Over the years, many ICOs have addressed MMM from their vantage points. Click on the links below to learn more about selected ICO’s interest in and efforts focusing on maternal health.
The mission of the All of Us Research Program is to accelerate health research and medical breakthroughs, enabling individualized prevention, treatment, and care for all of us. The program has a special interest in reducing health disparities—across all areas, including maternal health—and is building one of the largest and most diverse databases of its kind to support a wide range of studies. Researchers can register for data access to gain new insights into how biology, environment, lifestyle, and social determinants combine to influence health and disease.
The mission of the Clinical Center is to provide hope through pioneering clinical research to improve human health. As a research facility, the Clinical Center admits and treats only patients with the precise kind or stage of illness under investigation. Although there are no labor and delivery services at the Clinical Center, Clinical Center researchers may at times conduct research related to maternal health. For example, Clinical Center researchers in the Department of Bioethics completed a project in 2021 on the ethics of fetal therapy research, which argues for considering both the interests of the mother and the interests of the fetus when evaluating the potential risks and benefits of fetal therapies and proposes a way of weighing risks and benefits to ensure that research risks are not too unfavorable for either the fetus or the pregnant woman.
Mothers remain the anchor of families globally as predictors of the health of their children and primary caregivers for children and elderly family members. In low- and middle-income countries (LMICs), women also face higher levels of additional challenges such as HIV/AIDS and associated co-morbidities, complications of pregnancy and childbirth, reproductive health concerns and sexually transmitted diseases, breast and cervical cancers, domestic violence, particulate exposures from cooking fires, and societal stigma, among others. FIC supports both research and research training programs in all of these areas as they affect women in LMICs.
The National Cancer Institute (NCI) leads, conducts, and supports cancer research to advance scientific knowledge and help all people live longer, healthier lives. Women’s health, including maternal health, is an important component of that mission. NCI funds multiple research areas related to maternal health, including efforts examining prenatal and postpartum interventions to reduce cancer risks, efforts seeking to understand the impact of concurrent cancer diagnosis and pregnancy on maternal survival, and efforts evaluating the safety of in utero antiretroviral treatment for children born to HIV-positive mothers. Other pertinent areas include research focused on the reproductive health of pediatric, adolescent, and young adult cancer survivors. These and other efforts serve to improve maternal health outcomes around the world.
As part of its mission to bring more treatments to more people more quickly, the National Center for Advancing Translational Sciences (NCATS) funds a range of translational research to advance and improve maternal health. Through its Clinical and Translational Science Awards (CTSA) Program, NCATS supports initiatives that involve collaborations among researchers, clinicians, and communities to prevent and reduce maternal morbidity and mortality and to reduce health disparities in underserved and underrepresented populations, including efforts to lower preterm births. The center also enables novel research into COVID-19’s impact on maternal health and pregnancy outcomes through the Pregnancy Clinical Domain Team of its National COVID Cohort Collaborative initiative.
The mission of the National Center for Complementary and Integrative Health (NCCIH) is to determine—through rigorous scientific investigation—the fundamental science, usefulness, and safety of complementary and integrative health approaches and how they can be used to improve health and health care. Women may use complementary and integrative approaches to improve their health over the course of their lifespan, including during pregnancy and lactation. NCCIH will continue to further research on the health of women and sex as a biological variable by:
- Developing and testing interventions using complementary health approaches for managing symptoms such as perinatal and postpartum depression, stress, anxiety, pain, and sleep disturbance, and assessing the impact of such interventions on maternal health outcomes.
- Supporting research on the use of complementary health approaches to support pregnant and parenting women with opioid use disorder.
- Supporting research on the influences and intersection of sex and gender on the mechanisms underlying complex interventions including various mind and body approaches and natural products.
- Conducting research that investigates the influence of sex and gender on the use of complementary health approaches to improve health outcomes among diverse populations, including gender-diverse populations.
