Biography
Dr. Miller is Director of MotherToBaby UR Medicine (formerly known as the Perinatal Environmental and Drug Consultation Service) a Teratogen Information Service serving New Jersey, New York and Indiana) from the Department of Obstetrics and Gynecology at the University of Rochester Medical Center. This service was begun in 1987 and provides expertise concerning exposures during pregnancy and lactation or before pregnancy to environmental, occupational and therapeutic exposures to the women and/or family.
In 2015, Dr. Miller has co-edited the 3rd edition of "Drugs During Pregnancy and Lactation - Treatment Options and Risk Assessment".
Since 2007, Dr. Miller has been Co-Director of the New York State Center of Excellence in Children's Environmental Health for the 15 county Finger Lakes Region of New York State.
Dr. Miller provides these services to health care providers and families by telephone or by appointment. Please call 585 275 3638.
He has been Scientific Director of the NIH sponsored Women's Reproductive Health Research Scholars Program for training Obstetrician/Gynecologists as Clinical Scientists.
Dr. Miller is a member of the Scientific Board of TERIS as well as Dysmorphologist and Scientific Board Member for the US Ribavirin Pregnancy Registry, Belimumab Pregnancy Registry and MotHER Pregnancy Registry. He is also Co-Chair of the Perinatal LifeStages Committee, Co-Chair of the BioSpecimen Utilization Committee and Member of the Steering Committee for the NIH ECHO (Environmental Influences on Children's Health Outcome) Study of 50,000 children.
Professional Background
Dr. Miller received his undergraduate education in Biology and graduate training in Pharmacology/Toxicology /Teratology at Dartmouth College and Dartmouth Medical School with Prs WO Berndt, G Mudge, V Ferm and W Layton . He also did post graduate training at Jefferson Medical College with Prs RL Brent and T Koszalka in Developmental Biology /Teratology. In 1974, as an Assistant Professor he joined the Departments of Obs/Gyn at the University of Rochester under Pr HA Thiede and of Pharm/Toxicol under Pr L Lasagna. He is currently Professor of Obstetrics and Gynecology, of Pediatrics, of Environmental Medicine (Toxicology) and of Pathology and Clinical Laboratory Medicine.
During this time, he has been involved with the leadership of the NIEHS Environmental Health Sciences Center, as well as Associate Chair for Research in Obstetrics and Gynecology. In 1987, he developed the Perinatal Environmental and Drug Consultation Service (PEDECS) (now known as MotherToBaby UR Medicine) in Obs/Gyn and is its Director since that time. This service provides advice concerning exposures during pregnancy and lactation or before pregnancy to environmental, occupational and therapeutic exposures to the women and/or families. He also is co-Director of the New York State Center of Excellence in Children's Environmental Health at the U of Rochester (Finger Lakes Children's Environmental Health Center).
Dr. Miller is Past President of the Teratology Society and has been active with Natl and Intl concerns involving vitamins and herbals as well as environmental exposures during pregnancy.
He is actively involved with OTIS, Organization of Teratology Information Specialists, with their Committees on Occupational Exposures and on Research. He is current past Chair of the International Research Consortium for OTIS and ENTIS, and recently was the Chair of the Research Funding Committee for the Society of Toxicology. He has been Scientific Director of the NIH sponsored Women's Reproductive Health Research Scholars Program for training Obs/ Gyns as Clinical Scientists at the U of Rochester from 1999-2010.
Dr. Miller has edited the 3rd ed. of "Drugs During Pregnancy and Lactation - Treatment Options and Risk Assessment".
Dr. Miller is a member of the Scientific Board of TERIS as well as a Dysmorphologist and Scientific Board Member for the US Ribavirin Pregnancy Registry and the Genentech MoTHER Pregnancy Registry.
He has been involved with a number of research programs with the National Toxicology Program (Scientific Board), the FDA, NIH, Merck, Roche, Centecor, Eastman Kodak, Johnson and Johnson and other partners. He has trained more than 25 fellows and graduate students, who are providing leadership in Academia, Government and Industry.
His funding does and has come from NICHHD, NIAID, NIAAA, NCI, NIEHS, FDA, NCS, US Israel Binational Fdn, Goode Fdn and industry partners. He was the recipient of the Bock Prize for Developmental Biology and Child Health in 2011 and received the Distinguished Service Award from the Teratology Society in 2013.
Research
Perinatal Toxicology and Placentology are the foci of this laboratory. How viruses, metals (cadmium, gadolinium, arsenic, lead and mercury), air pollution (black carbon), and vitamins (A, B12, C and E), nanoparticles, and hyperthermia affect normal development of the embryo/ fetus are being investigated. In particular, the role of the placenta as the anchor, controller, and conduit during pregnancy as well as a site for toxic action is examined. NIH Clinical investigations in Rochester, Pittsburgh, Brooklyn and Beijing China are being conducted to determine the role of environmental exposures and the role of the placenta in influencing fetal growth and development.
Placental Toxicology and Pathology.
Cadmium can be a placental toxin in rodents by producing fetal death and placental necrosis. Using an in vitro dually perfused human placenta model, cadmium also produced necrosis. Pharmacokinetic studies in both rodent and human studies demonstrated the role of the placenta as a site for control of passage and intoxication. The response of the cell to cadmium toxicity may be regulated by metallothionein and calmodulin. Different isoforms of metallothionein are being identified via cDNA isolation and in situ hybridization for determination of metallothionein distribution and indelibility in placentae from women exposed during pregnancy to environmental metals (gadolinium, cadmium, arsenic, lead and mercury). Currently gene environment interactions during development are being pursued in an animal model of diabetes mellitus.
