EB Research: Upstate New York Infant Development Screening Program (Upstate KIDS)

Phase 1: Growth and Development

Upstate KIDS logoThis Study aimed to determine whether infertility treatments, such as ovulation-stimulating medications and various assisted reproductive technologies (ART), adversely affect the growth, motor, and social development of children from birth through age three years, or if these technologies are associated with differences in the timing or rates of infant and child development, including motor and social development, the development of major and, especially, minor neuro-developmental impairments, and with physical growth patterns. Secondarily, but equally important, the Study also aimed to determine to test the American Academy of Pediatrics developmental surveillance and screening algorithm. The Study aimed to provide information to the State of New York Department of Health that will allow it to more effectively plan and implement the New York State Early Intervention Program (EIP) and, by extension, to inform other States' programs nationally.

The Upstate KIDS Study, which represents a collaborative effort among the DIPHR Epidemiology and Biostatistics & Bioinformatics Branches, the New York State Department of Health, and the University at Albany School of Public Health, implemented a matched-exposure cohort design, recruiting infants who were born between 2008 and 2010 in New York State (exclusive of New York City). Using vital records data, all children conceived by infertility treatment and all twins were recruited. In total, approximately 1,300 families whose child(ren) were conceived with infertility treatment (exposed) and approximately 3,700 families whose child(ren) were not conceived with any infertility treatment (unexposed) were recruited. A separate cohort of all higher-order multiples (triplets, quadruplets) were also recruited. Parents completed the infant questionnaires along with the Ages & Stages Questionnaire© developmental screen at 4, 8, 12, 18, 24, 30, and 36 months of chronologic or gestation-corrected age, and the Modified Checklist for Autism in Toddlers at 18 and 24 months. Children who did not pass the screen were referred to the NYS EIP. In a subgroup, residual newborn blood spot samples (punches) from the Guthrie cards were retrieved by the NYS Newborn Screening Program for analysis of inflammatory and immune markers that may indicate an intrauterine infection and be predictive of later disease or delays in development. The Study also conducted linkages to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS), NYS Congenital Malformations Registry, Cancer Registry, Newborn Screening Program, and the EIP, among others.

Phase 2: Cardio-metabolic health

Upstate KIDS Follow-upRecent studies have drawn attention to concern that infertility treatment exposure may also increase cardio-metabolic risk. Low birth weight and preterm birth are tied to cardiovascular disease risk and mortality later in adult life. Both adverse birth outcomes are increased among singletons and twins conceived by in vitro fertilization (IVF) and among children conceived techniques apart from ART compared to children conceived naturally. These adverse birth outcomes of children conceived by infertility treatment may serve as an indicator of increased cardio-metabolic risk later in life. Increased risk among those having good birth outcomes, however, cannot be ruled out. The timing of puberty is also of interest, as some pubertal markers appear altered after IVF conception and early adrenarche may confer additional cardio-metabolic risks. Few studies have followed children conceived by non-ART treatment. As such, the cardio-metabolic status of children exposed to infertility treatment inclusive of ART remains unclear.

The Upstate KIDS Follow-Up Study, a collaborative effort among the Epidemiology and Biostatistics & Bioinformatics Branches at NICHD and the University at Albany School of Public Health, will continue the follow-up of approximately 3,200 children from the original cohort through age 8 years primarily by annual questionnaires. A subgroup will be invited to participate in a home/clinic visit program where measurements of cardio-metabolic risk along with biospecimens will be collected from mothers and their children. Lastly, all children will be asked to donate a saliva sample by mail when they reach age 8 years.

For more information on the Upstate KIDS Follow-Up Study, visit https://www.albany.edu/sph/upstate-kidsExternal Web Site Policy.

Principal Investigator

Edwina Yeung, Ph.D.

