The purpose of this proposal is to demonstrate the capabilities of the University of Pittsburgh to continue to participate as a clinical site in the Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units Network (MFMUN). We are particularly well suited to be a clinical site in this Network because of our delivery volume; clinical research infrastructure and track record; basic and translational experience and expertise; and specialized resources that we can bring to the Network. Approximately 10,000 women deliver per year at Magee-Womens Hospital, and 75% of these women initiate prenatal care in our system at < 14 weeks. Our site, a large volume delivery-perinatal center under a unified administrative structure, is ideal for participation in the MFMU Network. Through our extensive research infrastructure, we have successfully enrolled women as early as the first trimester, followed them longitudinally through pregnancy to delivery, conducted randomized clinical interventions, and have performed serial collection and processing of biological samples and ultrasound data. We also have demonstrated success in longitudinal postnatal maternal and neonatal follow-up. The demography of our population allows us to contribute uniquely to the study of preterm birth and other adverse pregnancy outcomes. Additionally, our site brings unique content and technical expertise in clinical obstetrics, fetal imaging, genomics and proteomics, placental pathology, and epidemiology. All these areas are represented among our faculty, and we have a long and successful history of research collaboration, within our institution and via multicenter studies. In this application, we aim to: 1. To describe our experience, infrastructure, and track record of participation in single- center and multicenter studies of adverse pregnancy outcomes 2. To demonstrate our ability to enroll a diverse patient population and demonstrate our ability to continue to enroll and provide maternal and newborn follow-up to subjects for ongoing and new MFMU studies 3. To delineate our unique suitability in terms of technical and multidisciplinary content expertise to address the objectives of the MFMU Network.