Gabriella (Gaby) Brigitte Smith

All Publications

• Incidence and Risk Factors for Soft Tissue Hand and Wrist Conditions in Pregnancy and Postpartum. Journal of hand surgery global online Smith, G. B., Young, B., Titan, A. L., Kenney, D. E., Ladd, A. L. 2025; 7 (5): 100778

  Abstract

  This study aimed to identify the incidence of and risk factors associated with soft tissue hand conditions in pregnancy and postpartum. We hypothesized that the incidence of de Quervain tenosynovitis (DQT) and possibly carpal tunnel syndrome (CTS) and trigger finger would be higher in pregnancy and postpartum and that gestational diabetes would be a risk factor for these conditions.Using the PearlDiver administrative claims database, we identified pregnant females undergoing vaginal or Cesarean delivery from 2011 to 2022. This cohort was propensity score matched based on age and Elixhauser comorbidity index to females who were not pregnant. We identified pregnant females with a diagnosis of gestational diabetes. Multivariate regression models were used to assess the risk of developing a hand condition within the first year postpartum, adjusting for age, geographical region, insurance plan, comorbidity index, and inflammatory arthritis or diabetes diagnosis. We applied these models to evaluate the risk of developing a hand condition in gestational diabetes patients.We identified a cohort of 357,534 postpartum patients and 357,803 control patients. We observed a 1.5% incidence of hand conditions postpartum compared to 1.3% in the control population (P < .001). Pregnancy was associated with an increased risk of diagnosis with DQT (odds ratio [OR], 5.11; 95% confidence interval [CI], 4.47-5.85; P < .001). Gestational diabetes was also associated with an increased risk of a hand condition diagnosis (OR, 1.34; 95% CI, 1.26-1.42; P < .001), specifically increased odds of CTS (OR, 1.40; 95% CI, 1.29-1.51; P < .001) and DQT (OR, 1.23; 95% CI, 1.12-1.34; P < .001).Pregnancy is a significant risk factor for hand conditions and was associated with increased odds of DQT. Gestational diabetes is a significant risk factor for CTS and DQT. Our findings can inform screening and patient education efforts for high-risk pregnant patients.Prognostic IIIb.

  View details for DOI 10.1016/j.jhsg.2025.100778

  View details for PubMedID 40746749

  View details for PubMedCentralID PMC12312026

• Risk Factors for Corticosteroid-associated Osteonecrosis in Children: A National Database Study. Journal of the Pediatric Orthopaedic Society of North America Smith, G. B., Pham, N. S., Alayleh, A., Smith, S., Chao, K., Goodman, S. B., Shea, K. G. 2025; 12: 100199

  Abstract

  Corticosteroid-associated osteonecrosis presents a risk for severe pain and joint collapse. While the relationship between corticosteroid treatment and osteonecrosis in pediatric patients is well-documented, less is known about which patients are at greatest risk across medical conditions. The purpose of this study was to identify high-risk pediatric populations for developing osteonecrosis following corticosteroid treatment across autoimmune, inflammatory, and oncologic conditions.The Merative MarketScan Research Databases (2007-2022) were queried to identify pediatric patients with an outpatient oral or intravenous corticosteroid prescription. Demographic, clinical, and prescription differences between osteonecrosis and non-osteonecrosis patients were analyzed using t-tests, Fisher's exact, and chi-square tests. Factors associated with time to osteonecrosis were assessed using a multivariable Cox proportional-hazards regression model.We identified 5,606,781 pediatric patients who received corticosteroids, and 131 developed osteonecrosis. The mean time to osteonecrosis following corticosteroid administration was 7.1 months (SD = 5.2). Osteonecrosis patients were significantly older at the age of corticosteroid administration (12.1 [SD = 4.9] vs. 8.2 [5.6], P < .001) and were prescribed corticosteroids for more total days (136.6 [224.8] vs. 17.1 [89.2], P < .001) compared to patients who did not develop osteonecrosis. Adjusting for all other covariates, risk factors for osteonecrosis include acute lymphoblastic leukemia (HR = 575.82, 95% CI = [346.68, 956.40], P < .001), systemic lupus erythematosus (HR = 106.41, 95% CI = [44.65, 253.63], P < .001), Crohn's disease (HR = 6.67, 95% CI = [1.54, 28.86], P = .011), juvenile idiopathic arthritis (HR = 4.62, 95% CI = [1.06, 20.08], P = .041), solid organ transplant (HR = 4.24, 95% CI = [2.08, 8.65], P < .001), dexamethasone (HR = 2.59, 95% CI = [1.56, 4.28], P < .001), older age (hazard ratio [HR] = 1.11, 95% CI = [1.06, 1.16], P < .001), and greater total days prescribed (HR = 1.01, 95% CI = [1.00, 1.02], P = .041).Our national database study highlights the need for targeted screening of pediatric patients treated with high-dose corticosteroids. This investigation may inform multidisciplinary studies and interventions in children treated with corticosteroids.(1)Corticosteroid-associated osteonecrosis presents a risk for severe pain and joint collapse, yet little is known regarding which pediatric patients are at greatest risk across medical conditions.(2)Adjusting for other covariates, pediatric patients with acute lymphoblastic leukemia, systemic lupus erythematous, Crohn's disease, juvenile idiopathic arthritis, solid organ transplants, patients prescribed dexamethasone, patients prescribed corticosteroids for greater total days, and older patients were at increased risk for osteonecrosis in our national database study.(3)Our findings highlight the need for targeted screening of pediatric patients treated with high-dose corticosteroids.(4)Future prospective multidisciplinary screening and intervention protocols should be studied in children treated with corticosteroids.Level III: Case-control study or retrospective cohort study.