The mission of the National Eye Institute (NEI) is to eliminate vision loss and improve quality of life through vision research. In alignment with NEI’s mission, NEI supports a number of research efforts related to maternal health, focusing on research areas of pregnancy-related ocular and systemic complications experienced by mothers and newborns. The research work covers healthy and high-risk pregnancies and many congenital and developmental ocular defects in infants, such as retinopathy of prematurity; congenital cataract; congenital glaucoma; microphthalmia, anophthalmia, and coloboma (MAC); and complications that may result from preterm birth. This research helps to enhance the health and well-being of pregnant, post-partum, and nursing mothers and their infants.
Cardiovascular disease is the leading cause of death for women overall and the leading cause of pregnancy-related death. The National Heart, Lung, and Blood Institute (NHLBI) is committed to addressing women’s unique health risks, including complications of pregnancy. NHLBI supports research to reduce maternal morbidity and mortality (MMM), especially among African American and American Indian/Alaska Native women, who are at higher risk than White women. NHLBI is addressing health disparities in MMM through implementation research, community-engaged research, interventional clinical trials, and outreach programming. NHLBI’s approach takes into account women’s health across their lifespan—before, during, and after reproductive age.
- Heart Health and Pregnancy
- The Heart Truth®
- Cardiovascular Risk Prediction for Maternal Mortality and Morbidity and Beyond Workshop
- Chronic Hypertension and Pregnancy (CHAP) Project
- Nulliparous Pregnancy Outcomes Study-Monitoring Mothers-to-Be (nuMoM2b) Heart Health Study
- Early Intervention to Promote Cardiovascular Health of Mothers and Children (ENRICH)
- Women’s Health
- Advancing Women’s Heart Health
- Studies Address Link Between Rising U.S. Maternal Deaths and Heart Disease
- Study Identifies Cardiovascular Risk Factors That May Lead to Pregnancy Problems for First-Time Moms
The mission of the National Human Genome Research Institute (NHGRI) is to improve the health of all people using advances in genomics research. Through efforts to maintain and sustain a robust foundation for genomics research, NHGRI is contributing to a better understanding of maternal health, such as through the development of noninvasive prenatal genetic testing and increasing knowledge of genetic diseases that affect the reproductive system. For example, DNA sequencing now allows us to test for specific genomic variants in an unborn baby using only a small sample of a pregnant mother’s blood. With this and other revolutionary technologies and research, NHGRI is improving health assessments as they relate to maternal health.
The National Institute of Allergy and Infectious Diseases (NIAID) supports basic and translational research to better understand, diagnose, prevent, and treat infectious and immune-mediated diseases, including diseases that impact pregnancy outcomes. NIAID research efforts aim to explain the underlying fundamental biological questions that identify and define immune mechanisms, with the goal of significantly improving maternal health and translating discoveries into effective treatments, preventive strategies, and diagnostics. This includes research into mechanisms of infection and related outcomes that occur during pregnancy or postpartum, immunization during pregnancy, and immune processes of pregnancy complications.
The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) includes a focus on rheumatic and musculoskeletal disorders that carry an increased risk of adverse reproductive events. NIAMS research aims to improve risk prediction and identify targeted approaches to improving maternal health and pregnancy outcomes among those affected by these diseases
The National Institute of Biomedical Imaging and Bioengineering (NIBIB) supports a number of research efforts related to maternal health, focusing on the development, engineering, and design of technologies that can monitor women before, during, and after pregnancy for risk factors related to maternal morbidity and mortality in alignment with NIBIB’s mission.
The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) is the lead NIH institute supporting research on maternal health, including studies focused on reducing pregnancy-related complications and deaths, known as maternal morbidity and mortality. Its efforts aim to advance understanding, early diagnosis, treatment, and prevention of pregnancy and birth complications, as well as to improve the quality of data collected on maternal health. To inform its research agenda, NICHD engages with communities disproportionately affected by poor maternal and infant health outcomes, particularly underserved racial and ethnic populations who experience disparities in access to quality prenatal and postpartum care.
