Marissa DeFreitas

September 2017

During my early career in pediatric nephrology, I developed a research interest in the field of fetal programming of adult disease, specifically as it relates to the long-term cardiovascular and renal risks of preterm birth. This has been under the strong mentorship of Dr. Carolyn Abitbol, who is a pioneer in the area of oligonephropathy of prematurity and risk of future chronic kidney disease. Dr. Abitbol guided me as an early stage investigator during my fellowship and for the past two years as a junior faculty member through a number of successful preliminary studies in this important topic area. During my fellowship training in a busy, tertiary referral center for high risk obstetrics I have been involved as a consultant in the care of several preterm neonates with acute kidney injury as well as have cared for many older children who were born preterm and have developed early chronic kidney disease and hypertension. In addition to this abundant bedside clinical experience, the multiracial and ethnic demographics of the patients we serve have allowed our group to study neonatal renal development more closely. I led efforts to recruit and longitudinally follow 54 mothers and infants in a sub-study of the Gerber Infant Kidney study at our center. The goal was to investigate umbilical cord histomorphometry and urine biomarkers across gestational age groups. My roles included managing the acquisition of blood, urine and umbilical cord samples for storage and evaluation. I have also gained experience in data management and statistical analysis as well as a working knowledge of electronic databases such as iMedidata and Redcap as part of our collaborative efforts. My personal research interest relates to how adverse or competitive intrauterine environmental factors impact the development of the renal and cardiovascular systems. Our preliminary work suggests that such adversity in-utero is associated with smaller kidney size and stiffer vessels which might explain the cardiovascular and renal disease seen later in life in this population. During this time I have had the fortune of building relationships and working with a multidisciplinary team in pediatric pathology, high risk obstetrics, and neonatology both locally and across centers to study this important topic and look forward to continuing this collaboration as part of this project. As such, I am well poised to conduct the proposed project to launch my research career and pave the way for future NIH funded proposals.