Publications by authors named "Suzan L Carmichael"

Article Synopsis
  • Mental health conditions and epilepsy often occur together during pregnancy and are linked to higher rates of severe maternal morbidity (SMM).
  • A study examining over 5 million births in California found that SMM was notably higher in pregnant individuals with either or both conditions compared to those without.
  • Results showed that the odds of SMM increased significantly with mental health issues (2.13 times), epilepsy (3.79 times), and even more so for those with both conditions (4.91 times), stressing the importance of monitoring these risks in pregnant women.
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Objectives: Describe the prevalence, health, and birth outcomes of incarcerated pregnant individuals in California between 2011 and 2015.

Study Design: A population-based cohort study was performed using linked birth certificate and hospital discharge data. Associations between incarceration and birth outcomes were examined, including multivariable logistic regression to estimate odds ratios and 95% confidence intervals.

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Objective: Black individuals carry the greatest burden of maternal mortality, with hypertensive disorders during pregnancy being a significant driving force to this disparity. However, research on maternal health disparities predominantly groups Hispanic Black individuals with all other individuals of Hispanic ethnicity. We hypothesized that this aggregation might obscure the risk patterns of hypertensive disorders in pregnancy for Hispanic-Black and non-Hispanic Black individuals.

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Purpose: The etiopathogenesis of coronal nonsyndromic craniosynostosis (cNCS), a congenital condition defined by premature fusion of 1 or both coronal sutures, remains largely unknown.

Methods: We conducted the largest genome-wide association study of cNCS followed by replication, fine mapping, and functional validation of the most significant region using zebrafish animal model.

Results: Genome-wide association study identified 6 independent genome-wide-significant risk alleles, 4 on chromosome 7q21.

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Importance: Historically redlined neighborhoods may experience disinvestment, influencing their likelihood of gentrification, a process of neighborhood (re-)development that unequally distributes harms and benefits by race and class. Understanding the combined outcomes of redlining and gentrification informs how the mutually constitutive systems of structural racism and racial capitalism affect pregnancy outcomes.

Objective: To examine if historical redlining and contemporary gentrification is associated with increased severe maternal morbidity (SMM) odds.

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Background: Understanding nutrition's role in multiple sclerosis (MS) can guide recommendations and intervention-based studies.

Objective: Evaluate the association between nutrition and pediatric-onset MS outcomes.

Methods: Prospective longitudinal multicenter study conducted as part of the US Network of Pediatric MS centers.

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Background: It is known that cesarean birth affects maternal outcomes in subsequent pregnancies, but specific effect estimates are lacking. We sought to quantify the effect of cesarean birth reduction among nulliparous, term, singleton, vertex (NTSV) births (i.e.

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Background: In population-based research, pregnancy may be a repeated event. Despite published guidance on how to address repeated pregnancies to the same individual, a variety of approaches are observed in perinatal epidemiological studies. While some of these approaches are supported by the chosen research question, others are consequences of constraints inherent to a given dataset (eg, missing parity information).

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Article Synopsis
  • Primary congenital glaucoma (PCG) affects about 1 in 10,000 infants in the U.S. and has a genetic basis that is not fully understood, with CYP1B1 being the most commonly mutated gene.
  • * The study investigated the genetics of PCG by analyzing 37 family trios through exome sequencing, looking for genetic variants that might contribute to the condition.
  • * Results showed that while CYP1B1 was present in some cases, 32% of infants had potentially harmful variants in other genes related to eye development, suggesting more complex genetics behind PCG.
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Our objective was to assess the relationship of socioeconomic disadvantage and race/ethnicity with low-risk cesarean birth. We examined birth certificates (2007-18) linked with maternal hospitalization data from California; the outcome was cesarean birth among low-risk deliveries (i.e.

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Article Synopsis
  • A study was conducted to analyze trends in postpartum readmission rates by race/ethnicity in California from 1997 to 2018, focusing on understanding disparities and factors that may influence these trends.
  • The data showed that overall postpartum readmission was highest among Black individuals, with an increase in readmissions across all racial/ethnic groups, but steepest for Black individuals, suggesting worsening outcomes for this demographic.
  • The study utilized over 10 million birth records to assess factors like patient demographics and clinical conditions, finding significant disparities that persisted over time, particularly affecting Black mothers.
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Police violence is a pervasive issue that may have adverse implications for severe maternal morbidity (SMM). We assessed how the occurrence of fatal police violence (FPV) in one's neighborhood before or during pregnancy may influence SMM risk. Hospital discharge records from California between 2002 and 2018 were linked with the Fatal Encounters database (n = 2 608 682).

