What racial disparities exist in the prevalence of perinatal bipolar disorder in California?

Purpose: Mental health conditions are the leading cause of preventable maternal mortality and morbidity, yet few investigations have examined perinatal bipolar disorders. This study sought to examine racial differences in the odds of having a bipolar disorder diagnosis in perinatal women across self-reported racial groups in a large sample in California, USA.

Method: This cross-sectional study uses data from 3,831,593 women who had singleton live births in California, USA from 2011 to 2019 existing in a linked dataset which included hospital discharge records and birth certificates.

CD38 expression by neonatal human naïve CD4 T cells shapes their distinct metabolic state and tolerogenic potential.

Neonatal life is marked by rapid antigen exposure, necessitating establishment of peripheral immune tolerance via conversion of naïve CD4 T cells into regulatory T cells (Tregs). Here, we demonstrate heighted capacity for FOXP3 expression and tolerogenic function among cord blood versus adult blood naive CD4 T cells and that this is linked to their unique metabolic profile and elevated expression of the NADase, CD38. Early life naïve CD4 T cells demonstrate a metabolic preference for glycolysis, which directly facilitates their differentiation trajectory.

Early Newborn Metabolic Patterning and Sudden Infant Death Syndrome.

Importance: Sudden infant death syndrome (SIDS) is a major cause of infant death in the US. Previous research suggests that inborn errors of metabolism may contribute to SIDS, yet the relationship between SIDS and biomarkers of metabolism remains unclear.

Objective: To evaluate and model the association between routinely measured newborn metabolic markers and SIDS in combination with established risk factors for SIDS.

Risk of Adverse Perinatal Outcomes Among African-born Black Women in California, 2011-2020.

Background: African-born women have a lower risk of preterm birth and small for gestational age (SGA) birth compared with United States-born Black women, however variation by country of origin is overlooked. Additionally, the extent that nativity disparities in adverse perinatal outcomes to Black women are explained by individual-level factors remains unclear.

Methods: We conducted a population-based study of nonanomalous singleton live births to United States- and African-born Black women in California from 2011 to 2020 (n = 194,320).

Resuscitation, survival and morbidity of extremely preterm infants in California 2011-2019.

Objective: To describe changes over time in resuscitation, survival, and morbidity of extremely preterm infants in California.

Study Design: This population-based, retrospective cohort study includes infants born ≤28 weeks. Linked birth certificates and hospital discharge records were used to evaluate active resuscitation, survival, and morbidity across two epochs (2011-2014, 2015-2019).

The validity of hospital diagnostic and procedure codes reflecting morbidity in preterm neonates born <32 weeks gestation.

Objective: To determine the validity of diagnostic hospital billing codes for complications of prematurity in neonates <32 weeks gestation.

Study Design: Retrospective cohort data from discharge summaries and clinical notes (n = 160) were reviewed by trained, blinded abstractors for the presence of intraventricular hemorrhage (IVH) grades 3 or 4, periventricular leukomalacia (PVL), necrotizing enterocolitis (NEC), stage 3 or higher, retinopathy of prematurity (ROP), and surgery for NEC or ROP. Data were compared to diagnostic billing codes from the neonatal electronic health record.

Predicting the risk of 7-day readmission in late preterm infants in California: A population-based cohort study.

Background And Aims: The American Academy of Pediatrics describes late preterm infants, born at 34 to 36 completed weeks' gestation, as at-risk for rehospitalization and severe morbidity as compared to term infants. While there are prediction models that focus on specific morbidities, there is limited research on risk prediction for early readmission in late preterm infants. The aim of this study is to derive and validate a model to predict 7-day readmission.

Developing a resiliency model for survival without major morbidity in preterm infants.

Objective: Develop and validate a resiliency score to predict survival and survival without neonatal morbidity in preterm neonates <32 weeks of gestation using machine learning.

Study Design: Models using maternal, perinatal, and neonatal variables were developed using LASSO method in a population based Californian administrative dataset. Outcomes were survival and survival without severe neonatal morbidity.

Incidence, Risk Factors, and Reasons for 30-Day Hospital Readmission Among Healthy Late Preterm Infants.

Objective: Late preterm infants have an increased risk of morbidity relative to term infants. We sought to determine the rate, temporal trend, risk factors, and reasons for 30-day readmission.

Methods: This is a retrospective cohort study of infants born at 34 to 42 weeks' gestation in California between January 1, 2011, and December 31, 2017.

Interpregnancy Interval and Birth Outcomes: A Propensity Matching Study in the California Population.

Introduction: Previous studies that used traditional multivariable and sibling matched analyses to investigate interpregnancy interval (IPI) and birth outcomes have reached mixed conclusions about a minimum recommended IPI, raising concerns about confounding. Our objective was to isolate the contribution of interpregnancy interval to the risk for adverse birth outcomes using propensity score matching.

Methods: For this retrospective cohort study, data were drawn from a California Department of Health Care Access and Information database with linked vital records and hospital discharge records (2007-2012).

Risk of early birth by body mass index in a propensity score-matched sample: A retrospective cohort study.

Objective: Evaluate the risk of preterm (<37 weeks) or early term birth (37 or 38 weeks) by body mass index (BMI) in a propensity score-matched sample.

