Research and Practice

Antihypertensive Medication in Pregnancy: An Update from the 2011 WHO Recommendations for Prevention and Treatment of Preeclampsia and Eclampsia

Donna Strobino, Saifuddin Ahmed, Erika Werner (Brown Univ, school of Medicine), Mahua Mandal, Laina Gagliardi, and Roxanne Beltran
The aim of this project is to update the science behind WHO recommended anti-hypertensive medications in pregnancy to prevent preeclampsia and manage hypertension and to estimates the prevalence of chronic hypertension, preeclampsia and all hypertensive disorders in pregnancy using data from population- based studies worldwide and facility based studies in resource poor settings. The study also using extant data to estimate unmet need and potential demand for antihypertensive medications in pregnancy in low resource settings.

Are Unmet Breastfeeding Expectations Associated with Maternal Depressive Symptoms?

Emily Gregory, Arlene Butz, Sharon R Ghazarian, Sara Johnson, Susan Gross
Using the 2005 - 2007 Infant Feeding Practices Study II (IFPSII) followed US mothers from their third trimester to one year postpartum examining associations between breastfeeding practices, expectation and depression symptoms. (Completed)

Associative Learning in the Fetus

Janet DiPietro
The goal of this project is to determine whether the late term fetus is capable of learning using a classical conditioning paradigm that pairs maternal postural adjustments with auditory tones.

Azithromycin to Prevent Bronchopulmonary Dsyplasia in Ureaplasma Infected Preterms: A Phase IIb randomized, placebo-controlled, double-blind trial

Rose Viscardi (University of Maryland), Pamela Donohue and the AZIP study team
This multicenter randomized controlled trial aims to determine the safety and microbiological efficacy of a multiple dose course of azithromycin to eradicate respiratory tract Ureaplasma infection that might lead to physiologic bronchopulmonary dysplasia in preterm neonates.
To learn more please visit the Study Record Detail page.

Clinical Correlates of Mycoplasma Genitalium in Young Women

Maria Trent
The primary aims of this study are to determine the rate and 12-month longitudinal clinical correlates of MG and TV infection among a sample of young pregnant women 13-29 years of age seeking reproductive health care in an urban hospital setting. The outcomes of this work will be critical for determining need for integration of MG testing in routine laboratory testing once available.

Effect of Maternal Psychosocial Behavioral Factors on Offspring's Developmental Outcomes

Xiaobin Wang, Xiumei Hong, Sheila Walker and other faculty from BSPH and SoM
This proposed study will investigate the link between a spectrum of maternal psychological stressors and offspring DNA methylation profiles at birth. It will provide a basis for expanding this study to examine postnatal DNA methylation changes and neuro-developmental outcomes in childhood. To learn more, please visit the Center on the Early Life Origins of Disease site.

Evaluation of the Knit to Quit Program in Baltimore City (Sponsor: Lerner Center for Health Promotion)

Allison West
Despite robust evidence linking perinatal tobacco exposure with poor maternal and child outcomes, a majority of pregnant women receiving opioid maintenance medication treatment smoke cigarettes. B’more for Healthy Babies (BHB) and the Baltimore City Health Department (BCHD) designed Knit to Quit, a group intervention to support smoking cessation among clients and staff at local substance use disorder treatment and recovery programs serving women of reproductive age. The model integrates psychoeducation and motivational messaging within a semi-structured group knitting class to improve participants’ knowledge, self-efficacy, and motivation to quit, increase social support for quitting, reduce stress, and, ultimately, reduce tobacco use. The goal of this project is to evaluate implementation and effectiveness of the Knit to Quit intervention.

Feasibility, Acceptability, and Preliminary Efficacy of Text4Father for Improving Infant and Family Health

Arik Marcell, Sara Johnson
This study evaluates a text messaging-based intervention to engage fathers in their children’s lives, promote positive parenting, and support men’s health.

Fetal Neurobehavioral Development & Postnatal Continuity

Janet DiPietro, Kristin Voegtline, Kathleen Costigan
This project spans the past 20 years and is focused on understanding neurobehavioral development in the human fetus and identifying the factors that may influence it. In addition, it seeks to identify how the prenatal period sets the stage for postnatal child development.
To learn more, please visit the project's page.