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Importance: Racial and ethnic inequities in the criminal-legal system are an important manifestation of structural racism. However, how these inequities may influence the risk of severe maternal morbidity (SMM) and its persistent racial and ethnic disparities remains underinvestigated.

Objective: To examine the association between county-level inequity in jail incarceration rates comparing Black and White individuals and SMM risk in California.

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Objectives: Diets with a high glycemic index (GI) leading to elevated postprandial glucose levels and hyperinsulinemia during pregnancy have been inconsistently linked to an increased risk for large-for-gestational-age (LGA) births. The effects of prepregnancy dietary GI on LGA risk are, to our knowledge, unknown. We examined the association of prepregnancy dietary GI with LGA births and joint associations of GI and maternal overweight/obesity and infant sex with LGA births among 10 188 infants born without congenital anomalies from 1997 to 2011, using data from the National Birth Defects Prevention Study (NBDPS).

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A growing number of studies are using birth certificate data, despite data-quality concerns, to study maternal morbidity and associated disparities. We examined whether conclusions about the incidence of maternal morbidity, including Black-White disparities, differ between birth certificate data and hospitalization data. Using linked birth certificate and hospitalization data from California and Michigan for 2018 (N=543,469), we found that maternal morbidity measures using birth certificate data alone are substantially underreported and have poor validity.

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Objective: Severe maternal morbidity (SMM) is increasing and characterized by substantial racial and ethnic disparities. Analyzing trends and disparities across time by etiologic or organ system groups instead of an aggregated index may inform specific, actionable pathways to equitable care. We explored trends and racial and ethnic disparities in seven SMM categories at childbirth hospitalization.

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Purpose: Recent studies have demonstrated an increased risk of severe maternal morbidity (SMM) for people living in rural versus urban counties. Studies have not considered rurality at the more nuanced subcounty census-tract level. This study assessed the relationship between census-tract-level rurality and SMM for birthing people in California.

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Background: Gastroschisis prevalence more than doubled between 1995 and 2012. While there are individual-level risk factors (e.g.

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Background: Individual measures of socioeconomic status (SES) have been associated with an increased risk of neural tube defects (NTDs); however, the association between neighborhood SES and NTD risk is unknown. Using data from the National Birth Defects Prevention Study (NBDPS) from 1997 to 2011, we investigated the association between measures of census tract SES and NTD risk.

Methods: The study population included 10,028 controls and 1829 NTD cases.

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Objective: To evaluate antepartum anemia prevalence by race and ethnicity, to assess whether such differences contribute to severe maternal morbidity (SMM), and to estimate the contribution of antepartum anemia to SMM and nontransfusion SMM by race and ethnicity.

Methods: We conducted a population-based cohort study using linked vital record and birth hospitalization data for singleton births at or after 20 weeks of gestation in California from 2011 through 2020. Pregnant patients with hereditary anemias, out-of-hospital births, unlinked records, and missing variables of interest were excluded.

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Gentrification, a racialized and profit-driven process in which historically disinvested neighborhoods experience an influx of development that contributes to the improvement of physical amenities, increasing housing costs, and the dispossession and displacement of existing communities, may influence the risk of severe maternal morbidity (SMM). Leveraging a racially diverse population-based sample of all live hospital births in California between 2006 and 2017, we examined associations between neighborhood-level gentrification and SMM. SMM was defined as having one of 21 procedures and diagnoses, as described in the SMM index developed by Centers for Disease Control and Prevention.

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Background: Neural tube defects (NTDs) still occur among some women who consume 400 μg of folic acid for prevention. It has been hypothesized that intakes of methyl donors and other micronutrients involved in one-carbon metabolism may further protect against NTDs.

Objectives: To investigate whether intakes of vitamin B6, vitamin B12, choline, betaine, methionine, thiamine, riboflavin, and zinc, individually or in combination, were associated with NTD risk reduction in offspring of women meeting the folic acid recommendations.

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Background: Two strong risk factors for gastroschisis are young maternal age (<20 years) and low/normal pre-pregnancy body mass index (BMI), yet the reasons remain unknown. We explored whether neighborhood-level socioeconomic position (nSEP) during pregnancy modified these associations.

Methods: We analyzed data from 1269 gastroschisis cases and 10,217 controls in the National Birth Defects Prevention Study (1997-2011).

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