Featured Projects

UCSF Resource Allocation Program 

The California Preterm Birth Initiative leverages the UCSF Resource Allocation Program (RAP) to attract great ideas from University of California and affiliated investigators across all disciplines, as well as community researchers. Our hope is that these promising studies will generate preliminary data that will support future NIH and foundation proposals.

The following is a list of research projects supported by the California Preterm Birth Initiative through the UCSF Resource Allocation Program (RAP). Learn more about the grant process, and apply for funding, here.

(*) Denotes completed projects.

Discovery Projects

Hyper-localized air pollution measures and preterm birth in the Bay Area

Maria Glymour, ScD, MS | Epidemiology & Biostatistics | UCSF School of Medicine
Joan Casey, PhD, MA | UC Berkeley School of Public Health

A fleet of Google Street View cars measured air quality 50 times on average on every block face within San Francisco Bay Area neighborhoods including three communities in Oakland (West, Downtown, and East Oakland) between 2015-2018. Monitors measured combustion-related pollutants: black carbon particles, nitric oxide, and nitrogen dioxide. We will use these hyper-localized measures to learn about air pollution and reproductive health. Our dataset relies on address-level birth certificate data from the California Department of Public Health and electronic health record data on pregnant women at Sutter Health from 2014–2016. We pursue two aims: (1): Estimate the association between hyper-localized air pollution levels and preterm birth; and (2): Assess the role of pregnancy-induced hypertension and preeclampsia in the relationship between hyper-localized air pollution levels and preterm birth. We will further consider how air pollution impacts the pregnancies of vulnerable subgroups including mothers of different race/ethnicities and socioeconomic status.

Telomere Length as a Predictor of Preterm Birth and Growth in Latino Neonates

Janet Wojcicki, PhD, MPH | Pediatrics | UCSF School of Medicine

Our study assesses the role of infant and maternal leukocyte telomere length in Latino infants in relation to known risk factors for preterm birth and growth outcomes in preterm babies.  Specifically, in mothers, we assess the relationship between maternal telomere length and known risk factors for prematurity such as advanced and younger maternal age and exposure to smoking, diabetes mellitus and hypertension in pregnancy.  In infants, we assess the relationship between telomere length at birth and rapid infant weight gain, a risk factor for future obesity.

*Qualifying risk: Exploring how life course stress experiences influence the risk of preterm birth among Black women

Leslie Dubbin, PhD, MPH, RN | Social & Behavioral Sciences | UCSF School of Nursing
Monica McLemore, PhD, MPH, RN | Family Health Care Nursing | UCSF School of Nursing

Objectives: The goal of this study was to understand the types of stress that Black women experience, and what tools of resilience and mechanisms of coping they use when experiencing stress during their pregnancy.

Methods: In-depth interviews based were conducted with Black women Black between the ages of 18- 44 and at or around their 30th week of pregnancy.

Results: Women's narratives focused on three themes of interest: life course stress, social support, and resiliency.

Life course stress: Most women in this study described unstable childhoods, the stress of which traveled with them to adulthood and shaped their current life situations. The main sources of current stress were housing instability and job insecurity.

Social Support and Social Networks: Few of the women in this study had a strong network of social support; most relied on individual family members, small group of friends and/or the father of the baby.

Resilience: Spirituality and belief in their own inner strength to "make it" and "keep going" is the foundation of their resilience. The pregnancy itself was seen as the reason for making positive life changes.

Conclusions: Experiences of pregnant black women who are very poor comprise a rich tapestry of life experiences. Each recognized their own unique expert knowledge they can pass on to their children and that the gift of resilience is one part of their legacy. All dreamed to provide a childhood of safety and care and were actively looking ahead to create paths that achieved those goals.

Persistent human cytomegalovirus infection of the amnion in preterm birth and intrauterine growth restriction

Takako Tabata, PhD | Cell & Tissue Biology | UCSF School of Dentistry

Human cytomegalovirus (HCMV) infection during pregnancy is a leading cause of birth defects and preterm birth, and African American and Hispanic women are at four- to five-fold greater risk for infection during reproductive years than white women. We propose to identify molecular pathways in the amniotic epithelium that enable persistent infection and preterm labor (Aim 1) and drugs that reduce persistent infection (Aim 2). This work has potential to reduce the risk of preterm birth, especially in communities disproportionately affected by HCMV.

