Primary Research Focus
About the Strahm Lab
Lab Projects and News
Midwest Birth Outcome and Indigenous American Pregnancy study
Indigenous American pregnancies in the Midwest have disproportionally high rates of adverse outcomes, however little research has been done on how historical trauma and stress may impact these adverse outcomes. This project gathers data from pregnant Indigenous American women on their experiences with historical trauma, stress, and birth outcomes, as well as physiological data of how they respond to stress, to better understand the associations between these factors and the biological mechanisms underlying them. Understanding the mechanisms by which both historical and proximal stress "get under the skin" and influence pregnancy health and perinatal outcomes, will afford new targets of intervention to help reduce these IA health disparities.
Maternal Stress and Blood Sugar Metabolization During Pregnancy Study
Through the research study, we are examining how women’s emotions and nutrition during pregnancy are associated with their blood sugar and overall pregnancy health. This study will help us better understand how pregnant women respond to stress, which may enable us to help women in the future.
Prenatal and Obstetric Maternal exposures and Islet autoantibodies in Early life (The Promise Study)
To examine the prenatal environment, including the mother’s exposure to viral disease, and clarify the causes of the mother’s protection by looking at fetal epigenetic changes and genomic imprinting and the child’s risk of type 1 diabetes.
Genetics play a role in the risk for type 1 diabetes (T1D); however, the number of new cases is rising 3-5% each year, and children are being diagnosed at younger ages. This suggests that the maternal environment during pregnancy and early life may be important risk factors. Past research has associated maternal infections, stress, diet, and obesity to an increased risk. Furthermore, children of mothers with T1D are less likely to develop the disease than those with a father or sibling affected, hinting at possible protective effects during pregnancy. This project aims to investigate how natural exposure to viruses during pregnancy and early childhood, combined with genetic risk, may influence the development and timing of T1D in children.
The Strahm Lab at Sanford Research is an additional recruitment and data collection site for a study that has been active since 2023 out of the Barbara Davis Center for Diabetes. The goal of this project is to assemble a prenatal risk cohort where the offspring has a mother, father or full sibling with T1D, to maximize the cases T1D in the cohort. This cohort will be followed in three phases, to allow for sufficient follow-up of the pregnancy from the first trimester through delivery and the offspring to a minimum age of 2 years. To efficiently identify cases of islet autoantibodies, newborns will be screened for genetic risk. Children with lower risk will be screened for islet autoantibodies at 2 years of age, and then a second time between 5-6 years of age. Results from this study will help in guiding further research and interventions to reduce the risks and impacts associated with T1D.
Nurturing Equity in Screening for perinatal Treatment (NEST)
To examine contributions perceived by practitioners that are barriers to screening for depression among women during pregnancy.
Screening for depressive symptoms during pregnancy is a priority for the ACOG. Current recommendations are that all patients should be screened for anxiety and depression at well-woman, pre-pregnancy, prenatal, and postpartum visits. Prior to prescribing medication for anxiety or depression, screening should occur for bipolar disorder. Screening results should be followed up with assessment, diagnosis, treatment, monitoring, and follow up in a timely manner. Providers must act upon affirmative answers regarding suicide and self-harm, as well as postpartum psychosis immediately.
The diagnoses of depression during pregnancy averages around 11% for our region, but is less likely to be identified among certain groups. This suggests that there may be barriers for screening and diagnosis for this population. This project aims to investigate these barriers to screening and assess possible solutions.
In this study, the Strahm Lab is collaborating with a medical student at Sanford School of Medicine (SSOM), to conduct informal informational interviews among prenatal care provider volunteers in order to gather qualitative data. The interview will occur for 15-20 minutes at a semi-private location during non-patient care hours. Interviews will be conducted until there is thematic convergence estimated to occur at or prior to 25 participants. Results from this study will help in guiding possible next steps of interviewing patients regarding their depressive symptoms screening experiences, and interventions to support maternal mental health during pregnancy and postpartum.