The Center's History
The Yale Perinatal Epidemiology Unit (PEU) was founded in 1979 by then Dean of the Yale School of Medicine, Robert Berliner, to support research in this area being conducted by the departments of Epidemiology and Public Health, Obstetrics and Gynecology, and Pediatrics (especially Neonatology). The founding Director was Professor Michael B. Bracken. The mission of the PEU was stated in the preface to the 1984 textbook Perinatal Epidemiology (MB Bracken Ed., Oxford University Press) which first described this area of scholarship:
“It has long been recognized that events during pregnancy influence the health and well-being of the newborn. This recognition, and the obvious need to provide integrated care to both mother and baby, has led to the establishment of perinatology as the medical specialty that bridges the gap between the obstetrician’s concern for the pregnant woman and the care of her newborn by a pediatrician. Only recently have we begun to understand that events occurring long before pregnancy, sometimes inter-generationally, can affect our reproductive capabilities. We also now know that vicissitudes in our own uterine existence may profoundly influence the rest of our lives both physically and behaviorally. Population based studies of these phenomena fall within the domain of perinatal epidemiology, which has evolved into a major subspecialty of epidemiology and an important component of perinatal medicine.”
During the early years of the PEU a large number of NIH-funded studies were conducted on infertility, risk factors for poor maternal health during pregnancy, spontaneous abortions, preterm delivery and for neonatal outcomes of fetal growth restriction, congenital malformations and developmental problems.
A major theme of the PEU during the 1980’s involved the newly emerging paradigm of “evidence-based medicine” and the creation of rigorous methodologies for reviewing and synthesizing scientific research. One of the first medical textbooks incorporating the principles of systematic review emerged, in part, from work at the PEU (Effective Care of the Newborn Infant, JC Sinclair and MB Bracken eds, Oxford University Press, 1992), and to the present day the Center is part of the editorial base of the Cochrane Neonatal Review Group.
In the early 1990’s Professor Brian Leaderer’s research into the environmental causes of respiratory disease in infants and young children increasingly involved collaboration with the PEU and several major studies were conducted on the role of a range of important air pollutants. In recognition of the importance of these collaborations the PEU was officially renamed the Center for Perinatal, Pediatric and Environmental Epidemiology (CPPEE) in 2002. Michael Bracken and Brian Leaderer currently serve as Co-Directors of the Center.
Current research at the CPPEE has moved into understanding the combined environmental and genetic causes of disease during pregnancy, in the perinatal period, during infancy and childhood. Although this methodological paradigm is used for a range of disorders, a principal research focus is on respiratory disease and asthma. Recent studies have included examining the role of maternal asthma in pregnancy on both maternal health during pregnancy and fetal outcomes, as well as examining the etiology of asthma and other atopic diseases in early infancy and childhood, with an increasing focus on how the genetic inheritance of the child is influenced by environmental risk factors and “triggers” that increase risk for disease.