Exploring the dual burden of severe maternal morbidity and preterm birth in California

Audrey Lyndon, PhD, RN | Family Health Care Nursing | UCSF School of Nursing

For most families experiencing preterm birth, the infant’s vulnerable health status will be the primary focus as the family adapts to this unexpected outcome. However, for a subset of families experiencing preterm birth, the mother also faces serious to potentially life-threatening complications. The consequences of the dual burden of severe maternal morbidity and preterm birth on the life of a young family may be profound. The purpose of this study is to explore the prevalence of this dual burden on families in California and in PTBi-CA geographies.

San Francisco Preterm Birth Review (SF PTBR)

Rebecca Jackson, MD | Obstetrics, Gynecology & Reproductive Science | UCSF School of Medicine

We have little knowledge about the psychosocial and medical factors present in the days and hours preceding preterm birth and, as result, lack a clear understanding of local factors that may contribute. In contrast, in cases of fetal or infant death, the San Francisco Fetal Infant Mortality Review (SF FIMR) program conducts systematic data collection from medical records and qualitative interviews with patients and providers to identify contributing factors and develop data-driven local interventions to reduce these early deaths. Our goal is to develop a similar surveillance system for preterm birth. The SF Preterm Birth Review (PTBR) will build upon the existing FIMR program and leverage biological data that are routinely collected in the medical record, but not currently abstracted. This project will fill gaps in our understanding of local factors that contribute to preterm birth.

*OMX, a novel oxygen carrying protein, for resuscitation in preterm delivery secondary to placental under-perfusion states

Jeffrey Fineman, MD | Pediatrics | UCSF School of Medicine
Emin Maltepe, MD, PhD | Pediatrics | UCSF School of Medicine

While hemoglobin is the primary oxygen delivery molecule used to maintain tissue oxygenation in metazoans, many organisms have other heme-containing proteins that can bind oxygen and other diatomic gases. Here, we tested whether a member of the H-NOX family of heme-containing proteins found in the thermostable bacterium Thermoanaerobacter tengcongensis can be engineered to deliver oxygen to severely hypoxic tissues in large mammals. This class of molecules has the advantage of high oxygen affinity and minimal nitric oxide reactivity. We demonstrate that these molecules can effectively deliver oxygen to a lamb heart with induced severe hypoxia, without over-exposing the animal to oxygen or triggering systemic vascular reactivity. These molecules thus represent a novel class of oxygen delivery biotherapeutics to specifically target hypoxic tissue beds without the toxicity concerns of hemoglobin-based oxygen carriers. Importantly, as ischemic placental disease processes such as preeclampsia and fetal growth restriction are major drivers of preterm birth, these types of oxygen delivery biotherapeutics may serve as novel therapies to increase oxygen delivery to the growing fetus in this setting. This would have the obvious benefit of supporting fetal well-being and growth, thereby minimizing the need for indicated preterm delivery

*Is preterm birth associated with air pollution from oil and gas power plants in California? A natural experiment

Joan Casey, PhD, MA | Department of Psychiatry | UCSF School of Medicine 

Background: Coal electricity generation has declined, but still accounted for 30% of U.S. electricity in 2016. Despite reduction in air emissions when coal and oil power plants retire, few studies have compared community health before and after power plants retire.

Objectives: We aimed to estimate the effect of coal and oil power plant retirements in California on preterm birth.

Methods: We obtained data on all births that took place in California between 2001-2011 from the California Department of Public Health. From the U.S. Energy Administration and the U.S. Environmental Protection Agency, we downloaded data on 8 retiring coal and oil power plants. We implemented a quasi-experimental design, comparing the probability of preterm birth before and after power plant retirements while accounting for maternal and neighborhood characteristics like maternal age and educational attainment.

Results: Our study population included 57,005 births that took place within 20km of one of 8 retiring coal (n = 2) or oil (n = 6) power plants in California during 2001-2011. We found that power plant retirements were related to a decrease in preterm birth among mothers living within <5km and 5-10km, using mothers living 10-20km away as a control. For example, after power plant retirement, we saw a 1.9% (95% CI: -3.1% to -0.8%) reduction in preterm birth among mothers living within 5km. Improvements in preterm birth appeared even larger for non-Hispanic Black and Asian mothers.

