NICHD Maternal Fetal Medicine Units Network

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DESCRIPTION (provided by applicant): Women and Infants Hospital (WIH) and the Ob/Gyn Department at Brown University Medical School have achieved a high level of participation in the Maternal-Fetal Medicine Units Network during its first funding cycle. The WIH MFM Unit, has ranked in the top half of Network Units in number of enlisted patients and in the top third with respect to enlistedielligible patient ratio and data quality. WIH has demonstrated a high degree of departmental and institutional commitment to the MFMU Network, providing significant space and infrastructure support and sustaining revenue shortfalls that have occurred in some protocols in order to optimize this Unit's functionality for the Network. The Division has also performed well in past and present NIH-funded multi-institutional observational trails (the FaSTER fetal sonography study of aneuploidy risk (completed), the Hyperglycemia and Adverse Pregnancy Outcome and the Stillbirth Cooperative Research Network studies, still ongoing. The MFM Unit operates on one site (WIH), productive of over 9500 annual births, one of the Nation's largest. The racial/ethnic distribution, economic status, and medical characteristics among WIH obstetrical patients mirror those of Rhode Island, insofar as WIH accounts for more than 71% of State births. The representative nature of WIH patients facilitates the generalizability of Network study findings. The WIH patients demonstrate expected population-based clinical characteristics. WIH patients are racially diverse with 66% white, 9% black, and 4% Asian. Hispanic ethnic identity is found in 14% of WIH patients. Biological risk factors such as diabetes (8.9%), premature birth (5.8%), hypertensive disorders (11.6%), asthma (4.5%) and multifetal pregnancy (2.4%) are found in over 50% of WIH deliveries. Moreover, social risk factors such as being unmarried (38%), under 18 years old (3%) and uninsured (10%) at time of birth admission allow opportunity to address hypotheses based on social disparity as well as biology. The WIH MFM Unit is strong. The Division is composed of six MFM physicians, three of whom have epidemiologic research training. The Division has a highly motivated and effect group of research nurses who have demonstrated a high degree of adaptability. WIH is also home to a Unit of the Neonatal Research Network. These attributes make the Brown/Women & Infants Unit a desirable candidate for funding renewal.