Pregnancy and Perinatology Branch (PPB)

Overview/Mission

Radiologist showing ultrasound image to a pregnant womanPPB’s goals are to improve the health of women before, during, and after pregnancy; increase infant survival; and ensure the long-term health of mothers and their children. Specifically, the branch supports research to understand fetal development and improve ways to diagnose, treat, and prevent diseases in pregnant women and newborns. As the focal point for NICHD extramural research and training in maternal-fetal medicine, neonatology, and related fields, branch staff also engage with and support investigators to identify knowledge gaps and opportunities for scientific advancement.

We are interested in applications that align with the following research priorities. For more information about NICHD’s research themes, cross-cutting topics, and aspirational goals, visit the plan’s Scientific Research Themes and Objectives.

Maternal Morbidity/Mortality and Perinatal/Infant Outcomes

Strategic Plan Theme 3: Setting the Foundation for Healthy Pregnancies and Lifelong Wellness
Strategic Plan Cross-Cutting Topic: Health Disparities

Gap: Women in the United States are more likely to die in pregnancy and childbirth than those in many other developed nations, and there currently exists significant racial and ethnic disparities in maternal morbidity and mortality. Black/African American, American Indian, and Alaska Native women are two to three times more likely to die from pregnancy-related causes than White women, and this disparity increases with age. Importantly, severe maternal morbidity causes major short- and long-term health consequences for the mother, and complications of pregnancy are associated with a higher risk of adverse perinatal/infant outcomes such preterm birth and infant death.

Priority: Research aimed at (1) improving the identification and treatment of women at high risk for pregnancy-related morbidities or mortality; (2) addressing health disparities in the identification and treatment of women at high risk for pregnancy-related morbidities or mortality; (3) elucidating the role of the healthcare system, from preconception through postpartum care, in improving outcomes for women, particularly racial and ethnic minority women and their offspring; and (4) elucidating issues related to maternal morbidity and mortality and perinatal/infant outcomes among people with intellectual, developmental, and physical disabilities.

Placental Structure and Function

Strategic Plan Theme 3: Setting the Foundation for Healthy Pregnancies and Lifelong Wellness
Strategic Plan Aspirational Goal: Use the growing understanding of immune factors in pregnancy and placental development to determine reasons for pregnancy rejection

Gap: Defects in placentation underlie major pregnancy disorders such as stillbirth, preeclampsia, fetal growth restriction, and preterm birth. The molecular processes that govern placental structure and function are poorly understood, hindering targeted therapeutic approaches to prevent or treat these disorders.

Priority: Research aimed at (1) understanding immune factors in pregnancy and placental development to determine reasons for pregnancy rejection and to evaluate mechanisms to prolong at-risk pregnancies; (2) characterizing placental structure and function using imaging techniques and biomarkers, including the development of technologies/devices that allow for safe, noninvasive real-time assessment throughout pregnancy; (3) implementing markers and imaging techniques developed in the Human Placenta Project; (4) elucidating factors involved in regulating placental metabolism, placental perfusion, and analyte transfer from the mother to the fetus; (5) addressing health disparities in the evaluation of placental structure and function; and (6) expanding our understanding of placental structure and function to include populations with intellectual, developmental, and physical disabilities.

Preterm Birth and its Consequences

Strategic Plan Theme 3: Setting the Foundation for Healthy Pregnancies and Lifelong Wellness
Strategic Plan Aspirational Goal: Enhance the survival and healthy development of preterm infants by exploring the role of environmental factors

Gap: The mechanisms that lead to preterm birth and the full extent of its consequences and treatments for the mother and infant are poorly understood.

Priority: Research aimed at (1) understanding the human gestational clock and the potential causes of preterm birth; (2) addressing the short- and long-term complications in children born preterm; (3) addressing health disparities in the etiology and management of preterm birth and its consequences; and (4) expanding our understanding of the etiology and management of preterm birth in people with intellectual, developmental, and physical disabilities.

Stillbirth and Sudden Infant Death

Strategic Plan Theme 3: Setting the Foundation for Healthy Pregnancies and Lifelong Wellness
Strategic Plan Theme 4: Improving Child and Adolescent Health and the Transition to Adulthood
Strategic Plan Cross-Cutting Topic: Health Disparities

Gap: There are no specific and sensitive predictive tests for identifying fetuses at risk for stillbirth, sudden infant death syndrome (SIDS), and sudden unexpected infant death (SUID).

Priority: Research aimed at (1) understanding the causal mechanisms of stillbirth, SIDS, and SUID; (2) addressing health disparities in the etiology of stillbirth, SIDS, and SUID; and (3) expanding our understanding of the etiology of stillbirth, SIDS, and SUID among populations with intellectual, developmental, and physical disabilities.

