Researchers at UMass Chan Medical School are collaborating with researchers at Yale University and the University of Buffalo to improve postnatal maternal health in a historically underserved and at-risk population. research outreach and increased levels of home support.
A five-year funding period of approximately $20 million, supported by the Patient-Centered Outcomes Institute, will begin in early November at UMass Chan.
“This study addresses the public health crisis of rising maternal mortality in the United States, especially given its disproportionate impact on those marginalized by racism and socioeconomic disadvantage. The purpose is that” Donna M. and Robert J. Manning Chairs of Obstetrics and Gynecology Chair and Professor of Obstetrics and Gynecology. “We are doing so by targeting the most common causes of preventable maternal mortality and morbidity – cardiovascular disease, including hypertension and mental health conditions – in a sustainable and transcendental way. We are trying to do it in a way that we can continue to do so.”
The study included a “step wedge design,” in which each of the three sites sequentially layered two interventions over usual standard of care, explained Dr. Moore Simus. adds these interventions at staggered intervals.
Beginning around May 2024, eligible postpartum patients seeing a UMass Memorial Health physician will be contacted by an Obstetrics (OB) Extender. Patients have their blood pressure monitored remotely and reviewed by a nurse practitioner. OB Extender also screens and treats depression and anxiety.
A second enhanced intervention, called the Community Health Model, will start locally around February 2026. Screen for social determinants of health such as housing, employment and food security. Connect them to resources.
“Across the study, all caregivers who interact with perinatal individuals receive training on anti-racism and trauma-informed care. A subset of caregivers addressed mental health and blood pressure management issues. parenting interventions to aid parent-child attachment, and receive additional training on how to assess social determinants of health and link them with necessary resources,” said Moore Simas.
The primary objective of this project is to improve mean systolic blood pressure at 6 weeks postpartum and reduce depression severity at 3 months postpartum.
“About 10% to 15% of all pregnancies are affected by hypertensive conditions, including gestational hypertension, chronic hypertension, or pre-eclampsia,” said an associate professor of medicine and co-investigator. Lara Kovell, MD said. “A significant fraction, about 50%, remain hypertensive postpartum, and an additional 10% of those who were normotensive during pregnancy develop hypertension postpartum. It’s one of the main reasons I do.”
Nancy Byatt, DO, Professor of Psychiatry, Obstetrics and Gynecology, Population and Quantitative Health Sciences, and Site Responsible for the Mental Health Aspects of the Study, said the study was supported by UMass Chan in collaboration with professional organizations. I said it’s based on what I developed to integrate. Screening, evaluation, and treatment for anxiety and depression in obstetric workflow.
“The emphasis is on mental health in addition to hypertension because medical conditions don’t occur in a box. “We train caregivers to provide mental health care using a trauma-based relationship health approach. We are also adding a testing approach that is not at the point of care, but adjacent to the point of care.”
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