Division Collaborators


  1. Ma WL, Yun S, Bell EM, Druschel CM, Caggana M, Aldous KM, Buck Louis GM, Kannan K. Temporal trends of polybrominated diphenyl ethers (PBDEs) in the blood of newborns from New York state during 1997 through 2011: analysis of dried blood spots from the newborn screening program. Environmental Science & Technology. 2013; 47(14):8015-8021. PMID: 23755886. PMCID: PMC3725776
  2. Andersen NJ, Mondal TK, Preissler MT, Freed BM, Stockinger S, Bell E, Druschel C, Louis GM, Lawrence DA. Detection of immunoglobulin isotypes from dried blood spots. Journal of Immunological Methods. 2014; 404:24-32. PMID: 24333851. PMCID: PMC4663688
  3. Buck Louis GM, Hediger ML, Bell EM, Kus CA, Sundaram R, McLain AC, Yeung E, Hills EA, Thoma ME, Druschel CM. Methodology for Establishing a Population-Based Birth Cohort Focusing on Couple Fertility and Children's Development, the Upstate KIDS Study. Pediatric and Perinatal Epidemiology. 2014; 28(3):191-202. PMID: 24665916. PMCID: PMC4563277
  4. Ma WL, Gao C, Bell EM, Druschel CM, Caggana M, Aldous KM, Louis GM, Kannan K. Analysis of polychlorinated biphenyls and organochlorine pesticides in archived dried blood spots and its application to track temporal trends of environmental chemicals in newborns. Environmental Research. 2014; 133: 204-210. PMID: 24968082. PMCID: PMC4119526
  5. Wylie A, Sundaram R, Kus C, Ghassabian A, Yeung EH. Maternal prepregnancy obesity and achievement of infant motor developmental milestones in the Upstate KIDS Study. Obesity (Silver Spring). 2015; 23(4):907-913. PMID: 25755075. PMCID: PMC4380825
  6. Buck Louis GM, Druschel C, Bell E, Stern JE, Luke B, McLain A, Sundaram R, Yeung E. Use of assisted reproductive technologies treatment as reported by mothers in comparison with registry data: the Upstate KIDS Study. Fertility and Sterility. 2015; 103(6):1461-1468. PMID: 25813287. PMCID: PMC4457573
  7. Yeung EH, McLain AC, Anderson N, Lawrence D, Boghossian NS, Druschel C, Bell E. Newborn adipokines and birth outcomes. Paediatric and Perinatal Epidemiology. 2015; 29(4):317-325. PMID: 26111443. PMCID: PMC4484786
  8. Ghassabian A, Sundaram R, Wylie A, Bell E, Bello SC, Yeung E. Maternal medical conditions during pregnancy and gross motor development up to age 24 months in the Upstate KIDS study. Developmental Medicine and Child Neurology. 2015; 58(7):728-734. PMID: 26502927. PMCID: PMC4846588
  9. Yeung EH, Sundaram R, Bell EM, Druschel C, Kus C, Ghassabian A, Bello S, Xie Y, Buck Louis GM. Examining Infertility Treatment and Early Childhood Development in the Upstate KIDS Study. Journal of the American Medical Association Pediatrics. 2016; 170(3):251-258. PMID: 26746435. PMCID: PMC5000851
  10. Michels KA, Mumford SL, Sundaram R, Bell EM, Bello SC, Yeung EH. Differences in infant feeding practices by mode of conception among a United States cohort. Fertility and Sterility. 2016; 105(4):1014-1022.e1. PMID: 26773191. PMCID: PMC4821670
  11. Yeung EH, Sundaram R, Bell EM, Druschel C, Kus C, Xie Y, Buck Louis GM. Infertility treatment and children's longitudinal growth between birth and 3 years of age. Human Reproduction. 2016; 31(7):1621-1628. PMID: 27165624. PMCID: PMC4901884
  12. Ghassabian A, Sundaram R, Bell E, Bello SC, Kus C, Yeung E. Gross motor milestones and subsequent development. Pediatrics. 2016; 138(1). ppi: e20154372. PMID: 27354457. PMCID: PMC4925077
  13. Stern JE, McLain AC, Buck Louis GM, Luke B, Yeung EH. Accuracy of self-reported survey data on assisted reproductive technology treatment parameters and reproductive history. American Journal of Obstetrics and Gynecology. 2016; 215(2):219.e1-6. PMID: 26875948. PMCID: PMC4967378
  14. Yeung EH, Louis GB, Lawrence D, Kannan K, McLain AC, Caggana M, Druschel C, Bell E. Eliciting parental support for the use of newborn blood spots for pediatric research. BioMed Central Medical Research Methodology. 2016; 16:14. PMID: 26846420. PMCID: PMC4741027
  15. Michels KA, Kim K, Yeung EH, Plowden TC, Chaljub EN, Lu YL, Mumford SL. Adjusting for abstinence time in semen analyses: some considerations. Andrology. 2017; 5(1):191-193. PMID: 27860459. PMCID: PMC5164957
