About

Leslie V. Farland, ScD, is an Associate Professor in the Department of Epidemiology and Biostatistics at the Mel and Enid Zuckerman College of Public Health at the University of Arizona. She has a background in biology from the University of Chicago and specialized training in reproductive epidemiology from Harvard T.H. Chan School of Public Health, where she earned both her MSc and ScD degrees. Prior to her current appointment, she served as an Instructor in the Department of Obstetrics and Gynecology at Harvard Medical School and in the Department of Epidemiology at Harvard T.H. Chan School of Public Health. She also held the position of Director of Epidemiologic Research at the Center for Infertility and Reproductive Surgery at Brigham and Women's Hospital. Her research program broadly focuses on women’s health, particularly examining the intersection between women’s reproductive health and chronic disease risk, the etiology and risk factors for conditions such as endometriosis, infertility, and polycystic ovary syndrome, and disparities in access to infertility care and fertility treatment utilization.

Research topics

• Medicine
• Sociology
• Internal medicine
• Family medicine
• Psychiatry
• Immunology
• Nursing
• Pediatrics
• Gerontology
• Environmental health

Selected publications

• Pregnancy and breastfeeding are associated with less later‐life cognitive decline in a longitudinal, prospective cohort

  Alzheimer s & Dementia · 2026-01-01

  articleOpen access

  INTRODUCTION: The brains of female mammals evolved to undergo structural and functional changes during pregnancy and lactation, equipping them for motherhood. However, long-term cognitive health implications of these adaptations in women are poorly understood. METHODS: In the Women's Health Initiative (WHI) Memory Study (WHIMS; n = 7427) and WHI Study of Cognitive Aging (WHISCA; n = 2304), postmenopausal women completed reproductive history interviews, annual global cognitive assessment from mean age 70 for up to 13 years, and multi-domain cognitive testing for up to 8 years. RESULTS: Each additional month pregnant was associated with higher scores of global cognition. Each additional month of breastfeeding corresponded to higher scores of global cognition, verbal memory, and visual memory. We observed equivalent results for binary formulations of gravidity and breastfeeding. DISCUSSION: Low rates of fertility and breastfeeding may have implications for postmenopausal cognitive health at the population level. Next steps include examining mechanisms linking women's reproductive history with postmenopausal cognitive health. HIGHLIGHTS: Motherhood may leave an enduring mark on women's brains, shaping cognitive health. Over 7000 women were assessed annually from approximately age 70 for up to 13 years. Ever being pregnant and cumulative time pregnant were linked with better cognition. Ever having breastfed and more time breastfeeding were linked with better cognition. These results imply that declining fertility may affect cognitive aging in future generations.

  PublisherOA PDFDOI

• Workplace Support and Breastfeeding Duration Among Registered Nurses: A Cross-Sectional Study

  Western Journal of Nursing Research · 2026-03-28

  article

  Background: Breastfeeding benefits both mothers and infants, but maternal employment can shorten its duration. There are limited data on workplace support for breastfeeding and pumping among registered nurses (RNs), who are predominantly women of childbearing age. Objective: This study examined the association between workplace support and breastfeeding duration among RNs currently or previously pregnant in the United States. Methods: We conducted a cross-sectional analysis of survey data from 89 RNs. Linear regression assessed breastfeeding duration and workplace support levels (low, moderate, high) for operational , managerial, coworker, time, physical environment , and an overall composite score. Results: On a scale from 0 to 100, operational support scored highest (69.7), whereas coworker and managerial support scored lowest (34.6 and 15.4, respectively). High overall workplace support was significantly associated with 4.7 months longer breastfeeding compared with low support (coefficient: 4.73; 95% CI: 1.17-8.29). Among the workplace support domains, physical environment support, such as equipment, place to store expressed breastmilk, and designated space, had the largest significant difference (coefficient: 4.26; 95% CI: 0.53-7.99). Discussion: RNs play a key role in promoting breastfeeding among new mothers, yet often lack workplace support to meet their own breastfeeding goals, potentially affecting their roles as breastfeeding champions and the length of their own breastfeeding. Therefore, implementing more comprehensive workplace support, including policies, physical environments, and interpersonal support, is imperative.

  PublisherDOI

• Association between parental firefighting status and adverse birth outcomes in Arizona: a cross-sectional study

