Weill Cornell Medicine and NewYork-Presbyterian receive NIH support for project addressing postpartum maternal health in underserved communities

(Press-News.org) As part of a National Institutes of Health initiative to improve maternal health and pregnancy outcomes nationwide, Weill Cornell Medicine and NewYork-Presbyterian will play a pivotal role as collaborators with Columbia University Irving Medical Center (CUIMC) as one of 10 nationwide IMPROVE (Implementing a Maternal Health and Pregnancy Outcomes Vision for Everyone) Maternal Health Research Centers of Excellence. 

The research center, called the NY Community-Hospital-Academic Maternal Health Equity Partnerships, or NY-CHAMP, will develop and evaluate innovative approaches to reduce pregnancy-related complications and deaths in underserved communities in New York City. NY-CHAMP received $2.3 million in first-year funding, and is the only research center in the Northeast to achieve this distinction.

“This initiative is a transformative opportunity to harness the power of the New York community, academia, public health and medicine to reduce maternal mortality and morbidity, and promote health equity for all birthing people in our state,” said contact principal investigator Dr. Uma Reddy, vice chair of research and a maternal-fetal medicine specialist in the Department of Obstetrics and Gynecology at Columbia University Irving Medical Center and NewYork-Presbyterian/Columbia.  

The center is led by nine principal investigators, including five from CUIMC and Weill Cornell Medicine and four from community-based initiatives. They have come together to form a training and community core as well as two research projects addressing maternal health care and policy.

The center’s flagship randomized controlled trial – called LivingHealthy for Moms— is a doula-delivered postpartum support intervention offered to New York City patients who come from underserved communities and give birth at NewYork-Presbyterian Brooklyn Methodist Hospital, NYC Health + Hospitals/Queens, and NewYork-Presbyterian Allen Hospital. The project is led by principal investigators Dr. Lauren Osborne, an associate professor of obstetrics and gynecology at Weill Cornell Medicine and a reproductive psychiatrist at NewYork-Presbyterian/Weill Cornell Medical Center, and Dr. Monika Safford, chief of the Division of General Internal Medicine at Weill Cornell Medicine and NewYork-Presbyterian/Weill Cornell, as well as project co-leads Dr. Heather Lipkind, director of the Division of Maternal Fetal Medicine at Weill Cornell Medicine and a gynecologist-obstetrician at NewYork-Presbyterian/Weill Cornell, and Dr. Reddy. The work will be conducted in collaboration with two organizations that are deeply anchored in the community —the Caribbean Women’s Health Association and the Northern Manhattan Perinatal Partnership.

The early postpartum period—the first few days and weeks after giving birth—is recognized as a crucial time for birthing patients’ mental and cardiovascular health. Undetected or undertreated postpartum depression and cardiovascular conditions often have a symbiotic relationship to each other and are the leading causes of preventable maternal death and morbidities—even more so among communities of color.

“Some people with postpartum depression may continue to experience depression up to 11 years after delivery,” Dr. Osborne said. “People who are experiencing depression are at greater risk of obesity, a sedentary lifestyle and smoking—all of which affect cardiovascular health. So the two are really intertwined.”

To help patients who are at the greatest risk for developing these conditions, Drs. Osborne, Safford, Lipkind and their teams developed LivingHealthy for Moms, a cognitive behavioral therapy intervention adapted from a globally used intervention for postpartum depression, and designed it to tackle the twin morbidities of mental health and cardiovascular health problems. Using a staggered enrollment plan, investigators will randomize 150 patients at each hospital into two groups: those who will receive the intervention, and those who will receive general education.

All of the patients will receive a blood pressure cuff and instructions on how to use it, a cardiovascular health educational video and an introduction to a doula from the collaborating community organizations, who will contact them within a week of discharge. Patients in the LivingHealthy for Moms intervention group then get daily interaction with a doula, either virtually or over the phone, as well as 12 sessions over the course of six months. Topics include breastfeeding success and healthy eating, bonding with your baby, and your changing body. Doulas will work to empower patients about taking charge of their own health care. Patients in the general education group will also engage with doulas for up to six months, but on general education topics around maternal and newborn care.

“Mental health conditions are the leading cause of pregnancy-related death, and we simply don’t have the workforce in health care to address this crisis,” Dr. Osborne said. “Our innovative program empowers community doulas to expand their practice of care with evidence-based mental health treatment that simultaneously addresses cardiovascular health – only these kinds of innovative mind-body combination treatments are going to solve the maternal morbidity crisis we face in our city.”

“Every week, people of color come to my office either pregnant or planning pregnancy with fear, recognizing the startling statistics around maternal morbidity and mortality,” said Dr. Laura Riley, chair of the Department of Obstetrics and Gynecology and the Given Foundation Professor in Clinical Obstetrics and Gynecology at Weill Cornell Medicine and obstetrician and gynecologist-in-chief at NewYork-Presbyterian/Weill Cornell Medical Center. “For me, the output of this research that harnesses the minds of researchers, clinicians and community groups working together is critical to our ability to change those statistics and improve the lives of the families we care for.”

The research center’s other project, led by CUIMC, will focus on policy solutions to address structural racism as a driver of maternal health disparities.

In addition to Drs. Osborne, Safford and Reddy, NY-CHAMP’s principal investigators include:

Dr. Kelli Stidham Hall (CUIMC, Mailman School of Public Health) Dr. Jacquelyn Y. Taylor (CUIMC, School of Nursing) Sevonna Brown (Black Women’s Blueprint) Madeleine Dorval Moller (Northern Manhattan Perinatal Partnership) Emilie Rodriguez (The Bridge Directory) Victoria St. Clair (Caribbean Women’s Health Association) END