not the genetic sequence. Basic laboratory research in the areas described in this paper (i.e., DNA methylation, telomeres, microbiome, HPA-axis) continuously offer up new perspectives, facts and theories on how variations contribute

Angela Starkweather

Angela Starkweather

to health and disease.

My background is in basic science, my first job out of college was as a groundwater remediation scientist. I worked on projects removing toxicants from the ground to keep drinking water safe. Although, I loved the work and it was meaningful; I wanted to more directly advocate for, protect, and help improve the health of other and became a nurse. After working in the neonatal intensive care unit and emergency departments, I was still bothered by the same question I started this blog with and returned to school to see if I could do some research to get more answers. Given my background, I’ve always been interested in focusing on how the environment influences health, particularly that of women and children. I became interested in this particular population because due to the historical exclusion of women from clinical research, there are many questions to be answered.

The purpose of this paper is to encourage nurse scientists to think of health research with women and children

Timothy York

Timothy York

through a different lens – one that brings together multiple environmental exposures across the lifespan and considers how those exposures get under our skin to influence health outcomes.

Some additional references of how Omics can be applied in Nursing Research for the interested reader:

Wright, ML., Starkweather, AR. (2015). Antenatal Microbiome: Potential Contributor to Fetal Programming and Establishment of the Microbiome in Offspring. Nursing, 64(4), 306-319. DOI: 10.1097/NNR.0000000000000101

Wright ML, Dozmorov MG, Wolen, A, Jackson-Cook, C, Starkweather AR, Lyon DE, York, TP. (2016). Establishing an analytic pipeline for genome-wide DNA methylation. Clinical Epigenetics. 8(1). 45. doi: 10.1186/s13148-016-0212-7

Wright ML, Housman, D., & Taylor, J. Y. (2016). A perspective for sequencing familial hypercholesterolaemia in African Americans. Npj Genomic Medicine, 1(April), 16012. doi:10.1038/npjgenmed.2016.12

Taylor, JY, Wright, ML, Crusto, CA, Sun, Y. (2016). The Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure Study (InterGEN): Design and Methods for Complex DNA Analysis. Biological Research for Nursing (in press) PMID: 27118148

Wright, ML, Ralph, JL, Ohm, JE, Anderson, C. M. (2013) DNA Methylation in Complex Disease: Applications in Nursing Research, Practice, and Policy. Nursing Outlook, 61, 235-241. http://dx.doi.org/10.1016/j.outlook.2013.04.010

Dahlen, HG., Kennedy. HP., Anderson, CM., Bell, AF., Clark, A., Foureur, M., Ohm, JE., Shearman, AM., Taylor, JY., Wright, ML., & Downe, S. (2013). The EPIIC hypothesis: Intrapartum effects on the neonatal epigenome and consequent health outcomes. Medical Hypotheses 80(5), 656-662. doi:10.1016/j.mehy.2013.01.017