Rollins School of Public Health | Faculty Profile
Emory Rollins School of Public Health

Carolyn  Drews-Botsch

Professor

Faculty, Epidemiology

My research has focused on the epidemiology of pediatric conditions and the factors, particularly in the perinatal period, that contribute to their etiology.  In particular, my work seeks to understand these conditions, and carefully apply modern epidemiologic methods to studies of these conditions.   My research program has included work in a variety of related fields including:  congenital cataracts, fetal growth restriction, sudden infant death syndrome, intellectual disability and autism. I am also beginning to expand my work to include an assessment of placental development and its relationship with fetal growth and cognitive development. 

Some key aspects of my work include: 

The role of socioeconomic status on developmental outcomes: It has long been recognized that social class is a strong predictor of neurodevelopment. For example, the prevalence of mild intellectual disability is more than twice as high in children from poorer households as among children whose families are more affluent. What has been less clear, however, is how this relationship impacts the effects of other, physiologic, risk factors for adverse development. I have been involved in a variety of studies which have sought to address this question by examining risk factors for intellectual disability and other developmental disabilities in more homogeneous phenotypic categories and within social strata. This work led to a paradigm shift in understanding that socioeconomic status contributes to severe intellectual disability when there are no other underlying biological factors that impact cognitive development, as well as an understanding that biological insults may impact the risk of intellectual disability differently depending on the child’s social class.

The impact of vision impairment on children’s quality of life: Spectacles and/or contact lenses, and occlusion therapy are commonly used to treat in children with vision disorders. Further, even given early and aggressive treatment, a significant proportion of children with unilateral cataracts are left with poor vision in the treated eye and little stereopsis. However, relatively little is known about the impact of these treatments or these conditions on the lives of children and their families. I have been instrumental in assessing the amount of occlusion therapy that these children receive during early childhood, as well as the impact of these treatments on quality of life. These studies have elucidated the amount of occlusion that children receive and that social factors are associated with occlusion. We have also found that children treated for unilateral cataract have poorer motor development than expected but that behavior problems are not more common. However, children with visual acuity of worse than 20/200 in the treated eye exhibit more behavior problems than children with better vision. This information has important implications for parents and educators.

Understanding and minimizing bias in epidemiologic studies of perinatal outcomes:  It has become increasingly recognized that pregnancy, and in utero development, set the stage for later health outcomes and risk of disease.  However, high rates of loss to pregnancy losses – even before pregnancy recognition, the importance of stages of vulnerability, the difficulty of assessing exposure to the fetus as compared to maternal exposure, the often long lag between development and identification of conditions, and the reliance on maternal recall of events and exposures complicate epidemiologic studies of conditions.  My methodologic work has sought to empirically investigate the impact of bias, particularly information bias, on the results of epidemiologic studies. Specifically, my dissertation investigated the extent to which mothers of infants who had died from Sudden Infant Death Syndrome reported events with differential accuracy as compared to mothers of control infants.  This work led to work to investigate the impact of how choosing different control groups might rectify this situation as well as work on analytic methods to control for differential recall.  

AWARDS and HONORS

  • Past President, Society of Pediatric and Perinatal Epidemiology

  • Selected by the President’s Commission on the Status of  Women and President Wagner to Attend, The Higher Education Research Services, Management Institute for Women in Higher Education, Wellesley College, MA in 2006

  • Elected, Upsilon Chapter, Delta Omega

  • UCLA Public Health Alumni Association, Outstanding Graduate Student

  • Participant, SER Student Workshop

  • UCLA Medical Center Auxiliary Scholarship

  • University Grant, School of Public Health, UCLA

  • National Research Service Award in Cancer Epidemiology

  • Bush Foundation, Predoctoral Fellowship

  • Elected, Phi Beta Kappa

  • Provost’s Honor Roll, UCSD

View Resume

Contact Information

Room 436

Atlanta , GA 30322

Phone: 404-727-5725

Fax: (404) 727-8737

Email: cdrews@sph.emory.edu

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Areas of Interest

  • Adolescent Health/Child Health
  • Epidemiology

Education

  • MPH 1983, University of California, Los Angeles
  • PhD 1988, University of California, Los Angeles
  • BA 1981, University of California, San Diego

Courses Taught

  • EPI 744: Pediatric& Perintl Epi

Publications

  • , , Measurement of von Willebgrand factr activity: Relative effects of ABO blood type and race, Journal of Thrombosis and Haemostatis, 1, 2191-7
  • , , Maternal aclohol abuse and neonatal infection, Alcoholism: Clinical and Experimental Research, 29, 1035-43
  • , , Combining internal and external validation data to correct for exposure misclassificaiton: A case study., American Journal of Epidemiology, 28, 321-8
  • , , Parenting stress among caregivers of children with congenital cataracts, JAAPOS,, 7, 244-50
  • , , Maternal alcohol abuse and neonatal infection. , Alcoholism: Clinical & Experimental Research, 29, 1035-43
  • , , Timeliness of childhood immunizations: a state-specific analysis. , American Journal of Public Health, 95, 1367-74
  • , , Body Mass Index and Risk of Oral Contraceptive Failure: A Case-Cohort Study in South Carolina. , Annals of Epidemiology , 16, 637-643
  • , , Parenting Stress in the Infant Aphakia Treatment Study, Journal of Pediatric Psychology , ,
  • , , New models for large prospective studies: is there a risk of throwing out the baby with the bathwater?." , American Journal of epidemiology , 177, 285-289
  • , , Genetic abnormalities in still birth: comparison of karyotype and microarray testing, New England Journal of Medicine, 367, 2185-2193
  • , , Concordance between child and parent-proxy report on a new self-report tool of vision related quality of life for children with JIA-associated uveitis – “Effects of Youngsters’ Eyesight on QOL -EYE-Q, Pediatric Rhuematology, 10, A43
  • , , Adherence to occlusion therapy in the six months of follow up and visual acuity among participants in the Infant Aphakia Treatment Study (IATS)., Investigative Ophthalmology Visual Science , 53, 3368-3375
  • , , Parent-reported prevalence of Autism Spectrum Disorders in US-born children: An assessment of changes within birth cohorts from the 2003 to the 2007 National Survey of Children’s Health. , Maternal and Child Health Journal, 16, 1151-1157
  • , , Predictors of adherence to occlusion therapy three months after cataract extraction in the Infant Aphakia Treatment Study, Journal of the American Association of Pediatric Ophthalmology and Strabismus, 16, 150-155
  • , , Effect of incorporating adaptive functioning scores on the prevalence of intellectual disability. , American Journal on Intellectual and Developmental, 5, 360-370
  • , , Socioeconomic differences in the impact of being small for gestational age on neurodevelopment among preschool-aged children. , Reviews on Environmental Health. , 26, 221-229
  • , , Screening questions to identify women with von Willebran Disease, Journal of the American Medical Women's Association, 57, 217-8
  • , , Prevalence of prenatal drinking at an urban public hospital and a suburband private hospital, Journal of Perinatal and Neonatal Medicine, 12, 85-93
  • , , Medical, reproductive and psycholosocial experiences of women diagnosed with von Willebrand's disease receiving care in haemophilia treatment centres: a case-control study, Haemophilia, 17, 231-7
  • , , Parenting stress among caregivers of children with congenital cataracts, JAAPOS, 74, 244-50
  • , , IOL implantation during infancy: perception of parents and AAPOS members, JAAPOS, 7, 400-5