# An AI-Directed CDS Tool to Reduce Iron Deficiency Anemia in Pregnancy: A Randomized Controlled Trial (AID-IDA Trial)

> **NIH AHRQ R21** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $118,089

## Abstract

Project Summary
Postpartum hemorrhage (PPH) is the most common complication during childbirth, occurring after 10% of all
deliveries, and is a significant contributor to maternal morbidity. While acute and active management of PPH is
required to prevent morbidity, pregnant individuals without anemia are better equipped to tolerate delivery-
associated blood loss without incurring morbidity. The primary cause of anemia in pregnancy is iron deficiency.
There is insufficient evidence to support universal iron deficiency screening during routine obstetric care in the
US. Currently, most individuals may only be screened for iron deficiency if they are anemic. This two-step
screening process can lead to 1) failure to diagnose iron deficiency if the patient does not undergo the secondary
work-up for anemia and 2) failure to adequately treat iron deficiency given the time it takes for oral therapy, the
historical standard treatment, to replete iron stores and its side effects that can limit regular use. Thus, innovative
strategies are needed to address iron deficiency and anemia in pregnancy, especially for the 10% of individuals
who will have a PPH and are at an increased risk for severe maternal morbidity. The primary objective of this
Phased Innovation Award (R21/R33) is to develop and test a clinical decision support (CDS) tool that proposes
a novel iron deficiency screening and management algorithm for individuals at high risk for PPH. In Phase I
(R21), structured data known at the end of the second trimester will be used to develop a machine learning-
based predictive model to identify those at high risk for PPH. We will then build a CDS tool within the electronic
health record (EHR) that will prompt providers to proactively screen and treat iron deficiency for patients at high
risk for PPH. In Phase II (R33), we will test this CDS tool’s efficacy in reducing the prevalence of anemia before
delivery via a randomized controlled trial. This phase will also monitor the acceptability of the CDS tool among
obstetric providers in the intervention group. Based at Massachusetts General Hospital, this work is led by an
experienced, multidisciplinary team of researchers with expertise in machine learning, informatics, practical
application of risk stratification tools, and clinical obstetrics. Ultimately, the proposed work seeks to improve
maternal health outcomes and accelerate the application of artificial intelligence-aided clinical tools in obstetrics
at the point of care. Specifically, it will demonstrate how a digital health tool, which uses a personalized risk
assessment, can be integrated into clinical workflows within prenatal care and offers an actionable, resource-
conscious strategy to address the ongoing public health crisis related to maternal morbidity in the US.

## Key facts

- **NIH application ID:** 10951600
- **Project number:** 1R21HS030148-01
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Mark Allen Clapp
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2024
- **Award amount:** $118,089
- **Award type:** 1
- **Project period:** 2024-08-01 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10951600

## Citation

> US National Institutes of Health, RePORTER application 10951600, An AI-Directed CDS Tool to Reduce Iron Deficiency Anemia in Pregnancy: A Randomized Controlled Trial (AID-IDA Trial) (1R21HS030148-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10951600. Licensed CC0.

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