Genome-wide Association Study of Preterm Birth

Xiaobin Wang, Guoying Wang, Xiumei Hong and faculty from BSPH, SoM and Boston University Medical Center (BUMC)
The major goal of this project is to conduct genome-wide association study to identify susceptibility genes of preterm delivery in a multi-ethnic, high-risk, U.S. birth cohort enrolled in Boston.

Hopkins Participant Research Innovations Laboratory for Enhancing WIC Services (HPRIL)

David Paige, Laura Caulfield, Susan Gross, Marycatherine Augustyn
The overall study objective is to improve participation and retention of children 1-4 years of age. JHU will select up to five WIC local agencies (LA) as sub-grantees and provide training, technical assistance and evaluation.

Impact of Baby Friendly Hospital Initiative (BFHI) in Maryland on Selected WIC Agency Breastfeeding Rates and Maternal Experiences of Breastfeeding

Laura Caulfield, Susan Gross, Marycatherine Augustyn
The project evaluates the impact of BFHI status on breastfeeding disparities among WIC participants in Maryland; assesses maternal perceptions of the 10 steps of the BFHI program among WIC participants in Maryland; and investigates the effects of BFHI implementation on maternal infant feeding experiences among a diverse group of WIC participants in Maryland.

The Impact of Advanced Maternal Age in Maryland

Blair Berger, Carrie Wolfson and Donna Strobino
The objective on this research to assess the association between advanced maternal age and adverse birth outcomes and pregnancy complications among women with and without pre-existing and pregnancy-related health conditions using Maryland PRAMS data. Maryland is somewhat unique in that it not only has a high percentage of women giving birth each year at ages 35 or older, but the state oversamples women aged 35 or older in the PRAMS survey. Support for the students has been through the MCH epidemiology training grant and the Center of Excellence in MCH education, research and practice.

Integrating Obstetrical Care and WIC Nutritional Services to Address Maternal Obesity and Postpartum Weight Retention: Altering the Life Course Trajectory

David Paige, Susan Gross, Marycatherine Augustyn
This pilot study addresses maternal obesity, periconceptional health and postpartum weight retention. The objective is to provide coordinated services beginning in the intra-partum period through six months post-delivery. This effort will be coordinated by a unified independent record to track participant progress and inform clinical and nutrition decisions. All geared to improving maternal and infant health, assuring appropriate postpartum weight, providing high risk nutrition counseling, emphasizing the importance of breast feeding, improving dietary practices, preparing the household for appropriate dietary choices and patterns over the long term while maximizing participation in the full range of community support services. (Completed)

Maryland MOLST for Pediatric Patients

Pamela Donohue, Elizabeth Harvey, Renee Boss, Nancy Hutton
Maryland is the first state to require consideration of Medical Orders of Life Sustaining Treatment eligibility for all pediatric patients. This research will study the impact of this law and regulations on pediatric clinicians, their patients and families, and systems of care.

Maternal and Child Health Needs Assessment in Pennsylvania

Donna Strobino, Carrie Wolfson (PhD candidate) and Pamela Donohue
This project is a collaboration with the Pennsylvania Division of Family Health in the Department on Health to assist with the prioritization process for their 2020 Needs Assessment for the Title V Maternal and Child Health (MCH) block grant. State Title V programs most complete a needs assessment every 5 years that identifies the need for: preventive and primary care services for pregnant women, mothers and infants up to age one; preventive and primary care services for children; and services for children with special health care needs. As part of this process, states must identify seven to ten highest MCH priority needs for the five-year reporting cycle. The objective of this project is to assist the state with the prioritization process. The prioritization process will be structured but flexible process, obtain critical input from stakeholders across the state including families and yield transparent data reported from analysis of data for the needs-assessment and the prioritization process. Regional meeting will be conducted in six locations throughout the state using a similar process in each location.

The project is funded in part through technical assistance with MCHB/HRSA funds and the PA Department of Health.

Maternal Mortality Estimation from Survey Data: Quality Assessment

Saifuddin Ahmed
This study examines the quality of sibling history data in the Demographic and Health Survey (DHS) and its impact on estimation of maternal mortality. DHS data are the main source of MMR estimation in developing countries, where complete vital registration data are not available.

Maternal Sleep and Sleep Disturbance in Relation to the Developing Fetus

Janet DiPietro, Janice Henderson, Grace Pien
Evaluates sleep disorders in pregnancy using polysomnography and the influence of sleep apnea and other sleep problems on the developing fetus.