Maternal Obesity and Adverse Outcomes

Strategic Plan Theme 3: Setting the Foundation for Healthy Pregnancies and Lifelong Wellness
Strategic Plan Cross-Cutting Topic: Health Disparities

Gap: The prevalence of maternal obesity is increasing both in the United States and worldwide, yet it remains an understudied area. Specifically, obesity before and during pregnancy increases the incidence of infertility as well as a woman’s risk for serious health problems, such as preeclampsia, and perinatal complications, such as preterm birth. Obesity may also complicate labor and delivery, increase the risk of a cesarean delivery, and negatively affect lactation.

Priority: Research aimed at (1) identifying strategies to mitigate excessive weight gain during pregnancy; (2) understanding the role of maternal obesity in maternal morbidity and mortality and perinatal/infant outcomes; (3) addressing health disparities in the etiology and management of maternal obesity; and (4) expanding our understanding of the etiology and management of maternal obesity among people with intellectual, developmental, and physical disabilities.

Nutrition During Pregnancy and Lactation

Strategic Plan Theme 3: Setting the Foundation for Healthy Pregnancies and Lifelong Wellness
Strategic Plan Cross-Cutting Topic: Nutrition

Gap: Although evidence in recent years has shown that the health of a mother and her baby depends on appropriate nutritional intake before and during pregnancy and during lactation, the role and importance of nutrition in supporting healthy reproduction, maternal health during pregnancy, intrauterine fetal programming, and lactation has been understudied.

Priority: Research aimed at (1) elucidating the optimal nutrition requirements and micronutrient needs for a healthy pregnancy and successful lactation; (2) addressing health disparities in the assessment of nutrition requirements for a healthy pregnancy and successful lactation; and (3) expanding the understanding of the nutrition requirements for a healthy pregnancy and successful lactation for people with intellectual, developmental, and physical disabilities.

  • Currently available in NICHD's Data and Specimen Hub (DASH): Data from these PPB-funded studies: Community Child Health Research Network, Global Network for Women's and Children's Health Research, MFMU Network, National Infant Sleep Position (NISP) Study, and Stillbirth Collaborative Research Network
  • NICHD supported the Cochrane Neonatal Review Group from 1998 through 2017 to provide systematic reviews on neonatology topics. 
  • PPB worked closely with the Food and Drug Administration and Centers for Disease Control and Prevention (CDC) to conduct the Infant Feeding Practices Study II (IFPS II) from 2005 to 2007. IFPS II was a longitudinal study focusing on infant feeding practices throughout the first year after birth and the diets of women in their third trimesters and at 4 months postpartum. De-identified data from this study are available at the CDC website.
  • NISP Study: Now-completed study of infant care practices and dissemination of infant sleep position recommendations
  • Collaborative Home Infant Monitoring Evaluation (CHIME): Now-completed study of home monitors for identifying episodes of infant apnea

  • Nahida Chakhtoura, Chief
    Main Research Areas: Epidemiology and natural history of HIV in pregnant and non-pregnant women; Zika; women's health; cohort studies and clinical trials
  • Stephanie Archer, Clinical Trials Specialist
    Main Research Areas: Coordinator for NRN and MFMU Network; PregSource® implementation team member
  • Maurice Davis, Health Scientist Administrator
    Main Research Areas: Perinatal epidemiology; psychosocial issues during and after pregnancy; pregnancy stress; perinatal demographics, family support, and health disparities of pregnancy; pregnancy in women with disabilities; infant outcomes
  • Guillermina Girardi, Health Scientist Administrator
    Main Research Areas: Reproductive immunology; autoimmunity; recurrent miscarriages; preeclampsia; gestational diabetes; in utero/developmental origins of disease; imaging (MRI and 1HMRS [spectroscopy]) in placental insufficiency and abnormal neurodevelopment; translational studies (particularly therapeutic strategies to prevent placental insufficiency)
  • John Ilekis, Program Director-Health Sciences Administrator
    Main Research Areas: Fetal pathophysiology/programming and developmental origins of disease; placental biology, structure, and function; preeclampsia; perinatal microbiome
  • Marion Koso-Thomas, Medical Officer
    Main Research Areas: Patient safety; neonatal/pediatric care; neonatal resuscitation; Global Network for Women's and Children's Health Research; infant follow-up; neonatal and pediatric immunity; SIDS
  • Monica Longo, Medical Officer
    Main Research Areas: High-risk pregnancy; hypertensive disorder of pregnancy; diabetes (type 1, type 2, and gestational); fetal developmental origins of health and disease; metabolic and cardiovascular programming; pregnancy as a window of future maternal health; cardiovascular maternal risk after pregnancy
  • Dorothy Tucker, Staff Assistant
  • Michele Walsh, Program Officer
  • David Weinberg, Project Lead
    Main Research Areas: Human Placenta Project

Highlights

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