Stanford prihsm: preventing inequities in hemorrhage-related severe maternal morbidity
Active Cooperative Agreement Awarded Last action
- Award ID
- U54HD113142
- Recipient
-
The Leland Stanford Junior University UEI HJD6G4D6TJY5
- Awarding agency
-
National Institute of Child Health and Human Development
National Institutes of Health, Department of Health and Human Services
- Obligated
- $6,142,005
Award facts
- Assistance listing
- 93.865 Child Health and Human Development Extramural Research
- Completion date 46% complete
- Place of performance
- Palo Alto, CA 94304, USA
Award details come from USAspending.gov.
Description
- Abstract
- Overall postpartum hemorrhage (PPH) is a leading cause of maternal death and severe maternal morbidity (SMM) and disproportionately affects socially marginalized groups. We propose to create a maternal health research center of excellence at stanford university called prihsm (preventing inequities in hemorrhage-related severe maternal morbidity). The goals of prihsm are to reduce PPH and associated SMM by reducing antenatal iron deficiency anemia (IDA), addressing disparities in rates of cesarean birth and cesarean-linked PPH, and attending to the impact of PPH on postpartum mental health. IDA affects approximately 16% of pregnancies in the U.S.; rates are 3-4X higher among black people and 1.5-2X higher among latinx people, compared to the rest of the population. This translates to higher rates of PPH-related SMM. We propose that by effectively addressing antenatal IDA and these disparities, we can reduce PPH-related SMM. Intrapartum exposures also play a major role in the risks and disparities associated with PPH. Almost 1 in 3 U.S. Births are by cesarean delivery, rates vary 10-fold across hospitals, and black and asian individuals have the highest prevalence of cesarean section among low-risk pregnancies. We propose that enhanced birth equity and reduced variability in obstetric management are important strategies in addressing disparities in cesarean- linked PPH and reducing PPH-related SMM. PPH may also dramatically alter the postpartum emotional life course. Prospective longitudinal research to understand mental health trajectories following PPH is needed, as are effective treatments. We propose an approach that is innovative in that IT targets the unique clinical and mental health spectrum of PPH at multiple intervention points, through multi-disciplinary, community-engaged science. Our aims are: aim 1 (project 1). Reduce antenatal IDA by developing, implementing, and disseminating a patient-informed anemia prevention toolkit, which will standardize the evaluation, diagnosis, and treatment of IDA and reduce the prevalence of IDA and racial/ethnic disparities in IDA at birth admission and PPH-associated SMM. Aim 2 (project 2). Reduce disparities in rates of primary cesarean birth and cesarean-linked PPH by conducting a mixed methods study to understand drivers of hospital-level disparities in these outcomes, and implementing a patient-informed maternal equity guide. Aim 3 (project 3). Advance our understanding of ptss following severe PPH by examining the course of ptss following PPH, and implementing patient-informed ptsd treatment and prevention strategies. Our work will involve community- university partnerships focused on improving maternal health equity and be driven by perspectives of patients, providers, and healthcare leadership. Our work will provide training opportunities to build research and clinical expertise relevant to PPH, especially among individuals who represent diverse perspectives and experiences within academic and community-based settings, and under-served areas. We propose a bold yet achievable agenda that will affect a sustainable decline in PPH-related mortality and morbidity and disparities.
Transactions
| Action | Obligated | Date |
|---|---|---|
| Amendment | $2,151,953 | |
| Amendment | $0 | |
| Amendment | $0 | |
| Amendment | -$250,000 | |
| Amendment | $250,000 | |
| Amendment | -$250,000 | |
| Amendment | $250,000 | |
| Amendment | $1,776,168 | |
| Amendment | $250,000 | |
| Amendment | $250,000 | |
| Amendment | $0 | |
| Amendment | $0 | |
| Amendment | $0 | |
| Amendment | $0 | |
| Amendment | $1,870,026 | |
| Original award | $1,870,026 |
Show all 16
Subawards
| Subrecipient | Amount | Awarded |
|---|---|---|
| Black Wellness & Prosperity Center | $84,574 | |
| Black Wellness & Prosperity Center | $86,144 |
Quick answers
Who received award U54HD113142?
U54HD113142 was awarded to The Leland Stanford Junior University by National Institute of Child Health and Human Development (National Institutes of Health) on August 17, 2023.
How much is award U54HD113142 worth?
$6,142,005 has been obligated on U54HD113142.
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