Federal Project Grant Award Summary

The National Institute of Child Health and Human Development (NICHD) awarded the University of North Carolina at Chapel Hill $427,625 under the Child Health and Human Development Extramural Research program (CFDA 93.865) for a 24-month project period extending from July 1, 2026 through June 30, 2028. The project delivers evidence-generation and analytical products addressing the impact of elective labor induction at 39 weeks on perinatal outcomes in resource-limited settings. The research leverages existing cohort data from the multi-country LABOR (Limiting Adverse Birth Outcomes in Resource-Limited Settings) study and the ARRIVE (A Randomized Trial of Induction Versus Expectant Management) trial to conduct target trial emulation analyses.

The primary deliverables include: (1) quantification of causal effects of elective induction versus expectant management on cesarean delivery rates and fetal/neonatal morbidity and mortality outcomes among low-risk, term nulliparous women in Zambia, Ghana, and India; (2) development of an individualized decision-making framework applying precision medicine methods to identify patient populations most likely to benefit from induction in obstetric care within resource-limited environments; and (3) harmonized comparative analyses and external generalizability assessments translating findings across the LABOR emulation cohort and ARRIVE trial populations. These research products are intended to address critical evidence gaps and inform dynamic, context-specific treatment strategies to reduce perinatal morbidity and mortality in low-resource settings.