  View details for DOI 10.1016/j.jposna.2025.100199

  View details for PubMedID 40756153

  View details for PubMedCentralID PMC12317409

• The Founders' 400 and Chicago Perinatal Origins of Disease study protocol: Following a prospective, longitudinal cohort from early pregnancy through two years of postnatal life. PloS one Fisher, S. A., Branche, T. N., Akel, M. J., Dwyer, J., Smith, G., Hamvas, A., Yee, L. M., Seed, P. C., Mithal, L. B. 2025; 20 (9): e0332928

  Abstract

  INTRODUCTION: The primary aim of the Chicago Perinatal Origins of Disease (CPOD) study is to characterize social, environmental, and biological exposures from early pregnancy through two years of postnatal life among a diverse cohort of mother-fetus/child dyads in the Chicago metropolitan community and to examine associations with pregnancy and early childhood health outcomes. This study is committed to ensuring the inclusion of participants historically underrepresented in perinatal research and most impacted by perinatal health inequities. CPOD is designed to align with key stakeholder and community input.METHODS: Approximately 400 pregnant people 8-28 weeks gestation and their neonates will be recruited into a longitudinal, prospective observational study enriched for participants who self-identify as Black and/or Latinx. Pregnant participants are followed at three time points antenatally and during their delivery hospitalization; mother-child dyads are followed at five time points in the first two years of life. Semi-structured interviews, patient-reported quantitative surveys, electronic health record abstraction, biological specimens, and environmental sampling from participant homes comprise data collection methods. Biospecimens (including placental biopsies) from mothers, infants, and other household members are collected, processed, and stored in a biorepository. Translational approaches, including a variety of biospecimen analyses (e.g., epigenetics, metabolomics, placental histopathology, microbiome analyses), will be employed to evaluate psychosocial and environmental exposures associated with biologic changes, and how dysregulation of one's underlying biology during pregnancy and early childhood are associated with adverse health outcomes.DISCUSSION: CPOD is a unique, prospective, observational study that includes a large, ethnically diverse cohort; rich, multifactorial phenotypic characterization of maternal health and pregnancy outcomes, neonatal health, and early childhood neurobehavior; and development of a biorepository of social, environmental, and clinical data and biospecimens from early pregnancy to two years of postnatal life. Using translational science approaches, data from this cohort will provide clinical and mechanistic insights into how environmental and psychosocial exposures, both during pregnancy and transgenerationally, influence changes in the underlying biology of maternal-child dyads, and how these changes are associated with the risk of adverse health outcomes that contribute to future disease.

  View details for DOI 10.1371/journal.pone.0332928

  View details for PubMedID 41021581

• Parental Perceptions of Early Childhood In-Home Research with Monitoring: A Qualitative Study. The Journal of pediatrics Smith, G. B., Jones, M. D., Akel, M. J., Barrera, L., Heffernan, M., Seed, P., Macy, M. L., Fisher, S. A., Mithal, L. B. 2024: 114437

