The Camden Study, a pregnancy cohort of 4,765 women recruited between 1985 and 2006 from one of America’s poorest cities, has found new life at Rutgers University – where it promises to unlock critical insights into maternal and child health for researchers worldwide.
According to a recent in Nutrients, the project was designed to study nutritional status in adolescent pregnancies but expanded into a comprehensive repository of maternal and infant health data that yielded more than a decade of significant papers.
Yet, it never gained widespread recognition as a major resource that others could mine.
Rutgers Health researchers and had never heard of the Camden, N.J., cohort until several years ago, when many of the studies they read cited it as a source of fascinating data.
“We started looking for more papers from the Camden cohort, and more papers and more papers. We were just like, ‘Oh my god, what is this cohort in our home state that we don’t know about?’” said Rivera-Núñez, adding she and Barrett soon reached out to the scholar who had been maintaining the data, Xinhua Chen, a professor at Rowan University.
The Camden Study is unique in several ways. It captures health data from a historically underrepresented population: Participants were 45% Hispanic, 38% non-Hispanic Black, and 17% white participants, with 98% receiving Medicaid during pregnancy. Many of them were teenagers during their participation, with some as young as 12 years old.
Newer cohorts rarely give researchers such an opportunity to study the complex dynamics of adolescent pregnancy because teen pregnancy numbers have declined so much.
“This started at the end of the ‘90s, and the population age reflects the realities of the time,” said , first author of the new paper and assistant professor at the . “Teen pregnancy has declined over time. So, recruitment of that population today will be challenging.”
What sets the Camden Study apart is its depth. Participants underwent maternal interviews, dietary assessments and clinical measurements such as anthropometry (measurements of the human body) and blood pressure. Biospecimens – blood, urine, saliva from mothers and cord blood from infants – were collected and stored. This massive collection of data includes data from throughout pregnancy and postpartum visits up to six months for some patients.
The Camden Study yielded significant findings before Rutgers took it over. It showed that adolescent growth during pregnancy correlates with smaller neonatal birth sizes, highlighting a nutritional tug-of-war between mother and fetus. Low dietary zinc intake early in pregnancy was linked to a threefold increase in very preterm delivery (before 33 weeks), while higher circulating fatty acid levels predicted greater insulin resistance. The study also uncovered racial and ethnic disparities, such as lower adiponectin levels in Black women tied to higher preterm birth risks.
These discoveries in nutrition, glucose regulation, hormones and oxidative stress have generated many papers already. Yet, according to Rivera-Núñez, a senior author of the new study and an assistant professor at the School of Public Health, “There’s so much data – it’s years and years of work and papers.”
The Camden Study might have remained a quiet legacy at Rowan had it not been for the interest of Rivera-Núñez and Barrett.
Their discussions with Chen revealed the cohort’s vast repository – eight freezers of biospecimens and a mountain of data – that she had been preserving. But with her retirement looming, she sought a new steward and told the Rutgers researchers they were the only ones interested in taking on the job.
In two months, Rivera-Núñez and Barrett orchestrated the move of those eight freezers and ensured the data’s integrity, de-identifying it to comply with regulations.
“It was intense and challenging,” said Barrett, a senior author of the study and the George G. Rhoads Endowed Legacy professor at the School of Public Health. “I worked with leadership to secure space and funding. Zorimar worked with the Institutional Review Board to show that we would store and use these materials ethically.”
Rutgers rose to meet the challenge, however, providing the lab space, funding, and support to house the material. Only the original participant links remain at Rowan, where they preserve the potential for future follow-up studies.
Now at Rutgers, the cohort has gained new life. The researchers have assembled a team to explore the data and develop new research projects. They published a paper summarizing the cohort’s background, methodology and findings to date, hoping to attract collaborators worldwide.
“We welcome questions from and collaborations with other researchers,” Shiau said. “It doesn’t matter where they’re from. We want to maximize the value of this data in making discoveries about health during pregnancy.”
The collection houses so much data that even after extensive publications from the original research team, much of it has never been fully mined and analyzed. For example, with 13 designated Superfund sites in Camden County, the cohort provides a resource for studying environmental exposures and pregnancy outcomes, an area that has received little attention to date.
The biorepository also offers unique opportunities to apply modern analytical techniques to historical samples. The ability to tease valuable information from both data and tissue samples has advanced greatly since researchers first analyzed the Camden data.
There also is much potential for follow-up. The Rutgers team hopes to re-engage some of the original participants, who would now be in their 30s to 70s, and the children from these pregnancies, who would now be young adults, to make discoveries about long-term maternal and child health outcomes.
For the Rutgers researchers, preserving and expanding this unique resource is both a scientific and personal mission.
“We’ll be forever grateful to Dr. Chen,” Rivera-Núñez said, acknowledging the decades of work that went into building and maintaining the cohort before its transfer to Rutgers. “We hope to continue her legacy and maximize the contribution her work makes for better public health.”
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