Conclusions: Future coal and oil power plant retirements may reduce preterm birth among nearby populations

"Preconception" Intervention Projects

Pediatric Clinic Survey of Maternal Preterm Birth Risk and Family Planning Needs and Preferences

Jayme Congdon, MD | Pediatrics | UCSF School of Medicine

Women interface frequently with their child’s pediatrician in the months following delivery, presenting a timely opportunity to identify and address unmet reproductive health needs during the period when women are at risk for short interpregnancy intervals, a risk factor for preterm birth. The Pregnancy, Early-Birth, and Reproductive Lives Study (PEARLS) will explore women’s preferences for addressing postpartum family planning in the pediatric clinic. We will survey women attending a preventive care visit for their 2-6-month-old infant in San Francisco and Alameda counties. Findings will inform the design of a pediatric-clinic based intervention to enhance access to postpartum family planning resources and care.

Perceptions and availability of postpartum contraception among women and health care providers following preterm birth

Heike Thiel de Bocanegra, PhD | Obstetrics, Gynecology & Reproductive Science | UCSF School of Medicine

Pregnancy occurring less than six months after delivery puts women at increased risk of preterm birth. Access to high-efficacy postpartum contraception can help women to prevent extremely short inter-pregnancy intervals. We will conduct 30 in-depth interviews with women who had preterm births in San Francisco, Oakland, and Fresno to explore their preferences and attitudes about postpartum contraception. Additionally, we will conduct 30 clinician interviews and review hospital birth data to assess provider and system factors in contraceptive provision in maternity wards. Findings will inform the development of patient-centered interventions to improve counseling and provision of contraception.

Exploring the relationship between preconception family planning and preterm birth through a community-engaged process

Christine Dehlendorf, MD, MAS | Family and Community Medicine | UCSF School of Medicine

Poor use of contraceptives in the postpartum period can contribute to unintended pregnancy and short interpregnancy intervals, a risk factor for preterm birth. We will engage with women of color and with reproductive justice advocates to conduct formative work around attitudes and preferences for perinatal family planning care and contraceptive counseling. We will also consider contextual factors related to reproductive health experiences and preferences of women of color. We hope to use results from this formative work to create a clinic-based intervention to improve the family planning experiences of peripartum women at risk for preterm birth.

Prenatal Intervention Projects

Adaptation of the Person-Centered Maternity Care scale for women of color in the U.S.

Patience A. Afulani, MBChB, MPH, PhD | Epidemiology & Biostatistics | UCSF School of Medicine
Molly Altman, PhD, CNM, MPH | University of Washington School of Nursing

Socially-driven issues such as disrespect, abuse, and discrimination within the health care system play a significant role in how women of color experience, and therefore access, care during pregnancy, birth, and postpartum, which influences outcomes for mother and baby. Women of color have repeatedly described disrespectful care experiences, with loss of autonomy and self-determination. As we move from describing preterm birth disparities to action-based research, we need measurement tools that adequately capture the care experiences of women at most risk for preterm birth. We aim to 1) use community engaged approaches to adapt a quantitative scale to measure person-centered maternity care (PCMC) for women of color in the United States; and 2) describe the extent to which women in the study population are receiving PCMC. We will use a mixed-methods approach including qualitative interviews for developing and refining items and quantitative data for psychometric analysis

Drug use and pregnancy policy study (D-APPS)

Sarah Roberts, DrPH | Advancing New Standards in Reproductive Health (ANSIRH), UCSF Bixby Center for Global Reproductive Health

Most states have enacted one or more policies targeting drug use during pregnancy. These include punitive policies, e.g. allowing civil commitment of pregnant women for drug use and mandating reporting to Child Protective Services (CPS). States have also enacted supportive policies, e.g. giving pregnant women priority in entering substance abuse treatment. These policies could influence preterm birth. Punitive policies could also have unintended consequences, such as deterring women from prenatal care and decreasing opportunities to provide other health-promoting interventions. The primary purpose of this project is to assess effects of state-level policies targeting drug use during pregnancy on preterm birth and prenatal care utilization and whether effects vary by race/ethnicity

