Pregnancy and Perinatology Branch (PPB)

We are interested in applications that align with the following research priorities. For more information about NICHD’s research themes, cross-cutting topics, and aspirational goals, visit the plan’s Scientific Research Themes and Objectives.

Maternal Morbidity/Mortality and Perinatal/Infant Outcomes

Strategic Plan Theme 3: Setting the Foundation for Healthy Pregnancies and Lifelong Wellness
Strategic Plan Cross-Cutting Topic: Health Disparities

Gap: Women in the United States are more likely to die in pregnancy and childbirth than those in many other developed nations, and there currently exists significant racial and ethnic disparities in maternal morbidity and mortality. Black/African American, American Indian, and Alaska Native women are two to three times more likely to die from pregnancy-related causes than White women, and this disparity increases with age. Importantly, severe maternal morbidity causes major short- and long-term health consequences for the mother, and complications of pregnancy are associated with a higher risk of adverse perinatal/infant outcomes such preterm birth and infant death.

Priority: Research aimed at (1) improving the identification and treatment of women at high risk for pregnancy-related morbidities or mortality; (2) addressing health disparities in the identification and treatment of women at high risk for pregnancy-related morbidities or mortality; (3) elucidating the role of the healthcare system, from preconception through postpartum care, in improving outcomes for women, particularly racial and ethnic minority women and their offspring; and (4) elucidating issues related to maternal morbidity and mortality and perinatal/infant outcomes among people with intellectual, developmental, and physical disabilities.

Placental Structure and Function

Strategic Plan Theme 3: Setting the Foundation for Healthy Pregnancies and Lifelong Wellness
Strategic Plan Aspirational Goal: Use the growing understanding of immune factors in pregnancy and placental development to determine reasons for pregnancy rejection

Gap: Defects in placentation underlie major pregnancy disorders such as stillbirth, preeclampsia, fetal growth restriction, and preterm birth. The molecular processes that govern placental structure and function are poorly understood, hindering targeted therapeutic approaches to prevent or treat these disorders.

Priority: Research aimed at (1) understanding immune factors in pregnancy and placental development to determine reasons for pregnancy rejection and to evaluate mechanisms to prolong at-risk pregnancies; (2) characterizing placental structure and function using imaging techniques and biomarkers, including the development of technologies/devices that allow for safe, noninvasive real-time assessment throughout pregnancy; (3) implementing markers and imaging techniques developed in the Human Placenta Project; (4) elucidating factors involved in regulating placental metabolism, placental perfusion, and analyte transfer from the mother to the fetus; (5) addressing health disparities in the evaluation of placental structure and function; and (6) expanding our understanding of placental structure and function to include populations with intellectual, developmental, and physical disabilities.

Preterm Birth and its Consequences

Strategic Plan Theme 3: Setting the Foundation for Healthy Pregnancies and Lifelong Wellness
Strategic Plan Aspirational Goal: Enhance the survival and healthy development of preterm infants by exploring the role of environmental factors

Gap: The mechanisms that lead to preterm birth and the full extent of its consequences and treatments for the mother and infant are poorly understood.

Priority: Research aimed at (1) understanding the human gestational clock and the potential causes of preterm birth; (2) addressing the short- and long-term complications in children born preterm; (3) addressing health disparities in the etiology and management of preterm birth and its consequences; and (4) expanding our understanding of the etiology and management of preterm birth in people with intellectual, developmental, and physical disabilities.

Stillbirth and Sudden Infant Death

Strategic Plan Theme 3: Setting the Foundation for Healthy Pregnancies and Lifelong Wellness
Strategic Plan Theme 4: Improving Child and Adolescent Health and the Transition to Adulthood
Strategic Plan Cross-Cutting Topic: Health Disparities

Gap: There are no specific and sensitive predictive tests for identifying fetuses at risk for stillbirth, sudden infant death syndrome (SIDS), and sudden unexpected infant death (SUID).

Priority: Research aimed at (1) understanding the causal mechanisms of stillbirth, SIDS, and SUID; (2) addressing health disparities in the etiology of stillbirth, SIDS, and SUID; and (3) expanding our understanding of the etiology of stillbirth, SIDS, and SUID among populations with intellectual, developmental, and physical disabilities.

Maternal Obesity and Adverse Outcomes

Strategic Plan Theme 3: Setting the Foundation for Healthy Pregnancies and Lifelong Wellness
Strategic Plan Cross-Cutting Topic: Health Disparities

Gap: The prevalence of maternal obesity is increasing both in the United States and worldwide, yet it remains an understudied area. Specifically, obesity before and during pregnancy increases the incidence of infertility as well as a woman’s risk for serious health problems, such as preeclampsia, and perinatal complications, such as preterm birth. Obesity may also complicate labor and delivery, increase the risk of a cesarean delivery, and negatively affect lactation.

Priority: Research aimed at (1) identifying strategies to mitigate excessive weight gain during pregnancy; (2) understanding the role of maternal obesity in maternal morbidity and mortality and perinatal/infant outcomes; (3) addressing health disparities in the etiology and management of maternal obesity; and (4) expanding our understanding of the etiology and management of maternal obesity among people with intellectual, developmental, and physical disabilities.

Nutrition During Pregnancy and Lactation

Strategic Plan Theme 3: Setting the Foundation for Healthy Pregnancies and Lifelong Wellness
Strategic Plan Cross-Cutting Topic: Nutrition

Gap: Although evidence in recent years has shown that the health of a mother and her baby depends on appropriate nutritional intake before and during pregnancy and during lactation, the role and importance of nutrition in supporting healthy reproduction, maternal health during pregnancy, intrauterine fetal programming, and lactation has been understudied.