Mercy Hospital Community Benefit Initiative: A Look at Low Birth Weight Outcomes in the Baltimore Region

Donna Strobino, Mary Webb, Robert Atlas, Jennifer White, Caroline Anderson and Elizabeth Harvey
This collaborative project with Mercy Medical Center (MMC) examines factors contributing to low birth weight among women delivering a live birth at MMC in 2010-11. It is one component of a larger assessment and community-benefit activity, intended to address needs of the surrounding community. (Completed)

Postnatal Growth and Retinopathy of Prematurity Model Development Study

Gil Binenbaum (Children”s Hospital of Philadelphia), Pamela Donohue and the g-ROP research team
The objective of this multicenter research is to develop a prognostic model that includes postnatal weight gain, birth weight, and gestational age at birth to predict infants who are likely to develop severe Retinopathy of Prematurity (ROP), the leading cause of preventable childhood blindness.

Preconception Nutrition, Endocrine Disruptors, Reproductive Outcomes

Xiaobin Wang and other faculty from BSPH and Chinese institutions
This study aims to examine the complex interplay of preconception nutrition and exposure to DDT/DDE in relation to a comprehensive spectrum of reproductive outcomes in a preconception cohort in China.
To learn more, please visit the Center on the Early Life Origins of Disease site.

PREDICT

Identification of Exosomal MicroRNA Markers of Maternal Distress and Offspring Metabolic Health using the PREDICT cohort

Sara Johnson, Kellie Tamashiro, Neil Goldenberg
This pilot grant seeks to understand whether exposure to maternal distress during pregnancy is reflected in changes in the circulating exosome miRNA profile and predicts risk for negative metabolic health conditions, such as diabetes and obesity, in offspring.

Johns Hopkins All Children’s Hospital Prospective, Inception Cohort Study of Healthy Children (PREDICT Cohort)

Sara Johnson, Neil Goldenberg
This funding supports the PREDICT longitudinal cohort of healthy children at JHM-ACH designed to investigate the etiology of obesity and developmental delay by describing the timing and nature of factors (molecular, genetic, clinical, behavioral and social) that are associated with divergent health trajectories beginning before birth.

Social Adversity, Epigenetics and the Obesity Epidemic

Sara Johnson
This project leverages the Johns Hopkins All Children’s Hospital PREDICT study to evaluate epigenetic mediators of the relationship between maternal lifetime and pregnancy- specific adversity and the early development of obesity in her offspring.

Prevention of Deaths from Hypothermia Among Preterm Neonates

Saifuddin Ahmed, Abul Hussam, Department of Chemistry and Biochemistry, George Mason University
We are developing a chemically induced thermal jacket for use in resource-poor settings where electricity and incubators are not available. The renewable heated jacket uses phase-changing materials for sustaining heat for prolonged periods.

Prognosis, Improvements in Quality of Life and Social Integration of Women with Obstetric Fistula after Surgical Treatments

Saifuddin Ahmed, Rene Genadry
This study examines the quality of life and social integration of women with obstetric fistula in Bangladesh, Ethiopia, Niger, and Nigeria.

Promoting Maternal Mental Health and Wellbeing in the Neonatal Intensive Care

Sara Johnson
This study will further develop and pilot test a mindfulness intervention to improve mental health and wellbeing of mothers with infants in the neonatal intensive care unit (NICU).

The Ruth and Norman Rales Center for the Integration of Health and Education

Sara Johnson, Tina Cheng
This funding creates a center to develop and test a fully integrated model of health services, health education, and family supports in high-poverty schools to reduce health and educational disparities.

For more information please visit The Rales Center.

Trends in Advanced Maternal Age in the US

Donna Strobino, Carrie Wolfson and ME Hughes
The objective of this project is to explore changing demographic characteristics of US women giving birth using national birth certificate data, with a focus on increasing age at birth and how the patterns of change differ by race and ethnicity. A second objection is to investigate if these changes are associated with recent changes in low birth weight rates and whether the effect of age differs by race and ethnicity.

Funds from the Center of Excellence in MCH education, research and practice provide support for students work on the project.

Unintended Birth, Fetal and Infant Loss and Maternal Depressive Symptoms

Pamela Surkan, Donna Strobino, Parul Christian, Keith West and the Javita1 research team
This longitudinal study examines the relation of unintended pregnancy, fetal and neonatal loss, maternal prenatal and postpartum complications and child gender with prenatal and postpartum maternal depressive symptoms among women in Bangladesh. (Completed)