*EatSF: Fruit and Vegetable Vouchers to Support Pregnant Mothers in San Francisco with Food Security and Healthy Dietary Intake

Hilary Seligman, MD, MAS | Departments of Medicine, and Epidemiology & Biostatistics | UCSF School of Medicine, Feeding America

Women in low-income households frequently report challenges affording enough of the healthy foods they would prefer to eat, particularly fruits and vegetables. The tension between what a limited food budget allows and the desire to eat a healthier diet is often strongest during pregnancy, when mothers most want to eat a healthy diet in order to support their developing baby.

The EatSF program allows participants to exchange vouchers for fruits and vegetables of their choice at 28 participating corner stores, farmers markets, and large grocery stores across San Francisco. With the support of PTBi-CA, we sought to determine the extent to which $10 in weekly F&V vouchers improves intake of fruits and vegetables, supports food security, and lowers preterm birth rates among low-income pregnant mothers in San Francisco. We collected surveys from 569 pregnant women from all 6 WIC locations in SF, both before starting in EatSF and after 3-6 months of participation. All of these women were enrolled in EatSF and receiving $40 per month in F&V vouchers. We also collected surveys from 106 non-pregnant women from WIC.

Results show that adding vouchers specifically for fruits and vegetables to existing WIC benefits improves the food security of low-income pregnant women, but at the current amount ($40 each month) does not increase consumption of fruits and vegetables. Improving food security is critically important due to its link to birth outcomes, but further studies are needed to determine what benefit level can support increased consumption of fruits and vegetables.

Periviable GOALS: Formative research to create a decision support tool for periviable decision-making

Miriam Kuppermann, PhD, MPH | Obstetrics, Gynecology & Reproductive Science | UCSF School of Medicine

We will conduct formative research among Spanish-speaking Latina and low income English-speaking women and their providers, as the initial step in developing a decision support tool. The tool will facilitate informed, shared decision making about neonatal resuscitation among women who present to labor and delivery at periviable gestations and their health care providers. We will conduct design sessions with women who delivered infants at 22-25 weeks gestation, pregnant women between 22 and 25 weeks gestation, and health care providers involved in their care, to help us gain an understanding of periviable birth issues and decision support needs from multiple perspectives.

*Social determinants of health, adversity and resilience (SOAR) Factors

Danielle Hessler, PhD | Family and Community Medicine | UCSF School of Medicine
Dayna Long, MD | UCSF Benioff Children’s Hospital Oakland

Preterm birth (PTB) is defined as an infant born before 37 weeks and is a prevalent problem in the U.S. with 1 in every 10 infants being born premature. A growing body of evidence highlights the importance of addressing social and environmental factors to prevent PTB and improve quality of life for families who experience PTB. This study uses the abbreviation “SOAR” to define the main social stressors that cause preterm birth, including (1) Social Determinants of Health (e.g., food insecurity, housing instability or homelessness), (2) areas of Adversity or experience of Adverse Childhood Events (e.g., experiencing abuse, caregiver substance use, caregiver mental health), as well as (3) areas of Resilience that can be further supported.

Pregnancy care can serve as a natural point for addressing SOAR factors for women at risk of PTB. Our study aimed to examine existing practices and standards for screening and responding to these factors in pregnancy care settings, and develop recommendations to increase screening and response to SOAR factors in Oakland and Alameda County.

Interviews were conducted with 25 providers across 10 clinic sites. Provider interviews revealed barriers to increased screening and response including understaffing, patients’ level of trust in providers, stigma related to “getting help,” and the structure of the Comprehensive Perinatal Services Program (CPSP), which is often utilized by clinics. Potential opportunities include addressing challenges in workflow and documentation, developing on-site social services, providing incentives for patient attendance to visits, as well as improved follow-up and care coordination.

