# Improving Health Outcomes and Equity by Targeting Postpartum Mothers at Highest Risk

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2020 · $634,448

## Abstract

Alarming racial and ethnic disparities in maternal mortality persist in the US. Black women are three to four
times more likely to die a pregnancy-related death as compared with White women, and in some regions
Latinas are also at increased risk. This disparity is rooted in the fact that Black and Latina women experience
elevated maternal health risks throughout the pregnancy-postpartum continuum. Women of color are more
likely to begin pregnancy with a chronic health condition such as hypertension or diabetes, experience a
complication while pregnant, and to suffer a life-threatening morbidity during delivery. Less recognized is that
heightened maternal health risks extend into the postpartum period. Black and Latina women are more likely to
experience a postpartum complication, to seek care in the emergency department (ED) after delivery, and
have an increased risk of postpartum hospital readmission relative to White women. Growing attention has
focused on the postpartum period as an important window to address maternal mortality disparities as half of
pregnancy-related deaths occur within one day to one year after delivery and the majority of maternal deaths
and a sizable portion severe complications are preventable. We propose a mixed method study to better
identify Black and Latina women most at risk for poor outcomes following delivery, the problems they
experience, and to adapt an evidence-based intervention that aims to improve quality of postpartum care for
high risk women. The aims of our research study, “Improving Health Outcomes and Equity by Targeting
Postpartum Mothers at Highest Risk” are to: 1) Develop a risk a prediction model using sociodemographic,
clinical, behavioral, and neighborhood factors to identify high-risk mothers using ED visits and postpartum
readmissions as a marker of severe maternal morbidity. 2) Use qualitative methods to adapt and intensify an
evidence-based behavioral educational intervention aimed at improving quality of care to reduce severe
maternal morbidity as measured by postpartum ED use and hospital readmission, 3) Conduct a pilot RCT
utilizing the cohort identified by the risk prediction model in Aim 1 to assess feasibility, acceptability, and target
effect size and potential efficacy of the refined intervention to reduce ED visits and postpartum readmissions,
and 4) Evaluate the pilot study results and procedures to inform the refinement of the intervention and to
prepare for a larger implementation trial of this intervention.

## Key facts

- **NIH application ID:** 10175650
- **Project number:** 1R01MD016029-01
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Elizabeth A Howell
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $634,448
- **Award type:** 1
- **Project period:** 2020-09-18 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10175650

## Citation

> US National Institutes of Health, RePORTER application 10175650, Improving Health Outcomes and Equity by Targeting Postpartum Mothers at Highest Risk (1R01MD016029-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10175650. Licensed CC0.

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