For some people, zip code may have more influence over their health than their genetic code
About our California Discovery Research
The mechanisms affecting preterm birth span an incredible range, making it a complex issue to tackle. To reduce preterm birth rates, we examine the full picture of risk such as:
- Molecular contributors such as inflammation and genetics
- Clinical factors like hypertension, diabetes, smoking, and depression
- Place-based social and historical contributors such as structural racism
- Housing, food security, stress, violence, and environmental toxins.
This integrated approach helps us better understand how factors work together to influence preterm birth and other disparities in mothers and babies.
We are particularly interested in understanding and addressing patterns and drivers of preterm birth among Black and Hispanic/Latina women, as they experience higher rates and greater burdens of preterm birth.
Collaboration Across Disciplines
In 2018, we launched a transdisciplinary discovery collaborative that brings together researchers from a wide range of disciplines to address the preterm birth epidemic in Oakland, San Francisco, and Fresno. The collaborative, which plays a key role in all of our Discovery research, is unique because it breaks down the siloes often found in traditional research. By harnessing expertise from multiple disciplines, we can approach preterm birth research in unique and surprising ways.
Our transdisciplinary discovery collaborative spans ten departments at UCSF and includes partners from UC Berkeley, UC San Diego, UC Davis, UC Irvine, UC Los Angeles, Stanford University, Fresno State University, the University of Iowa, the University of Alabama at Birmingham and Cincinnati Children’s Hospital.
We are proud to have published 18 articles in 2020. See our full list of publications.
Discovery Projects
Centering Black Preterm Infant Caregiver Priorities Study
Black families are at higher risk of preterm birth and its consequences compared to other groups. Even after Black infants are discharged home from the hospital, they continue to face increased risk of poor health outcomes compared to other groups. These differences are due to medical and societal racism. The Center and Care study hopes to interview 20 Black caregivers who have had preterm infants in a neonatal intensive care unit (NICU) in the Bay area in order to gain family perspectives about how the medical system and our society can best support the long-term health of Black preterm infants.
The HOPE COVID-19 Study
Now enrolling
The Study
The HOPE COVID-19 Study looks at how the virus that causes COVID-19 and factors associated with the pandemic like stress and social distancing might affect a woman or birthing person's risk for certain kinds of adverse pregnancy outcomes, like preterm birth and preeclampsia, as well as newborn and infant health.
We are especially interested in how the pandemic is affecting low-income and Black and Brown women and birthing persons who often suffer the impacts of systematic racism and are already at increased risk for adverse outcomes.
Who Can Participate and How
- Survey only cohort:
Pregnant women and birthing persons who are 18 years of age or older and can read/write in English or Spanish can participate by filling out surveys during pregnancy until their baby is 18 months old. California residents can earn up to $175. Currently enrolling!!
- The survey + testing cohort:
Pregnant women and birthing persons who are 18 years of age or older can participate by filling out surveys and having laboratory testing done during pregnancy until their baby is 18-months old. Participants can receive up to $550 in gift cards!
News from the study
- 435 people enrolled!
- Now in Spanish and Offering Compensation
- Featured on The Today Show
- Featured in New York Times
- Featured in The Atlantic
- Paper published in Reproductive Medicine
Risk Score for Preterm Birth
What if women could take a test before they were pregnant, or in their first trimester to understand how at-risk they might be of having a preterm birth or other poor birth outcomes?
Creating a risk score
We developed a scoring method to identify women at high risk of preterm birth. Using factors that are known prior to pregnancy or during the first trimester, we now understand how to create a cumulative risk score to identify women at the lowest and highest risk for preterm birth regardless of race/ethnicity or socioeconomic status.
We found that this cumulative risk score could also identify women at risk for other poor pregnancy outcomes who did not have a preterm birth (such as preeclampsia, problems with the placenta, or a baby that was born small for its age).
Why do we think the test works?
Less than 10% of women who scored 0 on our test, which means they were not at risk of poor birth outcomes, had a preterm birth or other poor pregnancy outcomes. Over 40% of women with a risk score of ‘3 or more’, the highest risk category on the test, had a preterm birth and an additional 18% had another poor pregnancy outcome.
What does this mean?
Such scoring may be useful for identifying a high-risk population that may benefit from
- Additional education aimed at increasing their understanding of preterm birth and of early signs of labor
- Assistance with modifying risk factors (such as smoking, weight loss, and birth interval) prior to pregnancy, and
- Preterm birth prevention clinical trials
Mapping Preterm Birth Outcomes
We developed an interactive data visualization website for parents, community members, public health professionals, clinicians, and researchers that maps patterns of preterm birth in urban, suburban and rural areas of Fresno and the Bay Area.
For example, users can examine the relationship between preterm birth and levels of air pollution in specific neighborhoods. We hope that this user-friendly data visualization tool will lead to new interventions aimed at decreasing preterm birth.
News from our Discovery Research
