# Large-scale Implementation of Community Co-led Maternal Sepsis Care Practices to Reduce Morbidity and Mortality from Maternal Infection

> **NIH NIH UG3** · DUKE UNIVERSITY · 2022 · $764,502

## Abstract

In the United States, infection is now the most common cause of direct maternal mortality and the third leading
cause overall after cardiovascular conditions and other pre-existing medical conditions. Nationally, there has
been no improvement in the overall percentage of deaths from infection since 1987 when the CDC began
maternal mortality surveillance, despite improvements in overall sepsis care for nonpregnant patients. The
long-term goal is to reduce maternal morbidity and mortality from maternal sepsis. The central hypothesis is
that though community leadership, addressing barriers, and intensive implementation of standardized
pregnancy-adjusted screening, diagnosis, and treatment that maternal morbidity from infection and sepsis will
decrease. The overall objectives in this application are to (i) identify patient-based and clinician-based barriers;
(ii) refine sepsis screening in pregnancy; and (iii) implement a large-scale quality improvement collaborative.
The central hypothesis will be tested by pursuing the following specific aims: UG3 phase 1) Develop and
support a Maternal Sepsis Community Leadership Group of community representatives, patients, patient
advocates, and survivors and family members of those who did not survive to inform and engage substantively
throughout the study; 2A) Identify patient-based barriers to care for severe maternal infection and sepsis; 2B)
Design strategies to implement evidence-based sepsis
care interventions, specifically targeted to address and overcome barriers identified in Aims 2A and 2B; 3)
Establish test characteristics of a pregnancy-adjusted intrapartum sepsis screen. Once barriers have been
identified with strategies to overcome them and the sepsis screening, diagnosis, and treatment care practices
have been adjusted based on qualitative and quantitative data it will be transitioned to the UH3 phase. UH3
Aim 1)
Identify clinician-based barriers to implementation; 2C)
Implement refined sepsis screening, diagnostic, and treatment care practices in California and Michigan
and evaluate outcomes of maternal morbidity and mortality. The research proposed in this application is
innovative because it is one of the first studies to co-lead a large-scale maternal initiative with representatives
from the community, diversity, equity and inclusion (DEI), patient advocate representatives, and patients and
families with lived experience with sepsis. This research is significant because it is expected that by identifying
and addressing barriers to care and implementation through community, clinician, patient and DEI
partnerships, this large-scale implementation initiative will serve as a national model to reduce maternal
mortality and morbidity from sepsis, and potentially serve as a model to address other causes of mortality.

## Key facts

- **NIH application ID:** 10490893
- **Project number:** 5UG3HD108053-02
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Melissa Bauer
- **Activity code:** UG3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $764,502
- **Award type:** 5
- **Project period:** 2021-09-30 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10490893

## Citation

> US National Institutes of Health, RePORTER application 10490893, Large-scale Implementation of Community Co-led Maternal Sepsis Care Practices to Reduce Morbidity and Mortality from Maternal Infection (5UG3HD108053-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10490893. Licensed CC0.

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