Obstetric and gynecologic research at the Institute is aimed at understanding all facets of human labor and childbirth, ranging from intrauterine growth retardation, congenital anomalies, and preeclampsia to factors influencing family formation and starting and maintaining healthy families. Many of the NICHD intramural and extramural research programs are engaged in this research, as described below.
Preterm labor, fetal well-being, high-risk pregnancy, and labor are all topics of investigation supported by the Pregnancy and Perinatology Branch (PPB). The mission of the PPB is to improve the health of mothers and children with a focus on maternal health, pregnancy, fetal well-being, labor and delivery, and the developing child. The Branch supports both basic and clinical research, including defining the basic mechanisms that underlie normal and disease processes; and identifying new drug treatments, treatment methods, and preventive health strategies.
The PPB conducts studies that target a wide range of topics related to obstetrical/gynecological care and pregnancy, including research on high-risk pregnancy, labor and delivery, including preterm labor, and fetal pathophysiology and normal development. In addition, the Branch also supports a great deal of research on Infant Care and Infant Health. Among the supported studies include research to expand and improve prenatal screening methods; define placental biology; evaluate how women with physical disabilities experience pregnancy; develop markers of fetal growth; define immune responses during pregnancy; and identify ways to prevent prematurity. In addition to research, the Branch supports training programs for investigators and clinicians.
The Program in Perinatal Research and Obstetrics, which is within the Division of Intramural Research (DIR), emphasizes a multidisciplinary approach to address key issues in obstetrics and gynecology and neonatology, including basic and clinical research to improve pregnancy and birth outcomes. The Program's research includes studies involving diagnostic imaging, perinatal pathology, molecular and cell biology, and clinical epidemiology.
Clinical laboratory research in this program focuses on:
The Program in Reproductive and Adult Endocrinology, also in the DIR, advances research in the areas of endometriosis, fibroids, infertility, and endocrine aspects of disease.
Researchers in the Division of Intramural Population Health Research (DIPHR) conduct a range of studies related to obstetrics and gynecology. DIPHR's research includes major studies to investigate the practice of labor management and other obstetric practices through the Consortium on Safe Labor. Also, a multidisciplinary team of researchers from DIPHR and the University of Buffalo are conducting an epidemiologic study called the Endometriosis Natural History, Diagnosis, and Outcomes (ENDO) study. One paper from this study has already been published; two others are currently under review.
Within the Epidemiology Branch of DIPHR, researchers track trends in preterm deliveries; such practices as induced labor; maternal characteristics; and how environmental and other factors may influence fertility, pregnancy, and pregnancy outcomes over time. Research initiatives utilize state-of-the-art methodologies for empirical investigation. Epidemiology Branch programs in the area of reproductive epidemiology include the following:
In the extramural program, the NICHD's Obstetric and Pediatric Pharmacology and Therapeutics Branch (OPPTB) conducts research to improve the safety and efficacy of pharmaceuticals used to treat pregnant women, infants, and children. The Branch also supports major training programs in obstetric, pediatric, and developmental pharmacology.
The NICHD supports other obstetric-related research through its Contraceptive Discovery and Development Branch (CDDB), which promotes contraceptive research and development for preventing or reducing unintended pregnancies. This includes developing safe and effective contraceptives for women across their reproductive lives, including the safe and effective use of contraceptives during the postpartum period and between pregnancies. Another focus within the Branch is pelvic floor disorders, which can be a consequence of pregnancy.
The Maternal and Pediatric Infectious Disease Branch (MPIDB) supports research examining mother-to-child transmission of HIV and how this can be prevented during pregnancy and labor, or after birth. A range of obstetric- and gynecologic-related studies are supported by the Branch's program in Pediatric & Maternal Biomedical HIV-Related Research.
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