Exploring women’s experiences to inform Drug and Alcohol Pregnancy Policies study (D-APPS: Women’s Experiences)

Fall 2018 Cycle
Sarah Roberts, DrPH | Obstetrics, Gynecology, and Reproductive Sciences | UCSF School of Medicine

Some have expressed concern that marijuana legalization leads to increased marijuana use among pregnant women and that increased use could adversely impact birth and childhood outcomes. Public health implications of increased marijuana use during pregnancy depend on whether marijuana use is substitution – e.g. marijuana instead of alcohol – complementary – e.g. marijuana along with alcohol – or new – i.e. no substance use, but now marijuana.  Public health implications of marijuana legalization also depend on policy approaches adopted in response. One state-level alcohol/pregnancy policy, Mandatory Warning Signs, has adverse effects on preterm birth and prenatal care utilization. Some states that have legalized marijuana have enacted Mandatory Warning Signs for marijuana and California health departments are considering public health warning approaches related to marijuana use during pregnancy. Using in-depth interviews, we will 1) examine substitution during pregnancy and 2) explore factors, including legalization and health messages, that inform women’s decisions around marijuana use during pregnancy.

Postnatal Intervention Projects

Exploring Lactation and Pasteurized Donor Human Milk Use Experiences among Black Families in NICU Settings

Ifeyinwa Asiodu PhD, RN, IBCLC | Family Health Care Nursing | UCSF School of Nursing.

Premature birth occurs at unacceptably high rates in the US, with Black families experiencing the highest burden. For premature infants, human milk is a life-saving therapy. The purpose of this study is to understand Black families’ experiences with lactation and infant feeding support in Bay Area NICU settings. The specific aims of this study are to: 1) identify life course factors that promote or hinder breastfeeding, maternal milk expression, and/or use of pasteurized donor human milk; and 2) gain insight into the ways racism and implicit bias practices are performed by healthcare providers and experienced by Black families. A mixed methodology approach guided by Community-Based Participatory Action Research (CBPAR) principles will be used. Data will be collected in two phases: 1) online surveys, in-person interviews and 2) community discussions with Black families. Results from this study will be used to inform and improve lactation services in NICU settings.

Improving Preterm Infant Outcomes with mobile enhanced Family Integrated Care (mFICare)

Linda Franck, PhD, RN | Department of Family Health Care Nursing | UCSF School of Nursing

This project tests the effectiveness of a new model of Family Integrated Care (FICare) care that transforms the culture of the NICU so that parents are more fully integrated as partners in their baby’s care. FICare was recently tested in NICUs across Canada, Australia, and New Zealand in a large cluster randomized controlled trial, which showed that preterm infants enrolled in the FICare intervention had better rates of weight gain and breastfeeding at discharge, while parents displayed lower levels of stress and anxiety, compared to usual family-centered care NICUs. We have enhanced FICare with the addition of a mobile app for the US context where many parents may be unable to be physically present in the NICU during the workday. The NFRC-supported mFICare comparison study has launched and will be conducted at six NICU sites by the end of 2017.

Clinical accuracy of a new method to wirelessly monitor skin temperature in preterm neonates using adhesive-embedded sensors

Linda Franck, PhD, RN | Department of Family Health Care Nursing | UCSF School of Nursing
Todd Coleman, PhD | Institute of Engineering and Medicine | UC San Diego

Hypothermia, hyperthermia and thermal instability are major causes of neonatal mortality and morbidity in preterm infants. Although an essential part of life-saving NICU care, temperature monitoring is a major source of daily stress for vulnerable preterm infants. This pilot study will generate preliminary data on the accuracy and feasibility of the new adhesive-integrated flexible electronic systems (AIFES) temperature sensor—which can be embedded in routinely used medical adhesives, applied to the skin and monitored wirelessly—compared with the ‘gold standard’ digital thermometer in preterm infants 28 to 37 weeks gestational age.

We3Health: A mobile health app for parents of NICU parents and clinicians

Linda Franck, PhD, RN | Department of Family Health Care Nursing | UCSF School of Nursing
Yao Sun, MD, PhD | Department of Pediatrics, Division of Neonatology | UCSF School of Medicine
Scott Bolick and Brittany Lothe | Will’s Way Foundation

Using human-centered design methods, we have co-created with parents of preterm babies a mobile application that facilitates information exchange between healthcare providers and parents, and enables parents to document their experiences and participate in shared decision-making. The We3Health Tracker version facilitates documentation of key parent engagement processes and outcome metrics regardless of the model of NICU care. The We3Health App mFICare version is uniquely designed to support parents in FICare NICUs with its features that educate, encourage, and engage parents as partners in their baby’s care. We3Health gives parents support in the palm of their hand, on demand and wherever they may be. User testing at Benioff Children’s Hospital San Francisco was very positive and the We3health App will be in use to support mFICare research at five other NICU sites in 2017.