Design: Retrospective cohort analysis.

Setting: California, USA.

Targeted newborn metabolomics: prediction of gestational age from cord blood.

Objective: Our study sought to determine whether metabolites from a retrospective collection of banked cord blood specimens could accurately estimate gestational age and to validate these findings in cord blood samples from Busia, Uganda.

Study Design: Forty-seven metabolites were measured by tandem mass spectrometry or enzymatic assays from 942 banked cord blood samples. Multiple linear regression was performed, and the best model was used to predict gestational age, in weeks, for 150 newborns from Busia, Uganda.

Racial disparities in emergency mental healthcare utilization among birthing people with preterm infants.

Background: Birthing people of color are more likely to deliver low birthweight and preterm infants, populations at significant risk of morbidity and mortality. Birthing people of color are also at higher risk for mental health conditions and emergency mental healthcare utilization postpartum. Although this group has been identified as high risk in these contexts, it is not known whether racial and ethnic disparities exist in mental healthcare utilization among birthing people who have delivered preterm.

Evaluation of heparinized syringes for measuring newborn metabolites in neonates with a central arterial line.

Newborn metabolic screening is emerging as a novel method for predicting neonatal morbidity and mortality in neonates born very preterm (<32 weeks gestation). The purpose of our study was to determine if blood collected by an electrolyte-balanced dry lithium heparin syringe, as is routine for blood gas measurements, affects targeted metabolite and biomarker levels. Two blood samples (one collected with a heparinized syringe and the other with a non-heparinized syringe) were obtained at the same time from 20 infants with a central arterial line and tested for 49 metabolites and biomarkers using standard procedures for newborn screening.

The association of COVID-19 infection in pregnancy with preterm birth: A retrospective cohort study in California.

Introduction: Our understanding of the association between coronavirus disease 19 (COVID-19) and preterm or early term birth among racially and ethnically diverse populations and people with chronic medical conditions is limited.

Methods: We determined the association between COVID-19 and preterm (PTB) birth among live births documented by California Vital Statistics birth certificates between July 2020 and January 2021 (n=240,147). We used best obstetric estimate of gestational age to classify births as very preterm (VPTB, <32 weeks), PTB (< 37 weeks), early term (37 and 38 weeks), and term (39-44 weeks), as each confer independent risks to infant health and development.

Maternal nativity and risk of adverse perinatal outcomes among Black women residing in California, 2011-2017.

Objective: Examine the risk of adverse perinatal outcomes among the United States (US)-born and foreign-born Black women in California.

Study Design: The study comprised all singleton live births to Black women in California between 2011 and 2017. We defined maternal nativity as US-born or foreign-born.

Cannabis-related diagnosis in pregnancy and adverse maternal and infant outcomes.

Background: Cannabis use and cannabis use disorders are increasing in prevalence, including among pregnant women. The objective was to evaluate the association of a cannabis-related diagnosis (CRD) in pregnancy and adverse maternal and infant outcomes.

Methods: We queried an administrative birth cohort of singleton deliveries in California between 2011-2017 linked to maternal and infant hospital discharge records.

The association between preterm birth and postpartum mental healthcare utilization among California birthing people.

Background: While mental health conditions such as postpartum depression are common, little is known about how mental healthcare utilization varies after term versus preterm delivery.

Objective: This study aimed to determine whether preterm birth is associated with postpartum inpatient and emergency mental healthcare utilization.

Study Design: The study sample was obtained from a database of live-born neonates delivered in California between the years of 2011 and 2017.

The independent and combined influences of small for gestational age and socioeconomic status on newborn metabolite levels.

Objectives: To determine whether socioeconomic status (SES) and small birthweight for gestational age (SGA) exhibit independent or joint effects on infant levels of 42 metabolites.

Study Design: Population-based retrospective cohort of metabolic newborn screening information linked to hospital discharge data. SGA infants defined by birthweight <10th percentile for gestational age by sex.

Racial and ethnic disparities in outcomes through 1 year of life in infants born prematurely: a population based study in California.

Objectives: To investigate racial/ethnic differences in rehospitalization and mortality rates among premature infants over the first year of life.

Study Design: A retrospective cohort study of infants born in California from 2011 to 2017 (n = 3,448,707) abstracted from a California Office of Statewide Health Planning and Development database. Unadjusted Kaplan-Meier tables and logistic regression controlling for health and sociodemographic characteristics were used to predict outcomes by race/ethnicity.

Risk of Early Birth among Women with a Urinary Tract Infection: A Retrospective Cohort Study.

 The aim of the study is to evaluate the risk of preterm birth (PTB, <37 weeks) and early term (37 and 38 weeks) birth among women with an emergency department (ED) visit or hospitalization with a urinary tract infection (UTI) by trimester of pregnancy.  The primary sample was selected from births in California between 2011 and 2017. UTIs were identified from the ED or hospital discharge records.

Risk and Protective Factors for Preterm Birth Among Black Women in Oakland, California.

This project examines risk and protective factors for preterm birth (PTB) among Black women in Oakland, California. Women with singleton births in 2011-2017 (n = 6199) were included. Risk and protective factors for PTB and independent risk groups were identified using logistic regression and recursive partitioning.