# Postpartum Remote Blood Pressure Monitoring Program: Study of Reducing Severe Maternal Morbidity among Black and Latina Women by Incorporating Patient Experiences and Systems Science

> **NIH NIH R01** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2024 · $232,664

## Abstract

PROJECT SUMMARY
Hypertensive disorders of pregnancy (HDP), such as gestational hypertension and preeclampsia, are
increasing yearly across the United States with a persistent racial inequity in prevalence and consequent
morbidity. Black birthing people are more likely to develop preeclampsia, more likely to suffer a severe
maternal morbidity, and more likely to develop cardiovascular disease compared to White counterparts. There
is growing evidence that health-related social needs, such as housing instability, contribute to this
inequity. While non-U.S. nativity imparts a protective effect against adverse pregnancy outcomes and chronic
disease, a finding deemed the “immigrant paradox,” there is emerging evidence that it does not protect against
racial inequities in pregnancy outcomes, including a higher rate of preterm birth and hypertensive disorders of
pregnancy among Black, non-U.S. born mothers compared to White non-U.S. born mothers. Over the past
several years, there has been a shifting demographic of migrants arriving in the U.S., with unprecedented
numbers traversing the U.S.-Mexico border under arduous conditions, prompting the need to examine the
impact of nativity on inequities in outcomes related to hypertensive disorders of pregnancy. This project will
examine inequities by nativity in postpartum outcomes at a large safety-net hospital with a diverse patient
population that is 40% Black, 40% Hispanic, and 60% foreign born. Our proposal will use electronic medical
record data on 6,000 deliveries with hypertensive disorders of pregnancy occurring from 2017-2023 and
proposes a novel assessment of health-related social needs using algorithms informed by screening tools,
social work contacts, and referral letters, to conduct the following aims: (1) examine disparities by nativity in
postpartum cardiovascular related outcomes, including hypertension and repeat hypertensive disorders of
pregnancy, (2) assess mediation between nativity and postpartum cardiovascular related outcomes by various
constructs of health-related social needs, such as housing instability. The ultimate goal of this research is to
harness an existing data in the medical record and use an intersectionality framework to conduct an in-depth
examination of disparities by nativity and intersections of nativity with race and ethnicity. Furthermore, in
alignment with the parent award (R01-HL158864) examining cardiovascular related severe maternal morbidity,
this administrative supplement will generate evidence that is critical in understanding postpartum outcomes in
the face of a changing demographic experienced at an urban, safety-net hospital that mirrors nationwide
trends.

## Key facts

- **NIH application ID:** 11019886
- **Project number:** 3R01HL158864-04S1
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Samantha Parker Kelleher
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $232,664
- **Award type:** 3
- **Project period:** 2021-08-01 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11019886

## Citation

> US National Institutes of Health, RePORTER application 11019886, Postpartum Remote Blood Pressure Monitoring Program: Study of Reducing Severe Maternal Morbidity among Black and Latina Women by Incorporating Patient Experiences and Systems Science (3R01HL158864-04S1). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/11019886. Licensed CC0.

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