*Milk, growth and microbiota: An RCT of donor milk vs. formula to supplement breastfeeding late preterm newborns

Valerie Flaherman, MD, MPH | Pediatrics | UCSF School of Medicine

Late preterm infants, who are born at 34, 35 or 36 weeks gestation, often have difficulty feeding, establishing growth, and fighting off infection. Breastfeeding provides improved nutrition to help fight infection, in part because breast milk encourages the growth of healthy bacteria (microbiota) in the infant’s intestine. However, when mothers give birth preterm, their breasts are usually not quite ready to make milk; it can take several days to have enough breast milk to match a baby’s nutritional needs. If there is not yet enough breast milk, formula is often used. However, formula can interfere with the growth of healthy intestinal bacteria. An alternate nutritional option is donor milk from a certified milk bank.

We randomly assigned 20 late preterm, breastfeeding newborns to either donor milk or formula and collected subsequent weights as well as bowel movements for analysis of microbiota. Infants lost weight for the first 2 days after enrollment and were gaining weight by the end of the first week. There were no differences in the rate of weight gain between newborns who received formula and those who received donor milk. Analysis of microbiota is not yet complete. This small study provides estimates of weight gain for late preterm newborns requiring supplementation. These estimates may inform the design of a future, larger study to determine whether donor breast milk is better than formula for late preterm newborns.

*Eliciting the family experience to plan an outcome evaluation: a pilot study of the Special Start neonatal follow upprogram

Laura Frame, PhD | UCSF Benioff Children’s Hospital Oakland

Infants born prematurely face many challenges during hospitalization, through the transition process from hospital to home. Caring for a premature baby at home can be further complicated for parents grappling with poverty, violence, migration and other stressors. For 20 years, UCSF Benioff Children’s Hospital Oakland has operated a specialized home-based program, Special Start, for families of premature babies at high social risk.

The aims of this study were to (a) describe the Special Start intervention model in detail, and (b) describe families’ experiences of premature birth and coping with stressors; bringing these together in a program manual and proposal for outcome evaluation.

This qualitative study used a theory of change approach that visually outlines the “how” and “why” a service model is believed to be effective in reaching its goals. Two rounds of focus groups and interviews were conducted with 10 former Special Start participants and 17 staff members, each. These were audiotaped and transcribed, and narratives were analyzed for key themes.

The perspectives of families and staff converged around a core set of intervention principles. At the foundation of Special Start’s model are 6 basic tenets: it is relationship-based; trauma-informed; flexible and family-driven; race, place and class matter; it is multidisciplinary; and interventions reach “beyond baby”. From there, interventions address a range of basic, psychosocial, and health/developmental needs, supporting parents to become confident experts on their own child; establish a strong, positive parent-child relationship; and to have the tools to handle future challenges. The ultimate goal is that children are healthy and developing well in strong, healthy families.

The study resulted in a detailed program manual for Special Start, in which interventions are described and illustrated in the words of former Special Start participants. A proposal for further evaluation of Special Start is provided.

Learn more about Laura Frame's work with Special Start Programs from our September 2018 Collaboratory

Evaluating the effect of San Francisco’s Paid Parental Leave Ordinance on preterm birth and associated maternal and newborn outcomes

Deborah Karasek, MPH, PhD | Obstetrics, Gynecology and Reproductive Sciences | UCSF School of Medicine
Julia Goodman, MPH, PhD | Division of Public Administration | Portland State University

Most women in the US work during pregnancy, yet only 13% of workers in the US have access to paid parental leave, forcing parents to return to work sooner than they would like, or face the financial burden of forgoing pay while on leave. Understanding that these conditions create stress and physical strain that may contribute to high rates of preterm birth among economically vulnerable populations, our study seeks to examine whether changes in parental leave policies improve outcomes. We use an experimental design to evaluate the impact of San Francisco’s recently enacted Paid Parental Leave Ordinance (PPLO), which provides new parents with 6 weeks of full wage replacement. This is the first study to examine the effect of the PPLO on preterm birth as well as potential mediating mechanisms. This study provides an important opportunity to understand policy levers to reduce preterm birth among women at highest risk.