  16. Broadney MM, Chahal N, Michels KA, McLain AC, Ghassabian A, Lawrence DA, Yeung EH. Impact of Parental Obesity on Neonatal Markers of Inflammation and Immune Response. International Journal of Obesity. 2017; 41(1):30-37. PMID: 27780976. PMCID: PMC5209273
  17. Yeung EH, Sundaram R, Ghassabian A, Xie Y, Buck Louis G. Parental Obesity and Early Childhood Development. Pediatrics. 2017; 139(2). pii: e20161459. PMID: 28044047. PMCID: PMC5260147
  18. Robledo CA, Yeung EH, Mendola P, Sundaram R, Boghossian NS, Bell EM, Druschel C. Examining the prevalence rates of preexisting maternal medical conditions and pregnancy complications by source: evidence to inform maternal and child research. Maternal and Child Health Journal. 2017; 21(4):852-862. PMID: 27549105. PMCID: PMC5322241
  19. Ghassabian A, Sundaram R, Chahal N, McClain AC, Bell E, Lawrence DA, Yeung EH. Determinants of neonatal brain-derived neurotrophic factor and association with child development.  Development and Psychopathology. 2017; 29(4):1499-1511. PMID: 28462726. PMCID: PMC6201316
  20. Boghossian NS, Mendola P, Liu A, Robledo C, Yeung EH. Maternal Serum Markers of Lipid Metabolism in Relation to Neonatal Anthropometry. Journal of Perinatology. 2017; 37(6):629-635. PMID: 28333159. PMCID: PMC5446273
  21. Mendola P, Ghassabian A, Mills JL, Zhang C, Tsai MY, Liu A, Yeung EH. Retinol-binding protein 4 and lipids prospectively measured during early to mid-pregnancy in relation to preeclampsia and preterm birth risk. American Journal of Hypertension. 2017; 30(6):569-576. PMID: 28338737. PMCID: PMC5861563
  22. Chahal N, McLain AC, Ghassabian A, Michels KA, Bell EM, Lawrence DA, Yeung EH. Maternal Smoking and Newborn Cytokine and Immunoglobulin Levels. Nicotine & Tobacco Research. 2017; 19(7):789-796. PMID: 28011791. PMCID: PMC5939663
  23. Vollet K, Ghassabian A, Sundaram R, Chahal N, Yeung EH. Prenatal fish oil supplementation and early childhood development in the Upstate KIDS Study. Journal of Developmental Origins of Health and Disease. 2017; 8(4):465-473. PMID: 28434427. PMCID: PMC5588657
  24. Liu D, Yeung EH, McLain AC, Xie Y, Buck Louis GM, Sundaram R. A two-step approach for analysis of nonignorable missing outcomes in longitudinal regression: an application to Upstate KIDS Study. Paediatric and Perinatal Epidemiology. 2017; 31(5):468-478. PMID: 28767145. PMCID: PMC5610633
  25. Michels KA, Ghassabian A, Mumford SL, Sundaram R, Bell EM, Bello SC, Yeung EH. Breastfeeding and motor development in term and preterm infants in a longitudinal US cohort. The American Journal of Clinical Nutrition. 2017; 106(6):1456-1462. PMID: 29092884. PMCID: PMC5698835
  26. Park H, Sundaram R, Gilman SE, Bell G, Louis GMB, Yeung EH. Timing of maternal depression and sex-specific child growth, the Upstate KIDS Study. Obesity. 2018; 26(1):160-166. PMID: 29090856. PMCID: PMC5739947
  27. Buck Louis G, Bell E, Xie Y, Sundaram R, Yeung E. Parental health status and infant outcomes: Upstate KIDS Study. Fertility and Sterility. 2018; 109(2):315-323. PMID: 29338856
  28. Bell GA, Sundaram R, Mumford SL, Park H, Mills J, Bell EM, Broadney M, Yeung EH. Maternal polycystic ovarian syndrome and early offspring development. Human Reproduction. 2018;33(7):1307-1315. PMID: 29668891. PMCID: PMC6251548
  29. Bell GA, Sundaram R, Mumford SL, Park H, Broadney M, Mills JL, Bell EM, Yeung EH. Maternal polycystic ovarian syndrome and offspring growth: the Upstate KIDS Study. Journal of Epidemiology and Community Health. 2018;72(9):852-855. PMID: 29789346
  30. Yeung EH, Sundaram R, Xie Y, Lawrence DA. Newborn adipokines and early childhood growth. Pediatric Obesity. 2018;13(8):505-513. PMID: 29781193. PMCID: PMC6105426
  31. Ghassabian A, Sundaram R, Chahal N, McLain AC, Bell EM, Lawrence DA, Gilman SE, Yeung EH. Concentrations of immune marker in newborn dried blood spots and early childhood development: Results from the Upstate KIDS Study. Paediatric and Perinatal Epidemiology. 2018;32(4):337-345. PMID: 29972605
