The National Institutes of Health will fund new research examining racial and ethnic disparities in pregnancy-related complications and deaths. According to the Centers for Disease Control and Prevention(link is external), approximately 700 women die each year in the United States from pregnancy-related complications. The grants to six institutions are expected to total over $21 million over five years, pending the availability of funds. The project is supported by the National Institute on Minority Health and Health Disparities (NIMHD), the National Heart, Lung, and Blood Institute (NHLBI), and the NIH Office of Research on Women’s Health.
Research will include original, innovative, and multidisciplinary efforts to advance the understanding, prevention, and reduction of pregnancy-related complications and deaths among disproportionately affected women. This includes women from racial and ethnic minority groups, women with underprivileged socioeconomic status, and those living in underserved rural settings.
The racial disparities in pregnancy-related mortality are stark: respectively, African American and American Indian/Alaska Native women are 3.2 and 2.3 times more likely to die from pregnancy-related causes than are white women. In the case of African American women, the disparity increases with age. Black women under 20 are 1.5 times more likely to die from pregnancy-related causes than are white women in the same age group, but black women ages 30-34 are 4.3 times more likely to die from pregnancy-related causes than are white women ages 30-34. Approximately two thirds of pregnancy-related deaths are preventable, underscoring the need for more research to improve the maternal health outcomes for women before, during, and after delivery.
In addition to maternal deaths, over 25,000 women each year experience severe maternal morbidity(link is external) (SMM), requiring unexpected short- or long-term life-saving healthcare interventions. Like maternal mortality, SMM has a high rate of preventability. All racial and ethnic minority populations have higher rates of SMM than do white women.
“This initiative is a significant undertaking to reduce preventable causes of maternal deaths,” said NIMHD Director Eliseo J. Pérez-Stable, M.D. “We need to take a closer look at underlying factors beyond the individual, such as healthcare access, health care settings providing care, community resources, and racial bias and examine how these factors may impact the maternal health outcomes of racial and ethnic minority women.”
In addition to examining factors influencing maternal health disparities, researchers will be among the first to evaluate the effectiveness of a multilevel intervention—at the individual, health care setting, community, and societal levels—to reduce maternal deaths and complications.
This funding effort expands upon NIH’s commitment to address the rising rates of illness and death from preventable pregnancy-related complications through the IMPROVE Initiative, which addresses disparities in maternal health.
Tufts University, Boston
Project name: Reducing Health Disparities in SMM Post COVID-19: Assessing the Integration of Maternal Safety Bundles and Community Doulas to Improve Outcomes for Black Women
Contact PI: Ndidiamaka Amutah-Onukagha, Ph.D.
This study will assess the effectiveness of an integrated care model to improve the level of maternal care for mothers of color and decrease disparities in severe maternal morbidity and mortality. This includes examining the engagement of mothers in the planning and implementation of maternal safety bundles in addition to prenatal, birth, and postpartum support from community doulas.
University of South Carolina at Columbia
Project name: Hospital Quality, Medicaid Expansion and Racial/Ethnic Disparities in Maternal Mortality and Morbidity
Contact PI: Nansi Boghossian, Ph.D.
This study will examine to what extent hospital quality contributes to maternal racial and ethnic disparities in eight U.S. states, and whether Medicaid expansion has impacted hospital quality and maternal outcomes.
University of Pennsylvania, Philadelphia
Project name: Improving Health Outcomes and Equity by Targeting Postpartum Mothers at Highest Risk
Contact PI: Elizabeth A. Howell, M.D.
This study aims to better identify Black and Latina women most at-risk following delivery, the problems they experience, and to adapt an evidence-based intervention to improve quality of postpartum care for high risk women.
Emory University, Atlanta
Project name: Minding the Gap: A Multidisciplinary Approach to Reducing Maternal Health Disparities in Georgia
Contact PI: Denise Jean Jamieson, M.D.
This study will assess racial disparities in adverse maternal health outcomes, evaluate the effects of Georgia’s Medicaid Inter-Pregnancy Care Program, and conduct and evaluate a trial of a comprehensive patient-centered postpartum care system in an urban safety-net hospital in Georgia.
Michigan State University, East Lansing
Project name: Meeting Women Where They Are: Multilevel Intervention Addressing Racial Disparities in Maternal Morbidity and Mortality
Contact PI: Jennifer E. Johnson, Ph.D.
This study will test the effectiveness and costs of a multilevel intervention to address pregnancy-related complications and deaths in two Michigan counties for Medicaid insured African American women.
The following award recipient is funded by the NHLBI:
University of Pittsburgh
Project name: Preconception and Prenatal Stress Effects on Cardiovascular Disease Risk in Black Women
Contact PI: Alison E. Hipwell, Ph.D.
This study will examine whether chronic stress impacts postpartum cardiovascular risk among Black women. New data from this study will improve understanding of cardiovascular risks and will inform the targets and timing of interventions to reduce persistent racial disparities in maternal health.
National Institute on Minority Health and Health Disparities (NIMHD): NIMHD leads scientific research to improve minority health and eliminate health disparities by conducting and supporting research; planning, reviewing, coordinating, and evaluating all minority health and health disparities research at NIH; promoting and supporting the training of a diverse research workforce; translating and disseminating research information; and fostering collaborations and partnerships. For more information about NIMHD, visit https://www.nimhd.nih.gov.