California Preterm Birth Initiative Funded Research Projects

The UCSF California Preterm Birth Initiative is a unique research platform which conducts and funds research across the reproductive lifecourse. The following is a list of research projects supported by the Initiative. 

Prenatal Intervention Projects 

  • Disrupting Current Models of Prenatal Care: GLOW! (Fresno, CA)

Postnatal Intervention Projects

  • Improving Preterm Infant Outcomes with mobile enhanced Family Integrated Care (mFICare)
  • Clinical accuracy of a new method to wirelessly monitor skin temperature in preterm neonates using adhesive-embedded sensors
  • We3Health: A mobile health app for parents of NICU parents and clinicians

Discovery Projects

  • Explore the molecular and place-based underpinnings of preterm birth and outcomes of prematurity using statewide and place-based data and banked biospecimens
  • Exploring physiological changes throughout pregnancy that may underpin parturition using samples from participants in the Smart Diaphragm Stud
  • Adaptation of an existing data integration/visualization platform for the purpose of visualizing and performing exploratory analysis of a multivariate dataset of risk factors of preterm birth in Fresno County, and validation of its usability with diverse and cross-sector PTBi stakeholder
  • Genetic associations with preterm birth
  • Comparison of risk and resiliency factors for preterm birth in rural, suburban and urban areas of Fresno County, California
  • Region-specific comparison of socioeconomic and environmental contributors to preterm birth
  • Outcomes of prematurity in rural, suburban and urban areas of Fresno County, California by race/ethnicity and socioeconomic status
  • Maternal hyperlipidemia and risk for preterm birth
  • Metabolic and inflammatory pathways of preeclampsia
  • Maternal serum cortisol, CRH and the risk of preterm birth
  • Metabolic underpinnings of preterm birth by timing and subtype
  • Genetic risk score for lipid levels and preterm birth
  • The relationship between tumor necrosis factor, genetic predisposition for dyslipidemia and preterm birth
  • Metabolic profiles in infants with PPHN
  • Experiences of racial discrimination among pregnant Black women during pregnancy
  • The impact of autoimmune rheumatic diseases on birth outcomes
  • The effect of fetal growth on mortality in preterm and term infants with critical congenital heart disease
  • The impact of multiple sclerosis on birth outcomes
  • Metabolic consequences of resuscitation
  • Assessing the utility of a pregnancy-adapted atherosclerotic cardiovascular risk score for the prediction of preterm birth and near-term cardiovascular diseases
  • Assessing the interaction between depression and select autoimmune conditions on birth outcomes
  • Risk of postpartum depression among mothers of preterm infants
  • Associations between mid-pregnancy telomere length and pregnancy outcomes
  • Do ICD-9 social codes predict preterm birth outcomes?
  • Assessing the effect of ambient air pollution on premature rupture of membranes
  • Race/ethnicity, census-level socioeconomic status and pregnancy cardio-metabolic disease
  • Sleep disorders during pregnancy and complications following preterm birth
  • Sleep disorders during pregnancy and preterm birth: identifying pathways using ICD-9 codes
  • Homelessness or unstable housing and adverse birth outcomes
  • Post-discharge mortality and rehospitalizations in late preterm and term infants with a diagnosis of persistent pulmonary hypertension of the newborn
  • The role of air pollution indicators in the association between race/ethnicity and rehospitalization rates for respiratory causes in preterm infants in California
  • Endometriosis and risk of preterm birth
  • Metabolic Vulnerability and Complications of Prematurity
  • Risk of preterm birth among women with an emergency department visit or hospitalization for a urinary tract infection by trimester of pregnancy
  • Metabolic vulnerability of newborns born to cancer survivors
  • Pregnancy outcomes among cancer survivors
  • Racial Disparities in Outcomes among Infants with Congenital Morbidities at 1 year: A Population-Based Study in California
  • Utilizing systematic screening approaches to identify pesticides that contribute to preterm birth

Completed Discovery Projects