  32. Ghassabian A, Bell EM, Ma WL, Sundaram R, Kannan K, Buck Louis GM, Yeung E. Concentrations of perfluoroalkyl substances and bisphenol A in newborn dried blood spots and the association with child behavior. Environmental Pollution. 2018;243(Pt B):1629-1636. PMID: 30296759. PMCID: PMC6221990
  33. Bell EM, Yeung EH, Ma W, Kannan K, Sundaram R, Smarr MM, Buck Louis GM. Concentrations of endocrine disrupting chemicals in newborn blood spots and infant outcomes in the upstate KIDS study. Environment International. 2018;121(Pt 1):232-239. PMID: 30219610. PMCID: PMC6376484
  34. Yeung EH, Bell E, Sundaram R, Ghassabian A, Ma W, Kannan K, Buck Louis GM. Examining endocrine disruptors measured in newborn dried blood spots and early childhood growth in the Upstate KIDS Study. Obesity 2019 Jan;27(1):145-151. PMID: 30569634 PMCID: PMC6309795
  35. Adeyeye TE, Yeung EH, McLain AC, Lin S, Lawrence DA, Bell EM. Wheeze and Food Allergies in Children Born via Cesarean Section - The Upstate KIDS Study. Am J Epidemiol. 2019 Feb 1;188(2):355-362. PMID: 30475936 PMCID: PMC6357798
  36. Bell GA, Perkins N, Buck Louis GM, Kannan K, Bell EM, Gao C, Yeung EH. Exposure to persistent organic pollutants and birth weight: The Upstate KIDS Study. Epidemiology 2019 Nov;30 Suppl 2:S94-S100. PMID: 31569158 PMCID: PMC7047652 [Available on 2020-05-01]
  37. Ha S, Yeung E, Bell E, Insaf T, Ghassabian A, Bell G, Muscatiello N, Mendola P. Prenatal and Postnatal Early Life Exposures to Ambient Air Pollution and Development. Environmental Research 2019 Jul;174:170-175. PMID: 30979514 PMCID: PMC6541527 [Available on 2020-07-01]
  38. Trinh M, Sundaram R, Robinson S, Lin TC, Bell EM, Ghassabian A, Yeung E. Trajectory and covariates of children's screen media time. JAMA Pediatrics 2019 Nov 25. doi: 10.1001/jamapediatrics.2019.4488. [Epub ahead of print] PMID: 31764966 PMCID: PMC6902189 (Available 11/25/2020)
  39. Robinson SL, Ghassabian A, Sundaram R, Trinh MH, Lin TC, Bell EM, Mendola P, Yeung EH. The associations of maternal polycystic ovary syndrome and hirsutism with behavioral problems in offspring. Fertility & Sterility 2020 Feb;113(2):435-443. PMID: 32106995 PMCID: PMC7185046 [Available on 2021-02-01]
  40. Robinson SL, Parikh T, Lin T, Bell EM, Heisler E, Park H, Kus C, Stern JE, Yeung EH. Infertility Treatment and Autism Risk using the Modified Checklist for Autism in Toddlers (M-CHAT). Human Reproduction2020 Mar 27;35(3):684-693. PMID: 32163552
  41. Hochstedler K, Bell G, Ghassabian A, Bell EM, Sundaram R, Grantz KL, Yeung E. Gestational age at birth and early childhood development: The Upstate KIDS Study. American Journal of Perinatology Am J Perinatol. 2020 Mar 6. doi: 10.1055/s-0040-1702937. PMID: 32143225
  42. Robinson SL, Ghassabian A, Sundaram R, Trinh MH, Lin TC, Bell EM, Yeung EH. Parental weight status and offspring behavioral problems and psychiatric symptoms. Journal of Pediatrics 2020 Feb 14. pii: S0022-3476(20)30029-9. doi: 10.1016/j.jpeds.2020.01.016. PMID: 32067780 PMCID: PMC7186145
  43. Putnick DL, Sundaram RS, Bell EB, Ghassabian A, Goldstein RB, Robinson SL, Vafai Y, Gilman SE, Yeung E. Trajectories of Maternal Postpartum Depressive Symptoms: Demographic and Perinatal Predictors. Pediatrics 2020 Oct 27;e20200857.  doi: 10.1542/peds.2020-0857. PMID: 33109744 PMCID:  PMC7772818
  44. Robinson SL, Zeng X, Guan W, Sundaram R, Mendola P, Putnick D, Waterland RA, Gunasekara CJ, Kannan K, Gao C, Bell EM, Yeung EH. Perfluorooctanoic acid (PFOA) or perfluorooctane sulfonate (PFOS) and DNA methylation in newborn dried blood spots in the Upstate KIDS cohort. Environmental Research 2021 Mar;194:110668. doi: 10.1016/j.envres.2020.110668. PMID:  33387539 PMCID:  PMC7946760
  45. Yeung EH, Mendola P, Sundaram S, Zeng X, Guan W, Tsai MY, Robinson SL, Stern JE, Ghassabian A, Lawrence D, O’Connor TG, Segars J, Gore-Langton RE, Bell EM. Conception by fertility treatment and offspring deoxyribonucleic acid methylation. Fertility & Sterility 2021 Apr 3;S0015-0282(21)00216-8.  PMID:  33823999
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