The mission of the National Institute of Dental and Craniofacial Research (NIDCR) is to advance fundamental knowledge about dental, oral, and craniofacial health and disease and translate these findings into prevention, early detection, and treatment strategies that improve overall health for all individuals and communities across the lifespan. NIDCR supports research to improve maternal oral health during pregnancy, as well as initiatives to promote positive oral health outcomes for infants and young children. NIDCR encourages research on strategies for promoting oral health and dental care utilization in expectant mothers, especially those experiencing health disparities. Additionally, NIDCR supports studies into mechanisms, prevention, and treatment of diseases for maintaining and enhancing maternal oral health.
Metabolic diseases, such as obesity and diabetes, increase risk for adverse pregnancy outcomes for mothers and babies and their likelihood of developing metabolic disease later in life—setting the stage for a “vicious cycle” of metabolic disease in future generations. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) has supported research to understand, prevent, and treat diabetes and obesity in women of childbearing age and those who are already pregnant to improve their overall health and potentially break the transgenerational propagation of metabolic disease. Through such studies, NIDDK hopes to improve the health of women and their families before, during, and after pregnancy.
The National Institute of Environmental Health Sciences (NIEHS) supports a variety of research related to maternal health to (1) identify vulnerable times during pregnancy and the postpartum period that may have implications for health problems that arise later in life, (2) develop biomarkers that indicate at-risk pregnancies, and (3) identify environmental contaminants and conditions, including racism and environmental injustice, that can undermine the health of both mother and baby or lead to health disparities. In addition, NIEHS supports NIH’s IMPROVE initiative to ensure that environmental factors are considered in maternal morbidity and mortality research.
The National Institute of General Medical Sciences (NIGMS) supports several ongoing research programs focused on maternal health, primarily in underserved populations, that look at mechanisms underlying complications during and after pregnancy, such as preeclampsia, gestational diabetes, milk production complications, and heart problems. An area of specific interest for NIGMS-funded programs is maternal and child health among American Indian women, including the effects of maternal adverse childhood experiences on teen pregnancy and poor birth outcomes and factors underlying alcohol-exposed pregnancies. One program for research trainees resulted in the landmark report titled 2020 Navajo Nation Maternal and Child Health Needs Assessment.
The National Institute of Mental Health (NIMH) supports a number of efforts related to maternal health, including research on perinatal depression and associated psychiatric morbidity (e.g., bipolar disorder, perinatal psychosis, self-harm, and suicide attempts). Areas of interest include research to understand the neural mechanisms that lead to perinatal mental illnesses and the identification of biomarkers that can help detect risk for and protection from mental illnesses during the perinatal period. NIMH also supports research on ways to optimize, sequence, and personalize prevention and treatment intervention approaches; improve screening and identification of perinatal mental illnesses; connect women with accessible and appropriate evidence-based treatment; and engage women in mental health care.
The National Institute of Neurological Disorders and Stroke (NINDS) supports a number of research efforts related to maternal health, focusing on neurological morbidities and sequelae of pregnancy, lactation, and related endocrinological and inflammatory conditions. Specifically, but not exclusively, NINDS supports research on neurological sequelae of COVID-19 during pregnancy, pregnancy- and lactation-associated episodic headache, pregnancy and lactation in women with epilepsy, and stroke and intracranial hemorrhage during pregnancy and in the postpartum months.
The National Institute of Nursing Research (NINR) supports efforts focused on understanding the underlying causes of adverse pregnancy outcomes and developing interventions to prevent and manage these outcomes. NINR is especially invested in efforts to address maternal health disparities among women in underserved racial and ethnic groups and low-income women. In addition, NINR supports the NIH Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE) initiative, which supports research to reduce preventable causes of maternal deaths and improve health for women before, during, and after delivery.
