NICHD conducts and supports research on maternal health, including problems that may lead to maternal mortality. The institute invests in research that encompasses disease processes and clinical interventions, demographic and socioeconomic risk factors, and clinical and institutional factors that influence pregnancy and childbirth outcomes.
An overarching goal of NICHD research is to advance scientific evidence and develop new information and treatments to improve pregnancy, childbirth, and outcomes for mothers, fetuses, and infants.
Some NICHD goals related to maternal health and mortality include studies to understand the following:
- Physiological processes of pregnancy and childbirth and factors that may alter those processes, such as advanced maternal age
- Effects of pregnancy and childbirth on women’s health across the lifespan
- Effects of pregnancy-related disorders on women
- Effects of non-pregnancy-related disorders on pregnancy and pregnancy outcomes
- Effects of pregnancy on women with chronic medical conditions and disabilities
- Disparities in rates of pregnancy complications, treatment success, and short- and long-term outcomes
- Appropriate use of medication during pregnancy
- Ways to improve reliability and use of data on pregnancy, complications, and mortality
NICHD also supports specialized training for obstetricians and researchers and is committed to developing new technology to advance pregnancy and maternal health research.
NICHD research on maternal health includes basic research on specific complications of pregnancy, such as preeclampsia and eclampsia; studies of contexts related to pregnancy and childbirth; studies of safety and effectiveness of interventions and treatments; and research on other topics. More than 50 years of NICHD research on maternal health has led to a range of key scientific findings that have improved clinical practice and enhanced health outcomes.
Because the causes of maternal mortality are complex and varied, research on maternal mortality crosses multiple NICHD branch, center, and division research portfolios. Some recent findings from NICHD-supported and NICHD researchers include the following:
- The contribution of maternal characteristics and cesarean delivery to an increasing trend of severe maternal morbidity
- Trends and state variations in out‐of‐hospital births in the United States, 2004‐2017
- RNAi modulation of placental sFLT1 for the treatment of preeclampsia
- Exposures to air pollution and risk of acute-onset placental abruption: A case-crossover study
- A prospective cause of death classification system for maternal deaths in low and middle-income countries: Results from the Global Network Maternal Newborn Health Registry
- Use of antihypertensive medications and uterotonics during delivery hospitalizations in women with asthma
- Accuracy of international classification of diseases, ninth revision, codes for postpartum hemorrhage among women undergoing cesarean delivery
- Prevalence of depression among women of reproductive age in the United States
- Timing and risk factors of postpartum stroke
- Venous thromboembolism prophylaxis during antepartum admissions and postpartum readmissions
- Adjunctive azithromycin prophylaxis for cesarean delivery
- Pregnancy-associated homicide and suicide in 37 US states with enhanced pregnancy surveillance
- Racial-ethnic differences in midtrimester maternal serum levels of angiogenic and antiangiogenic factors
- Safety and pharmacokinetics of pravastatin used for the prevention of preeclampsia in high-risk pregnant women: A pilot randomized controlled trial
- Frequency of and factors associated with severe maternal morbidity
Many NICHD components address pregnancy, pregnancy-related complications, and maternal deaths. The following pages provide information on NICHD research for some topics relevant to maternal mortality:
- High-Risk Pregnancy
- Labor and Delivery
- Obesity and Overweight
- Preconception Care and Prenatal Care
- Preeclampsia and Eclampsia
- Preterm Labor and Birth
- Women’s Health
Other NICHD-led efforts related to maternal mortality include the following:
- Human Placenta Project (HPP)
HPP is a collaborative research effort to understand the role of the placenta in health and disease. HPP aims to develop new tools to study the placenta in real time to learn how it develops and functions throughout pregnancy.
- Task Force on Research Specific to Pregnant Women and Lactating Women (PRGLAC)
The 21st Century Cures Act established PRGLAC to advise the Secretary of Health and Human Services regarding gaps in knowledge and research on safe and effective therapies for pregnant women and lactating women. PRGLAC was tasked with identifying these gaps and reporting its findings back to the Secretary.
- PregSource®: Crowdsourcing to Understand Pregnancy
PregSource® is a research project that aims to improve understanding of pregnancy by gathering information directly from pregnant women through confidential online questionnaires. This firsthand knowledge promises to help researchers learn how women from a variety of backgrounds experience pregnancy, which may lead to improvements in care.
Networks and Initiatives
- Building Interdisciplinary Research in Women’s Health (BIRCWH)
This program supports physician-scientists as they move between completion of clinical or postdoctoral training and an independent research career. BIRCWH research spans the spectrum of women’s health topics, and the program is open to all types of clinicians and non-clinicians.
- Global Network for Women’s and Children’s Health Research
This network supports and conducts clinical trials in resource-limited countries by pairing foreign and U.S. investigators, with the goal of evaluating low-cost, sustainable interventions to improve maternal and child health and simultaneously building local research capacity and infrastructure.
- International Maternal, Pediatric, Adolescent AIDS Clinical Trials (IMPAACT) Network
The IMPAACT Network is a cooperative group of institutions, investigators, and other collaborators focused on evaluating potential therapies for HIV infection and its related symptoms in infants, children, adolescents, and pregnant women.
- Maternal-Fetal Medicine Units (MFMU) Network
NICHD established the MFMU Network in 1986 to respond to the need for well-designed clinical trials in maternal-fetal medicine and obstetrics. The network aims to reduce maternal, fetal, and infant morbidity related to preterm birth, fetal growth abnormalities, and maternal complications and to provide the rationale for evidence-based, cost-effective obstetric practice.
- Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b)
This study followed pregnant women to explore the underlying, interrelated mechanisms of several common adverse pregnancy outcomes, which can be unpredictable in women who have little or no pregnancy history, to help guide their treatment.
- Obstetric-Fetal Pharmacology Research Centers (OPRC) Network
The mission of the OPRC Network is to improve the safety and effective use of therapeutic drugs in women during pregnancy and lactation.