A variety of exogenous stressors have been proposed to contribute to birth defects risks and to racial-ethnic disparities in risks. Unfortunately, there is a huge void in the actual epidemiologic knowledge base. The objective of this research application is to use newly collected epidemiologic data to rigorously explore how several exogenous stressors -- low socioeconomic status, nutritional deprivation, negative life events and living environment, negative health indicators, and compromised embryonic development of the mother -- contribute, separately and in combination, to risks of neural tube defects, orofacial clefts, and conotruncal heart defects. This objective will be achieved by the following specific aims: 1) Assess the separate and combined contribution of each stressor to risk of each birth defect, and 2) Assess the separate and combined contribution of each stressor to disparities in risk of each defect between Hispanic and non-Hispanic white women.
The aims will be achieved using data that are currently being collected for a large, population-based, case-control study of birth defects in California. The study population is derived from the approximately 800,000 deliveries that will occur in Los Angeles, Santa Clara, and San Francisco counties from 7/1/99 through 6/30/03. Eligible cases are actively ascertained and include infants or fetuses that are liveborn, stillborn, or electively terminated; nonmalformed controls are selected to be as representative as possible of the underlying birth population. Mothers are interviewed by phone in English or Spanish; interview data are expected to be obtained for more than 1,200 cases and 500 controls. Data collection for the study is underwritten by the Centers for Disease Control and Prevention. This application requests support only for specific epidemiologic and statistical analyses of this large data collection effort. This is the largest study to ever address these issues, and it is the first to examine them systematically and in combination. This research will enhance scientific understanding of the causes of several common, costly, often deadly birth defects, which will undoubtedly have important implications for their risk assessment and prevention.
| Grewal, Jagteshwar; Carmichael, Suzan L; Song, Jun et al. (2009) Neural tube defects: an analysis of neighbourhood- and individual-level socio-economic characteristics. Paediatr Perinat Epidemiol 23:116-24 |
| Carmichael, Suzan L; Ma, Chen; Shaw, Gary M (2009) Socioeconomic measures, orofacial clefts, and conotruncal heart defects in California. Birth Defects Res A Clin Mol Teratol 85:850-7 |
| Carmichael, Suzan L; Witte, John S; Shaw, Gary M (2009) Nutrient pathways and neural tube defects: a semi-Bayesian hierarchical analysis. Epidemiology 20:67-73 |
| Shaw, Gary M; Carmichael, Suzan L (2008) Prepregnant obesity and risks of selected birth defects in offspring. Epidemiology 19:616-20 |
| Carmichael, Suzan L; Shaw, Gary M; Song, Jun et al. (2008) Markers of acculturation and risk of NTDs among Hispanic women in California. Birth Defects Res A Clin Mol Teratol 82:755-62 |
| Grewal, Jagteshwar; Carmichael, Suzan L; Ma, Chen et al. (2008) Maternal periconceptional smoking and alcohol consumption and risk for select congenital anomalies. Birth Defects Res A Clin Mol Teratol 82:519-26 |
| Carmichael, Suzan L; Yang, Wei; Herring, Amy et al. (2007) Maternal food insecurity is associated with increased risk of certain birth defects. J Nutr 137:2087-92 |
| Carmichael, Suzan L; Shaw, Gary M; Yang, Wei et al. (2007) Maternal stressful life events and risks of birth defects. Epidemiology 18:356-61 |
| Carmichael, S L; Shaw, G M; Yang, W et al. (2006) Correlates of intake of folic acid-containing supplements among pregnant women. Am J Obstet Gynecol 194:203-10 |