  Occupational and Environmental Medicine · 2026-03-01

  articleSenior author

  BACKGROUND: Firefighters are continuously exposed to hazardous conditions including smoke, chemicals, stress, long work shifts and exhaustion, which may lead to a higher risk for chronic conditions and reproductive health issues. However, there is limited research looking at the association between parental firefighting with adverse birth outcomes. This cross-sectional study aimed to determine whether female or male firefighting was associated with adverse birth outcomes. METHODS: Arizona birth certificates for the years 2006-2013 were used to compare firefighters with teachers, law enforcement officers and all other occupations while stratifying by sex. Logistic regression models estimated ORs and 95% CIs. RESULTS: We included 720 686 births, 5490 paternal firefighters and 376 maternal firefighters. Maternal firefighting was associated with increased odds of preterm birth compared with teachers (OR: 1.46, 95% CI 1.06 to 1.97) and all other occupations (OR: 1.41, 95% CI 1.02 to 1.88). Higher odds for neonatal intensive care unit admission were observed when compared with teachers (OR: 1.77, 95% CI 1.22 to 2.48), law enforcement officers (OR: 1.74, 95% CI 1.07 to 2.81) and all other occupations (OR: 1.84, 95% CI 1.30 to 2.56). Paternal firefighting was statistically significantly associated with decreased caesarean section and low birth weight. CONCLUSIONS: Female firefighters may have higher odds of adverse birth outcomes. Further research should aim on understanding the biological mechanism behind these associations and ways to mitigate the risk in this population.

  PublisherDOI

• Relationship between endometriosis diagnosis, staging, and typology and inflammatory cytokines

  F&S Reports · 2026-02-21

  articleOpen access

  Objective: ). Design: Cross-sectional analysis using data from the Endometriosis, Natural History, Diagnosis, and Outcomes (ENDO) study. Subjects: A total of 395 premenopausal females in Utah, with no prior endometriosis diagnosis, participating in diagnostic or therapeutic gynecologic laparoscopy/laparotomy, 2007-2009. Exposure: Endometriosis diagnosis, staging (minimal, mild, moderate, severe), and typology (superficial endometriosis [SE], deep infiltrating endometriosis [DE], ovarian endometrioma [OE]), determined through postoperative reports and the revised American Society for Reproductive Medicine classification. Main Outcome Measure: Elevated serum cytokine concentrations defined as IL-6 ≥2 pg/mL, IL-8 ≥3 pg/mL, and TNF-α ≥7.5 pg/mL. Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) were estimated using generalized linear models controlling for age, body mass index (BMI), race/ethnicity, serum cotinine, and reported use of oral hormonal contraception within the past 2 years. Results: or that staging or typology was associated with any of the inflammatory biomarkers. Conclusion: . Our results are in line with several other studies finding null associations between systemic cytokines, measured via blood-derived specimens, and endometriosis. Whether other cardiovascular disease risk biomarkers, including lipoprotein abnormalities, are associated with endometriosis warrants further research.

  PublisherDOI

• Endometriosis and antimüllerian hormone: future research directions & clinical implications (reply to letter to the editor)

  American Journal of Obstetrics and Gynecology · 2026-03-01

  articleSenior author
  PublisherDOI

• Protecting Nurses During Pregnancy: Cross‐Sectional Study of Workplace Exposures and Modifications

  Journal of Advanced Nursing · 2026-01-13

  article

  AIMS: This study examined associations between pregnancy-related fear and stress, occupational exposures, and workplace modifications among pregnant registered nurses in the United States engaged in direct patient care. METHODS: A cross-sectional design was used with data collected via an online survey between November 2021 and April 2022. Participants (n = 358) were recruited through social media and listservs. Log-binomial regression models, adjusted for age and parity, estimated prevalence ratios and confidence intervals for associations between occupational exposures and workplace modifications with prevalence of pregnancy-related stress at work and fear of pregnancy or infant complications. Stress, a non-specific physical/psychosocial response to demands, and fear, an emotional response to perceived threat, functioned as distinct constructs. RESULTS: Emotional and physical environmental hazards were associated with increased prevalence of stress. Emotional and environmental hazards, as well as physical movement, administering antineoplastic medications, infectious disease transmission and scans, were associated with increased prevalence of fear. Each additional occupational exposure increased prevalence of stress by 4% and fear by 12%. Nurses also mitigated risks by implementing workplace modifications. Stress was associated with changing work schedules, while fear was statistically significantly associated with taking extra infection precautions and seeking assistance for CPR. CONCLUSIONS: Findings highlight the need for interventions that address modifiable occupational hazards and improve access to modifications that reduce stress and fear among pregnant nurses. IMPLICATIONS FOR THE PROFESSION: Strengthening workplace protections could reduce occupational stress, improve nurse retention and enhance patient care quality. IMPACT: Pregnant nurses face significant occupational hazards, yet limited research has examined their psychosocial effects and mitigation strategies. This study identified key exposures associated with increased stress and fear and showed that workplace modifications varied by stress/fear levels and pregnancy trimester, informing policies to better protect pregnant nurses. REPORTING METHOD: Authors adhered to the STROBE checklist for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTIONS: This study did not include patient or public involvement in its design, conduct or reporting.