The National Institute on Aging (NIA) supports and conducts research to increase understanding of diseases and conditions associated with growing older and to promote healthy aging. NIA’s work encompasses many research areas related to women’s health, including studies on the correlation between pregnancy history and the rate of biological aging after menopause, the influence of pregnancy-related changes and complications (such as high blood pressure and diabetes), and the impact of reproductive risk factors on cognitive decline and dementia after menopause.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) supports a number of research efforts related to maternal health, with a primary focus on preventing and reducing drinking during pregnancy and improving birth outcomes, in alignment with NIAAA’s mission. In addition, NIAAA sponsors the Interagency Coordinating Committee on Fetal Alcohol Spectrum Disorders (ICCFASD), which promotes improved communication, cooperation, and collaboration among disciplines and Federal agencies that address issues related to prenatal alcohol exposure. NIAAA also sponsors the Interagency Work Group on Drinking and Drug Use in Women and Girls, which works to develop and implement collaborative initiatives to improve the quantity, range, and quality of prevention, treatment, and recovery services for all forms of alcohol misuse among women of childbearing age.
The National Institute on Deafness and Other Communication Disorders (NIDCD) is dedicated to improving the health and quality of life for people living with communication disorders by supporting and managing a broad portfolio of both basic and clinical research in the areas of hearing, balance, taste, smell, voice, speech, and language. NIDCD research efforts related to maternal health include investigation of sex differences in susceptibility to noise-induced hearing loss and the protective effect of estrogen, therapeutic interventions to prevent congenital deafness due to maternal–fetal viral transmission, and evaluation of the physiological differences underlying the increased risk of voice problems in women.
The National Institute on Drug Abuse (NIDA) supports a growing number of research efforts on the prevention and effects of substance use on maternal health. NIDA-supported studies seek innovative solutions to deliver effective prevention interventions, including family-based parenting interventions, and quality addiction care before, during, and after pregnancy. As part of the NIH Helping to End Addiction Long-term (HEAL) Initiative, NIDA leads the Medication Treatment for Opioid-dependent Expecting Mothers (MOMs) trial, which evaluates different formulations of the medication buprenorphine to treat opioid use disorders among pregnant women. NIDA research also aims to better understand the link between maternal substance use and pregnancy-related complications—such as postpartum depression and preeclampsia—and to prevent neonatal opioid withdrawal syndrome (NOWS) and other fetal complications related to prenatal substance exposure. The NIDA-led HEALthy Brain and Child Development (HBCD) Study will follow mothers and their children from the prenatal period through up to a decade later to evaluate the long-term health effects of factors related to substance use. These and similar initiatives are also being leveraged to evaluate the impacts of the COVID-19 pandemic on pregnant women and new mothers.
Rates of maternal morbidity and mortality are significantly worse for people of color compared with White people. The National Institute on Minority Health and Health Disparities (NIMHD) aims to address this disparity by supporting original, innovative, multidisciplinary research to advance the understanding, prevention, and reduction of pregnancy-related complications and deaths among disproportionately affected women. NIMHD-funded research examines multilevel interventions—at the individual, health care setting, community, and societal levels—to reduce maternal deaths and complications. Examples of factors at higher levels of influence include patient–clinician communication, clinician implicit and explicit bias, availability or accessibility of health care, availability of social services, and societal-level discrimination and violence exposure.
The National Library of Medicine (NLM)—a leader in research in biomedical informatics, computational biology, and data science—supports research efforts related to maternal health, including the use of artificial intelligence methods to predict cervical cancers, data science–enabled solutions to support the self-management needs of women living with endometriosis, and research to develop better methods of continually assessing risk for gestational diabetes and effects of nutrition in pregnancy, leading factors of maternal morbidity and mortality. NLM’s computational health research methods and tools also advance research and discovery related to maternal health and the influences of sex and gender on health and disease. NLM provides consumer content specific to maternal health through its MedlinePlus website.
Maternal health is a matter of critical importance to the Office of AIDS Research (OAR), which works to advance research to end the HIV pandemic and improve health outcomes for people with HIV. Globally, women remain at significant risk for HIV, and the virus poses unique challenges for women throughout their lifespans. OAR supports innovative research across NIH, focused on priority areas such as the development and implementation of new HIV prevention, treatment, and cure strategies for girls and women; the prevention of mother-to-child transmission of the virus; the HIV-related needs of transgender women; and studying HIV-negative children who were exposed to the virus during their mothers’ pregnancies to monitor for any abnormalities or adverse health outcomes.
