An estimated 700 U.S. women die each year from conditions related to or associated with pregnancy or childbirth, the highest rate among developed nations. More than 50,000 women experience severe maternal morbidity (SMM), life-threatening health problems that are present at delivery.
The NIH-wide IMPROVE initiative supports research on how to mitigate preventable maternal mortality, decrease SMM, and promote health equity. Using an integrated approach to understand biological, behavioral, sociocultural, and structural factors contributing to maternal mortality, SMM, and maternal morbidity, including a focus on the ongoing COVID-19 pandemic, IMPROVE will build an evidence base for improved care and outcomes in specific populations and regions of the country.
IMPROVE is a multipronged, innovative research initiative designed to understand and eliminate health disparities among populations disproportionately affected by maternal morbidity and mortality, including African American, American Indian/Alaskan Native, Asian Pacific Islander, Hispanic/Latina, very young women, women of advanced maternal age, and women with disabilities. Many of these populations are also disproportionately affected by the COVID-19 pandemic. The IMPROVE approach also addresses geographic disparities and social determinants of health, including education, racism, and socioeconomic standing.
NICHD co-chairs the NIH Maternal Health Task Force, which leads the IMPROVE initiative. In addition, maternal health is central to NICHD’s research mission and is part of the NICHD Strategic Plan, Scientific Theme 3: Setting the Foundation for Healthy Pregnancies and Lifelong Wellness. Because of the broad nature of maternal mortality and morbidity research, NICHD relies on nearly all of its branches, offices, and labs across all of its divisions and centers to conduct and support these efforts.
Through the Notice of Special Interest (NOSI): Administrative Supplements and Urgent Competitive Revisions for NIH Grants to Add or Expand Research Focused on Maternal Health, Structural Racism and Discrimination (SRD), and COVID-19 (NOT-OD-21-071), the IMPROVE initiative will support projects to address the following areas of research interest related to the COVID pandemic:
- Investigate the impact of the COVID-19 pandemic on the health, well-being, and functioning of pregnant persons and up to 1 year postpartum using psychosocial and behavioral research approaches
- Investigate the impact of SRD in the context of the COVID-19 pandemic on the health and well-being of persons during pregnancy and up to 1 year postpartum
- Understand how knowledge, attitudes, and beliefs about COVID-19 influence decisions and behaviors related to COVID-19 testing and vaccination during pregnancy and up to 1 year postpartum
- Develop an integrated understanding of pregnancy-related and pregnancy-associated maternal morbidity and mortality causes, related to COVID-19
The NIH IMPROVE initiative website provides a full listing on grantees.
Fiscal Year 2021 NICHD Awardees:
- A Multisite Randomized Controlled Trial of an Internet-Based Program for Preventing and Reducing Perinatal Depressive Symptoms (5R01HD100395-02)
- Community Events and Pathways to Inequities in Birth Outcomes (1R01HD103684-01)
- Community Violence and Disparities in Maternal and Infant Health: Effects and Mechanisms (3R01HD098138-02S1)
- Fetal Brain-Placental Immune Activation in Maternal Obesity (5R01HD100022-03)
- Molecular Basis of Early Childhood Obesity Programming by Intrauterine Growth Restriction (5R01HD092533-05)
- Psychosocial Intervention, Maternal Inflammation, and Birth Outcomes: Centering vs. Routine Prenatal Care (PIINC) Study (5R01HD092446-04)
- Psychosocial Stress and Its Relation to Maternal and Infant Outcomes Among Women with Disabilities (1R01HD102927-01A1)
Fiscal Year 2020 NICHD Awardees:
- A Health Equity Paradigm Shift: Predictors of Healthy Pregnancy in African American Women (3K23HD095075-03S1)
- Maternal Obesity and Inflammation as Drivers of Maternal Morbidity in COVID-19 (3R01HD100022-02S2)
- GO MOMS Hybrid Simulation Model for Labor and Delivery Care (3R01HD087425-04S1)
- QUS Technology for Identifying At-Risk Women for Spontaneous Preterm Birth (3R01HD089935-04S1)
- Administrative Supplement to Policy Change and Women's Health (3R01HD095951-02S1)
- Pregnancy-Associated Mortality (3R01HD092653-03S1)
- Improving Health by Linking Postpartum and Well-Baby Visits (3R01HD097171-02S1)
- NIH Website: IMPROVE initiative
- NICHD A to Z Topic: Maternal Mortality and Morbidity
- NICHD News and Features on Maternal Mortality and Morbidity
- COVID-19 Research and NICHD
- Decoding Maternal Morbidity Data Challenge
- NIH Office of the Director, Office of Research on Women’s Health: Maternal Morbidity and Mortality
- NOSI: Administrative Supplements for NIH Grants to Add or Expand Research Focused on Maternal Mortality (NOT-OD-20-104)
- NICHD Contact: Nahida Chakhtoura