Priority: Research aimed at (1) elucidating the optimal nutrition requirements and micronutrient needs for a healthy pregnancy and successful lactation; (2) addressing health disparities in the assessment of nutrition requirements for a healthy pregnancy and successful lactation; and (3) expanding the understanding of the nutrition requirements for a healthy pregnancy and successful lactation for people with intellectual, developmental, and physical disabilities.

• Improving Health Before, During, and After Pregnancy: Includes research on maternal health from pre-pregnancy, through pregnancy, and postpartum, including maternal morbidity and mortality
• Reducing Preterm Labor and Birth and Other Birth Complications: Studies factors affecting the initiation and completion of labor, including the physiology, endocrinology, and medical management of birth
• Increasing Infant Survival, Free from Disease and Disability: Addresses causes, prevention, treatment, and medical management of conditions associated with or resulting from birth and the newborn period
• Ensuring the Long-Term Health of Mothers and Children: Seeks to understand aspects of birth, newborn, and infant care that may influence long-term health
• Global Network for Women's and Children's Health Research: Supports and conducts clinical trials on cost-effective and sustainable interventions to improve maternal and infant health outcomes and build health research capacity in resource-limited countries
• Human Placenta Project: Supports improvement to existing and development of new technologies for real-time assessment of placental development across pregnancy
• Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE) Initiative: Supports activities to reduce preventable causes of maternal death and improve maternal health; PPB leads and coordinates this NIH-wide effort
• Maternal-Fetal Medicine Units (MFMU) Network: Supports clinical research to reduce maternal, fetal, and infant morbidity related to preterm birth, fetal growth anomalies, and pregnancy complications, and to provide the rationale for evidence-based, cost-effective obstetric practice  
• Neonatal Research Network (NRN): Generates rigorous evidence on the health of infants admitted to neonatal intensive care units to improve the treatment and health outcomes of critically ill newborn babies
• Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b): Evaluated the underlying, interrelated mechanisms of several common adverse pregnancy outcomes in first-time moms
• PregSource^®: Crowdsourcing to Understand Pregnancy: Used online surveys to gather information about the pregnancy experience directly from pregnant people
• Advancing Clinical Trials in Neonatal Opioid Withdrawal Syndrome (ACT NOW): Informs the clinical care of infants exposed to opioids in the womb; part of the NIH-wide Helping to End Addiction Long-term^® Initiative

• Research Challenges and Competitions: These mechanisms encourage research, development, and innovation among communities that do not traditionally apply for funding support. PPB leads and has led several challenges related to improving maternal health.
• PPB-funded studies available in NICHD’s Data and Specimen Hub (DASH). Researchers, check out data from Collaborative Home Infant Monitoring Evaluation, Community Child Health Research Network, Global Network for Women's and Children's Health Research, MFMU Network, National Infant Sleep Position Study, and Stillbirth Collaborative Research Network, to name a few.
• Cochrane Neonatal Review Group : NICHD supported the group from 1998 through 2017 to provide systematic reviews on neonatology topics.  
• Infant Feeding Practices Study II (IFPS II): This longitudinal study focused on infant feeding practices throughout the first year after birth and the diets of pregnant women in their third trimesters and at 4 months postpartum. The branch worked closely with the Food and Drug Administration and Centers for Disease Control and Prevention (CDC) to conduct the study from 2005 to 2007. De-identified data from this study are available at the CDC website.

• Nahida Chakhtoura, Chief
  Main Research Areas: Epidemiology and natural history of HIV in pregnant people and women; Zika; women's health; cohort studies and clinical trials; NIH-wide IMPROVE initiative
• Stephanie Archer, Clinical Trials Specialist
  Main Research Areas: Coordinator for NRN and MFMU Network
• Guillermina Girardi, Health Scientist Administrator
  Main Research Areas: Reproductive immunology; autoimmunity; recurrent miscarriages; preeclampsia; gestational diabetes; in utero/developmental origins of disease; imaging (MRI and 1HMRS [spectroscopy]) in placental insufficiency and atypical neurodevelopment; translational studies (particularly therapeutic strategies to prevent placental insufficiency)
• Diane Gumina, Program Officer
  Main Research Areas: Cellular mechanisms of placental insufficiency; development of treatment modalities and improved diagnostic technologies for pregnancy-associated complications; women’s health; translational research and clinical trials
• John Ilekis, Program Director/Health Sciences Administrator
  Main Research Areas: Cell-, molecular-, and genetic-based studies in pregnancy and perinatology; placental development and function; trophoblast differentiation; basic mechanisms underlying maternal and fetal disorders, such as spontaneous preterm birth, preeclampsia, and fetal growth restriction; parturition; fetal pathophysiology/programming and developmental origins of disease; perinatal microbiome and metagenomics; epigenetics, molecular biomarker discovery
• Marion Koso-Thomas, Medical Officer
  Main Research Areas: Patient safety; neonatal/pediatric care; neonatal resuscitation; Global Network for Women's and Children's Health Research; infant follow-up; neonatal and pediatric immunity; sudden infant death syndrome (SIDS)
• Monica Longo, Medical Officer
  Main Research Areas: High-risk pregnancy; hypertensive disorder of pregnancy; diabetes (type 1, type 2, and gestational); fetal developmental origins of health and disease; metabolic and cardiovascular programming; pregnancy as a window of future maternal health; cardiovascular risk after pregnancy
• Megan Mitchell, Program Analyst
  Main Research Areas: Funding opportunity and announcement development; human subjects research; clinical trials; program analysis/program management
• Dorothy Tucker, Staff Assistant
• David Weinberg, Project Lead
  Main Research Areas: Human Placenta Project