  Abstract

  To explore perceptions, concerns, and enthusiasm from a diverse group of parents regarding early childhood research that involves home monitoring technologies for collecting environmental exposure data.A diverse group of new and expecting parents participated in semi-structured interviews. A single interviewer conducted all sessions and introduced a hypothetical longitudinal early childhood research study, which included novel home monitoring approaches: 1) wearable devices, 2) audio monitoring, and 3) environmental sampling. Interviews were audio-recorded, transcribed, and coded. Qualitative description guided the study, and a constant comparative approach was used to identify themes from transcripts.Twenty-four interviews were completed. Emerging themes included 1) Ready and Willing to Participate; 2) Helping Others, Helping Ourselves: Motivation for Participation; 3) Trust and Transparency: Understanding the "What?" and the "Why?"; 4) Data Privacy and Security: "What If It Gets into the Wrong Hands?"; 5) It's a Lot to Juggle: Logistical Realities. Perceptions were similar across racial, ethnic, and socioeconomic groups. Perceptions were positive, and participants desired additional information about study feasibility and purpose. Many had concerns related to wearable device safety and data privacy; a trusting relationship with the research team was a priority.Participants had positive sentiments regarding longitudinal observational studies involving pregnancy and infancy yet expressed concerns about safety, privacy, feasibility, and transparency. These findings can inform future early childhood research study design to ensure protocols are transparent, inclusive, and appealing to parents.

  View details for DOI 10.1016/j.jpeds.2024.114437

  View details for PubMedID 39675665

• Factors Influencing Parental Willingness to Consent to a Survey Study for Patients in the Pediatric Emergency Department. Pediatric emergency care Fischer, K., Smith, G. B., Luna, S. E., Jamro-Comer, E., Leupold, O., Ahmed, H., Govindji, S., Ahmad, F. 2024

  Abstract

  To identify factors that impact parental willingness to consent to research studies conducted for their children during visits to pediatric emergency departments (EDs).Parents and guardians of children receiving care in our pediatric ED were approached and asked if they would be willing to let their child participate in a research study requiring the child to complete an electronic questionnaire. No such questionnaire existed, however, because the primary purpose was to ascertain the parent's willingness to let their child participate. All parents were debriefed and informed of the true purpose of the study and asked to complete a survey themselves to help understand factors that influenced their initial decision of whether to consent. Bivariate tests and logistic regression were used to evaluate unadjusted and adjusted associations between parent and patient characteristics and parental consent decision.We approached 431 eligible parents about the hypothetical research study involving their children, and 386 (89.6%) consented for their children to participate. After the debriefing, 392 (91.0%) parents consented to complete the parental survey. We observed statistically significant associations between shorter length of ED stay to approach for consent for the study (P = 0.048) as well as longer travel time (P = 0.03) and willingness to consent in bivariate analysis, though this did not hold in regression analysis. Regression analysis revealed parents of children who have previously participated in research had 79 times lower odds of consenting to participate in our study adjusted for parent race, ethnicity, actual and perceived length of stay, traveltime to the ED, and altruism.A high proportion of parents consented to their child participating in research in our ED with previous child participation in research being associated with lower odds of parental consent even when adjusted for other factors. Our findings may inform future research practices and studies investigating parental perceptions and motivations surrounding research studies.

  View details for DOI 10.1097/PEC.0000000000003126

  View details for PubMedID 38412522

• Single-cell transcriptomics reveals cell-type-specific diversification in human heart failure. Nature cardiovascular research Koenig, A. L., Shchukina, I., Amrute, J., Andhey, P. S., Zaitsev, K., Lai, L., Bajpai, G., Bredemeyer, A., Smith, G., Jones, C., Terrebonne, E., Rentschler, S. L., Artyomov, M. N., Lavine, K. J. 2022; 1 (3): 263-280

  Abstract

  Heart failure represents a major cause of morbidity and mortality worldwide. Single-cell transcriptomics have revolutionized our understanding of cell composition and associated gene expression. Through integrated analysis of single-cell and single-nucleus RNA-sequencing data generated from 27 healthy donors and 18 individuals with dilated cardiomyopathy, here we define the cell composition of the healthy and failing human heart. We identify cell-specific transcriptional signatures associated with age and heart failure and reveal the emergence of disease-associated cell states. Notably, cardiomyocytes converge toward common disease-associated cell states, whereas fibroblasts and myeloid cells undergo dramatic diversification. Endothelial cells and pericytes display global transcriptional shifts without changes in cell complexity. Collectively, our findings provide a comprehensive analysis of the cellular and transcriptomic landscape of human heart failure, identify cell type-specific transcriptional programs and disease-associated cell states and establish a valuable resource for the investigation of human heart failure.

  View details for DOI 10.1038/s44161-022-00028-6

  View details for PubMedID 35959412