PCORI funds $5.6 million study to improve disparities in maternal and child health

The Patient-Centered Outcomes Research Institute (PCORI) this month has awarded University of California, San Francisco more than $5.6 million to study disparities in prenatal care among ethnic and low-income patients, with a focus on premature births. Babies born prematurely have a high risk of death – two-thirds of babies who die during their first year of life are premature – and those who survive are at risk of suffering a range of physical and mental problems, some quite serious. Fresno County has the highest rate of prematurity in California.

Women who are poor, Black, Latina, Pacific Islander or Native American have more premature babies than Caucasian women but the reasons why are unclear. PCORI pointed to some early studies that suggest that women in these groups may experience more depression and anxiety which can influence child health negatively during pregnancy. A study published in JAMA Pediatrics, for example, indicates that maternal stress can hurt an infant’s ability to develop neurologically compared to women who are not stressed during pregnancy.

The scope of the study, described in PCORI’s Research and Results literature, is to conduct comparisons between two separate local prenatal support organizations of which some 2,200 Medicaid-eligible English- or Spanish-speaking women who are less than 20 weeks pregnant will be assigned. The participants will fill out surveys during their second and third trimesters, and at 6 weeks and 3 months postpartum. The researchers will use the results to measure depression, anxiety, and experience of care and cross-check the patient’s medical records to identify whether any of them had premature births.

PCORI stated: “Patient stakeholders in Fresno have told us that having healthy babies, feeling less depressed and anxious, and receiving respectful prenatal care are the outcomes that matter most to them. With these patient stakeholders, as well as community prenatal care providers and representatives from community organizations, we have designed a study to determine the best way to address these critically important outcomes.”

Miriam Kuppermann, PhD, MPH, Professor, Ob/Gyn, Reproductive Sciences at UCSF School of Medicine is the principal investigator of the study.