LEAP-HI: Coordinated Advances in Reproductive Engineering for Health Research (CARE4HeR)

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The overall goal of this Leading Engineering for America's Prosperity, Health, and Infrastructure (LEAP-HI) Coordinated Advances in Reproductive Engineering for Health Research (CARE4HeR) project is to address the alarming healthcare challenges associated with pregnancy and childbirth by integrating novel and transformative approaches in experimental, theoretical, and computational mechanics. Pregnancy and childbirth can have tragic and devastating effects on the health, wellness, and quality of life of many women, children, and families. The maternal mortality rate in the United States (US) is rising, even as other developed countries experience a decline in pregnancy-related deaths. Preterm birth is very common: 500,000 babies are born preterm every year in the US. Complicated vaginal deliveries make up 16 percent of all childbirths in the US annually, and they represent primary risk factors for the development of pelvic floor disorders. These disorders affect 25 percent of all women, leading to not only physical pain but also social isolation, depression, anxiety, and sexual dysfunction. Large racial and ethnic disparities exist, with higher rates in maternal mortality and preterm birth among African Americans. Although several factors undoubtedly play a role, alterations of the mechanical function of reproductive tissues throughout pregnancy significantly contribute to pregnancy-related and childbirth-related complications: (a) most maternal birth injuries are due to excessive tissue stretching, (b) spontaneous preterm birth is attributed to loss of tissue structural integrity, and (c) pelvic floor disorders develop as a result of compromised tissue support.State-of-the-art experimental methods will be employed to characterize the fascinating mechanical interplay of the uterus, cervix, and vagina, both in vivo and ex vivo, in the murine model. These include biaxial inflation testing with digital image correlation, multiphoton microscopy, biochemistry, three-dimensional ultrasound, and high-precision magnetic resonance imaging techniques. A new constitutive framework will be developed to describe the experimentally-observed mechanical properties of reproductive organs, including the remarkable remodeling during pregnancy and postpartum. High-fidelity and robust finite element models will be created and validated using the new experimental data to study the anatomically complex function of the female pelvic system during pregnancy and parturition, offering a new, non-invasive risk detection method for women's health. The PIs will facilitate and nurture vibrant interactions among researchers in engineering and healthcare professionals by organizing symposia and conference sessions, serving as guest-editors for special issues in peer-reviewed journals, and publishing various types of scientific publications. This CARE4HeR project will support the creation of innovative research and unique educational opportunities for high school, undergraduate, and graduate students, especially from racial and ethnic minorities. This CARE4HeR project will break down the existing silos in reproductive biomechanics, streamlining research operations and accelerating progress and innovation in women’s reproductive health. New resources, ranging from cutting-edge experimental methodologies to novel constitutive models and high-fidelity simulation tools, will be created that can be used by both the engineering and medical communities to address the urgent US women’s reproductive health needs.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.