The mission of the Office of Behavioral and Social Sciences Research (OBSSR) is to enhance the impact of health-related behavioral and social sciences research. The office continues to support the general mission of the Office of Research on Women’s Health (ORWH) when it coincides with the mission of OBSSR by supporting the importance of studying the health of women, sex as a biological variable, and research on maternal health. Specifically, OBSSR provides representation on the NIH Maternal Mortality Task Force and other cross-division activities, and it provides additional funding support toward ORWH initiatives related to maternal health.
The Office of Data Science Strategy (ODSS) has committed immense efforts and resources to identify data-driven solutions to address complex health issues, such as maternal morbidity and mortality (MMM). Given the multitude of physiological, clinical, and social factors that contribute to MMM, ODSS firmly believes in the development of high-quality, diverse datasets and the application of advanced data methodologies, including artificial intelligence, to better understand the interplay of complex factors underlying this public health crisis. Research advances do not happen without the hard work of dedicated researchers. ODSS supports the training of a diverse workforce in data science. It achieves these goals through participatory engagement with diverse communities and partnership with NIH Institutes, Centers, and Offices. Ultimately, it is up to all of us to solve the complex puzzle of maternal morbidity and mortality.
The Office of Dietary Supplements (ODS) supports research efforts related to maternal health, especially those that strengthen knowledge and understanding of nutritional status and nutrient requirements that impact the health and well-being of women during pregnancy and the preconception and postpartum periods. In alignment with ODS’s mission, the office also supports initiatives that better characterize the potential for adverse events associated with the consumption of dietary supplement ingredients, including botanicals, that may be used by pregnant women.
The mission of the Office of Disease Prevention (ODP) is to improve public health by increasing the scope, quality, dissemination, and impact of prevention research supported by NIH. Current research has shown that most maternal deaths are preventable, highlighting the importance of enhancing screening and preventive services and reducing health disparities as critical issues for maternal health in the United States. ODP is working to ensure that NIH research contributes to a better understanding of these issues as they relate to maternal health, with a specific focus on identifying risk factors for complications during and after pregnancy, including how the conditions in which people live, learn, work, and play affect maternal health.
The Office of Research Infrastructure Programs (ORIP) advances the NIH mission by supporting research infrastructure and research-related resource programs. ORIP-supported resources and infrastructure help NIH-funded investigators develop new treatments and approaches to address today’s most pressing health challenges, such as the high rates of maternal morbidity and mortality. For example, ORIP-funded research with nonhuman primate colonies supports translational research on pregnancy complications, preterm labor, fetal alcohol syndrome, gestational malnutrition, and the consequences of advanced maternal age for pregnancy outcomes.
The Sexual & Gender Minority Research Office (SGMRO) is dedicated to advancing the health and well-being of all members of the sexual and gender minority (SGM) community, including members who were assigned female at birth and/or who identify as women. There is currently a significant dearth of NIH-supported research and activities devoted specifically to the health of pregnant people who are also members of SGM populations. SGMRO encourages more efforts in this crucial field, potentially including funding more research projects centered on the health of pregnant SGM people; the expansion of sex, sexual orientation, and gender identity data collection in relevant projects about pregnant people; and increasing the usage of gender-inclusive language in relevant funding opportunity announcements.
In its role as the coordinating hub for NIH American Indian and Alaska Native (AI/AN) health research activities, the Tribal Health Research Office (THRO) works across NIH and with other agency partners to include Tribal Nations in biomedical research in a way that respects their sovereignty, cultural beliefs, and community values. THRO’s outreach and engagement efforts help reduce barriers to participation in beneficial research, including facilitating a data sharing and use agreement in a study investigating the effects of environmental exposure to toxicants on maternal and pediatric health. Improving maternal health in Indian Country is critically important as Healthy moms and children are key to greater health for AI/AN communities.