# Center for Clinical and Translational Science

> **NIH NIH UL1** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2020 · $148,500

## Abstract

PROJECT SUMMARY
Maternal mortality (MM) and severe maternal morbidity (SMM) are higher in the United States (US) than any
other high-income country and have increased over time. This national maternal health crisis is also
characterized by significant racial disparity. MM is three times as likely among non-Hispanic black women as
non-Hispanic white women. Likewise, non-Hispanic black women are twice as likely to experience SMM even
when controlling for sociodemographic confounders. Given that over 60% of US maternal deaths could be
prevented, there is an urgent need for research to better understand and address the pervasive and persistent
health disparities. Consistent with the goals of this Notice of Special Interest (NOT-OD-20-104), we will utilize
established community-engaged approaches to better understand racial disparities in pregnancy-related and
pregnancy-associated MM and SMM in the priority region of the US South. Our multidisciplinary team will
leverage the clinical research informatics and community engagement resources of the Center for Clinical and
Translational Science (CCTS) to identify multi-level (individual, interpersonal, community, and sociocultural)
determinants of maternal health disparities, as well as factors that contribute to optimal maternal outcomes in
high risk Southern communities. This research will focus on women in Alabama, the state with the third highest
MM in the country. The first specific aim is retrospective cohort study of over 40,000 obstetric patients over the
past 10 years to better evaluate the individual (race, age, education, payer status, medical history), community
(residence), and system (clinic/provider) factors associated with MM and SMM. The second specific aim is to
identify provider, system and community-based perspectives on potential areas of intervention to improve
maternal outcomes and reduce racial inequities in MM and SMM. The third specific aim is a prospective mixed-
methods study of obstetric patients to examine healthcare system distrust, perceived discrimination and racism
experienced by black women receiving obstetric care (hypothesized contributing factors to the 3 to 4 times higher
rate of MM experienced by black mothers). We believe that accomplishing the aims below will significantly
contribute to the evidence-base for NIH’s forthcoming Implementing a Maternal health and PRegnancy
Outcomes Vision for Everyone (IMPROVE) initiative and future longitudinal studies by this research team.

## Key facts

- **NIH application ID:** 10200215
- **Project number:** 3UL1TR003096-02S4
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** Robert P. Kimberly
- **Activity code:** UL1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $148,500
- **Award type:** 3
- **Project period:** 2019-05-06 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10200215

## Citation

> US National Institutes of Health, RePORTER application 10200215, Center for Clinical and Translational Science (3UL1TR003096-02S4). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10200215. Licensed CC0.

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