NIH Grant to Improve Pregnancy Outcomes for African Americans

By Anne Buckley

The Virginia Commonwealth University School of Medicine has received a grant totaling nearly $6.4 million from the National Institutes of Health's National Center on Minority Health and Health Disparities to examine  adverse pregnancy outcomes in African Americans and potential interventions to prevent them.

Despite improvements to the nation's general health, African Americans experience adverse pregnancy outcomes much more frequently than whites, resulting in neonatal morbidity and mortality rates that are more than twice those for white population.

The five-year grant will support basic and clinical research that will help identify women at risk of adverse pregnancy outcomes and evaluate new interventions to improve maternal and neonatal health.  The grant will also raise awareness and promote participation in evidence-based research among minority populations.

"This research program addresses a major unmet need in the United States and the Commonwealth of Virginia.  In developing new ways to ensure healthy pregnancies with healthy outcomes, we will have a major impact on the cost of health care, and in the long term, reduce the burden of chronic diseases that have their roots in pregnancy complications" said Jerome F. Strauss III, M.D., Ph.D., dean of the VCU School of Medicine and primary investigator for the project.

"It further underscores our commitment to providing care to the uninsured and underinsured, particularly in the area of maternal and child health," he said. In 2005, the VCU Health System's Virginia Coordinated Care for the Uninsured program, VCC, was recognized as one of the nation's success stories in providing indigent patient care by the National Association of Public Hospitals and Health Systems.

VCC uses managed-care principles to provide care to a subset of the uninsured population served by the hospital. VCC is funded by the state indigent care program, and provides access to inpatient and outpatient services, primary and specialty care visits, ancillary and diagnostic services, family planning and prescription drugs. The program is coordinated with Virginia Premier, a Medicaid health maintenance organization owned by VCU Health System, to ensure continuity of care regardless of insurance status.

Through the NIH grant, Strauss and a multidisciplinary research team at the VCU Center on Health Disparities will initiate three research projects that will focus on varying aspects of health disparities. They will investigate the genetics of preterm birth in African Americans; immunological responses to periodontitis that may lead to premature birth; and ways to increase safe-sex awareness skills among pregnant women at high risk for HIV infection.

Additionally there will be two pilot projects that will aim to enhance fetal exposure to antiretroviral medications and examine the geographic distribution of birth outcomes and environmental stressors.

They hope these findings will help researchers to identify and implement new diagnostic tools and interventions that will address major health disparities.

Strauss said that the center will also provide research training opportunities for disparity population students. The grant designates funds for students from Virginia Union University, a historically black university in Richmond, to work with investigators through the health education intervention and other research projects. Investigators from the VCU School of Medicine, the School of Dentistry, the Department of Psychology and Virginia Union University will collaborate with Strauss on this work.