  PublisherDOI

• History of Infertility and Plasma Markers of Inflammation, Cholesterol, and Adipokines Among Participants in the Nurses’ Health Study II

  Journal of Women s Health · 2026-01-12

  article1st authorCorresponding

  Introduction: There is increasing evidence that women who have experienced infertility are at greater risk for several chronic conditions. However, the mechanisms underlying these associations are not clear. Pathophysiology may be illuminated through observation of aberrant systemic biomarkers. However, there are limited data on infertility history and midlife biomarkers of inflammation, lipids, and adipokines. Materials and Methods: Among participants with biomarker measurements in the Nurses’ Health Study II, we used generalized linear models to assess history of infertility and plasma C-reactive protein (CRP, n = 3,518), interleukin-6 (IL-6, n = 3,145), soluble tumor necrosis factor-alpha receptor 2 (sTNFR2, n = 2,648), high-density lipoprotein-cholesterol (HDL-C, n = 1,387), low-density lipoprotein-cholesterol (LDL-C, n = 1,193), total cholesterol ( n = 4,427), leptin ( n = 2,228), and adiponectin ( n = 3,810). We investigated specific infertility diagnoses separately, as well as heterogeneity by body mass index (<25 kg/m 2 versus ≥25 kg/m 2 ), age at first infertility report, and primary versus secondary infertility. Results: On average, participants were 44 years at blood draw (range: 32–54 years). We observed no difference by infertility history in levels of CRP (% difference: 6.9, 95% confidence interval [−1.4,16.0]), sTNFR2 (−0.6% [−2.4,1.2]), HDL-C (0.2% [−3.1,3.6]), total cholesterol (0.6% [−0.5,1.8]), or adiponectin (−1.7% [−5.0,1.8]). Women who had experienced infertility had higher IL-6 (5.0% [0.1,10.1]) and leptin (6.5% [1.7,11.6]) and lower LDL-C (−3.7% [−7.0, −0.3]). Discussion: There was little evidence that women with a history of overall infertility have altered levels of inflammatory markers, total and HDL-C, or adiponectin compared with gravid women without infertility. In fully adjusted models, history of infertility was associated with higher IL-6 and leptin, as well as lower LDL-C levels.

  PublisherDOI

• Disordered eating behaviors during adolescence and risk of endometriosis: a prospective cohort study

  Fertility and Sterility · 2026-01-08

  articleOpen access
  PublisherOA PDFDOI

• Plasma Proteomic Signatures of Physical Activity Provide Insights into Biological Impacts and its Protective Role against Dementia

  Medicine & Science in Sports & Exercise · 2026-01-23 · 1 citations

  articleOpen access

  PURPOSE: Physical activity (PA) and sedentary behavior (SB) are associated with many diseases, including Alzheimer disease and all-cause dementia. However, the specific biological mechanisms through which PA protects against disease are not entirely understood. This study aims to address this gap, with a specific focus on all-cause dementia. METHODS: We first assessed the conventional observational associations of three self-reported and three device-based PA/SB measures with circulating levels of 2911 plasma proteins measured in the UK Biobank ( nmax = 39,160) and assessed functional enrichment of identified proteins. We then used bidirectional Mendelian randomization to further evaluate the evidence for causal relationships of PA/SB with protein levels. Finally, we performed mediation analyses to identify proteins that may mediate the relationship of PA with incident all-cause dementia. RESULTS: Our findings revealed 41 proteins consistently associated with all PA measures and 1027 proteins associated with at least one PA measure. Both conventional observational and Mendelian randomization study designs converged on proteins that appear to increase as a result of PA, including integrins such as ITGAV and ITGAM, as well as MXRA8, CLEC4A, CLEC4M, LPL, and ADGRG2; and on proteins that appear to decrease as a result of PA such as LEP, INHBC, CLMP, PTGDS, ADM, OGN, and PI3; and on proteins that are more responsive to high-intensity PA, such as CA14, CA6, CA4, KIT, and ANGPT2. Functional enrichment analyses revealed processes such as cell-matrix adhesion, integrin-mediated signaling, and collagen binding. Finally, GDF15, ITGAV, ITGAM, ITGA11, HPGDS, GFAP, ADM, AHNAK, and DPP4 were among 21 unique proteins found to mediate the relationship of PA with all-cause dementia, implicating processes such as synaptic plasticity, neurogenesis, and inflammation. CONCLUSIONS: Our results provide insights into how PA affects biological processes and protects against dementia, and provide avenues for future research into the health-promoting effects of PA.

  PublisherDOI

• Incident endometriosis diagnosis and AMH: how surgical staging and typology relate to serum AMH levels

  American Journal of Obstetrics and Gynecology · 2026-01-08 · 2 citations

  articleOpen accessSenior author
  PublisherOA PDFDOI

Frequent coauthors

• Stacey A. Missmer

  Brigham and Women's Hospital

  283 shared

• Catherine Racowsky

  Brigham and Women's Hospital

  137 shared

• Elizabeth S. Ginsburg

  Harvard University

  118 shared

• Randi H. Goldman

  85 shared

• Janet W. Rich‐Edwards

  Brigham and Women's Hospital

  64 shared

• Daniel J. Kaser

  Reproductive Medicine Associates of New York

  63 shared

• Jorge E. Chavarro

  61 shared

• Paula C. Brady

  Columbia University

  56 shared

Labs

• Healthy Aging LabPI