Placental Pathology and the relationship to in utero development and adult disease is being evaluated. Focus is on specific evaluations of shape, size and vascular structure of the placenta and an understanding of the underlying pathology. These investigations have been pursued as part of an NIH National Children's Study Formative Research Study and are currently being studied as the NIH ECHO Placental Processing Center.
Implantation Biology.
Pregnancy loss due to implantation failures is being examined using an in vitro model consisting of both human trophoblast and endometrium to study the biology of attachment and invasion as well as the influence of hormones, xenobiotics and disease (antiphospholipid syndrome, pre-eclampsia). Additional investigations are examining the effects of plasticizers - phthalates and bisphenol A on human placental function to understand the relationship between plasticizer exposures and miscarriages.
Vertical transmission of HIV.
Why do only 25-40% of the babies of HIV positive mothers become infected? Why not all the babies? What controls infectivity of the fetus in utero? These are questions being explored in patients who are pregnant and HIV positive. In vitro models of human placenta are used to study how the placenta may modulate HIV infection in utero. Certain strains of HIV-1 can selectively infect the human placenta, while others do not. Molecular techniques are being used - Real Time - PCR, ISPCR - to determine which cells are being infected. With these models we can test how anti-HIV therapies may best prevent the vertical transmission of HIV as well as produce toxicity in the human placenta.
Clinical Investigations:
Developing noninvasive measures of human placental assessment to predict fetal and childhood disease and compromise using Ultrasound and Magnetic Resonance Elastography.
Preeclampsia is a major contributor to adverse pregnancy outcomes for both mother and baby. A major difficulty is diagnosing the illness before the conditions are too severe. Previous studies have demonstrated that placental growth factor and vascular endothelial growth factor levels are reduced in women who will develop severe preeclampsia. Current investigations are underway examining the clinical possibilities of early diagnosis of preeclampsia in hopes that treatment modalities will then be possible to prevent the disease.
Awards
2016
Agnish Fellowship for Outstanding Contributions to Teratology Education
Sponsor: Teratology Society
2016
Senior International Award in Placentology
Sponsor: International Federation of Placenta Associations
Location: Portland, Oregon
2014
Plank Owner Award - National Children's Study
Sponsor: NIH- US Public Health Service
Location: Bethesda, Maryland
2013
Teratology Society Distinguished Service Award
Sponsor: Teratology Society
2011
Bock Prize for Developmental Biology and Child Health
Sponsor: Nemours Foundation
Location: Wilmington, Delaware
2006
Graduate Student Society Faculty Award for Outstanding Teaching
Sponsor: University of Rochester
1999 - Present
Fellow, Academy of Toxicological Sciences
Sponsor: Academy of Toxicological Sciences
1997
200th Anniversary - Alumnus Recognition Portrait/Profile
Sponsor: Dartmouth Medical School
1991 - 1992
President, Teratology Society
1988 - Present
Scientific Review Board, NIH TERIS
1988 - 1992
Member, Board of Scientific Counselors, US National Toxicology Program
1988
Fulbright Distinguished Professorship
Sponsor: NIH
Location: Belgrade, Yugoslavia
1983 - 2001
Editor, Trophoblast Research
1983 - 1983
NIH/Fogarty Senior International Fellow
Location: Universite de Paris VI
Who's Who in the East, USA
Who's Who in the East, USA
Who's Who in Medicine and Healthcare, USA
Who's Who in the World, USA
Fellow, American College of Forensic Medicine
Who's Who in American Education, USA
Who's Who in Men and Women of Science, USA
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Publications
Journal Articles
2022
Coyte, RM; Darrah, TH; Barrett,E.; O'Connor, TH; Olesik, JW; Salafia, CM; Shah, R.; Love, T.; Miller, RK. "Comparison of Trace Element Concentrations in Paired formalin-Fixed paraffin-embedded and frozen Human Placentae". PLACENTA. 2022; .
12/7/2021
Barad A, Guillet R, Pressman EK, Katzman PJ, Miller RK, Darrah TH, O'Brien KO. "Placental Iron Content is Lower than Previously Estimated and is Associated with Maternal Iron Status in Women at Greater Risk for Gestational Iron Deficiency and Anemia." The Journal of nutrition.. 2021 Dec 7; Epub 2021 Dec 07.
4/19/2021
Narang C, Rosen-Carole C, Miller RK, Perez-D'Gregorio R, Shaw MH, Schaffer S, Jee SH. "Who Makes the Choice: Ethical Considerations Regarding Instituting Breastfeeding in a Mother Who Has Compromised Mental Capacity." Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine.. 2021 Apr 19; Epub 2021 Apr 19.
Books & Chapters
2018
Chapter Title: Does the Placenta Protect Against Insult or Is It a Target?
Book Title: Teratology Primer
Author List: Miller, RK
Edited By: Hales, B, Scialli, A and Tassinari, M
Published By: Teratology Society 2018
2015
Book Title: Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment 3rd edition
Author List: C Schaefer, P Peters, RK Miller, eds.
Published By: Academic Press 2015 in San Diego
2015
Chapter Title: Occupational, Industrial and Environmental Agents
Book Title: Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment 3rd edition
Author List: S Barlow, F Sullivan, RK Miller
Edited By: Ch Schaefer, P Peters, RK Miller
Published By: Academic Press 2015 in San Diego
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