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.

"Preconception" Intervention Projects


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.



Postnatal Intervention Projects


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