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Maternal, Perinatal and Fetal Health

Research and Practice

TitlePI / TeamDescription
Advanced maternal age and maternal healthDonna Strobino, ME Highes, Alison GemmillThis project examines changing demographic characteristics of US women giving birth, with a focus on increasing age at birth. Using various sources including national birth certificate data, PRAMS survey data, and hospitalization records, a key objective is to understand how the shift of the maternal age distribution to later ages may be associated with trends in adverse birth outcomes, and whether these associations differ by race/ethnicity.
Assessment of Barriers and Facilitators of New Infant Feeding Guidelines for People Living with HIV in the United StatesSusan Gross 
Greg Rosen (PI) 
Andrea Ruff 
 
This study seeks to identify potential barriers and facilitators associated with implementation of the recently revised guidelines regarding infant feeding for people living with HIV in the United States. The study involves cross-sectional in-depth interviews in Baltimore, Maryland, (with one potential interview in Washington, District of Columbia) with 3 types of key stakeholders potentially impacted by the revised guidelines: people living with HIV (PLWH), HIV-focused healthcare providers, and individuals providing general care to PLWH and their infants (who may not specialize in HIV), including breastfeeding support. In-depth interviews will be conducted with a purposive sample of individuals from each of these groups. The ultimate goal of this research is to inform the guideline implementation process.
Autism Longitudinal Data Project (ALDP)Xiaobin Wang, Xiumei Hong, Guoying WangALDP seeks to gain deep insight into early life origins of autism spectrum disorders (ASD) and related developmental disabilities (DD). ALDP studies a large, prospective birth cohort of US urban, low income, understudied minority mother-child dyads (~60% Black, 25% Latinx). ALDP employs innovative methods by integrating multi-level-dimensional data (psycho-social, environmental, nutritional, clinical, and biomarkers) across the life course to identify upstream modifiable targets to inform a new paradigm towards early identification and optimal care of ASD/DD across the life course. To learn more, please visit the Center on the Early Life Origins of Disease site.
Breast Improving breast cancer disparities in the State of Maryland by addressing breastfeeding behavior in young womenSusan Gross
Kala Visvanathan (PI)
 
To examine whether pre-diagnostic breastfeeding (BF) can reduce mortality from breast cancer (BC) in young low-income women residing in the State of Maryland (MD), identify at-risk clusters. This study will develop a new cohort by linking individual-level data on women enrolled in the WIC program across the state of Maryland (2000-2023) to individual-level BC data and evaluating the association between BF and BC mortality and test whether nutritional status measures and physician diagnosis of depression significantly modify this association. In addition, spatial analysis informed by individual-level data to identify additional at-risk clusters based on nutritional status and depression for future intervention studies.
Changes in pregnancy outcomes among high-risk pregnancies post-Dobbs: An interrupted time series analysis of hospital discharge dataSuzanne Bell, Alison Gemmill, Anne BurkeThis study aims to understand how abortion bans imposed following the Supreme Court’s Dobbs v. Jackson Women’s Health Organization impact pregnancy care among hospitalized high-risk pregnancies involving lethal congenital anomalies, and how abortion bans impact maternal outcomes via changes in pregnancy care among hospitalized high-risk pregnancies for whom intervention to end the pregnancy is medically indicated.
HEALthy Brain and Child Development Study (HBCD)Susan Gross, David Paige, Heather Volk (PI)The Healthy Brain and Child Development National Consortium (HBCD-NC), multi-site consortium research study, will follow 7,500 mothers and their children from 24 locations across the U.S. from before birth to 10 years of age to better understand which harmful and protective environments exert the greatest impact on child development. The overall goal of this study is to understand the neurodevelopmental trajectories of children growing up in diverse environments.
Hopkins Participant Research Innovations Laboratory for Enhancing WIC Services (HPRIL)David Paige (PI), Laura Caulfield, Susan Gross, Marycatherine AugustynThe overall study objective is to improve WIC participation and retention of children 1-4 years of age. JHU selected five WIC local agencies (LA) as sub-grantees and provide training, technical assistance and evaluation.
Immune Development Across the Life Course: Integrating Exposures and Multi-Omics in the Boston Birth CohortXiaobin Wang, Xiumei Hong, Guoying WangThis project aims to profile early life antibody response to a broad array of pathogenic and commensal microbes and early life exposure to multiple environmental pollutants. This longitudinal birth cohort study allows us to examine the temporal, dose-response, and synergistic effects of these early life factors on the development and prognosis of allergic diseases, including asthma and food allergies. New knowledge gained will inform the development of novel strategies for early prediction and prevention of allergic diseases and environmental standards and regulations. To learn more, please visit the Center on the Early Life Origins of Disease site.
Maternal Preconception Cardiovascular Health, Metabolomic Profile, and Postpartum Cardiovascular OutcomesXiumei Hong
Garima Sharma
Xiaobin Wang
 
Funded by the March of Dimes, this study aims to 1) characterize maternal cardiovascular health and cardiometabolic outcomes that begin in preconception, persist or worsen during pregnancy and persist up to 1-year postpartum; 2) identify pre-, peri and postpartum factors that could modify this trend; and 3) explore underlying molecular pathways by leveraging metabolomics as a powerful tool.
MORE WICLaura Caulfield (PI), Susan Gross, Elizabeth KushmanMatching, Outreach, Referrals for Enrollment in WIC (MORE WIC!) is a cooperative agreement with the USDA Food and Nutrition Services (FNS). It is led by the Johns Hopkins Bloomberg School of Public Health, with support from the National WIC Association (NWA). The project is part of USDA's broader plan to modernize, strengthen, and expand WIC's reach to improve the health of young children and their families. MORE WIC! will use data matching, data sharing and outreach to streamline the enrollment process and increase participation in WIC. 
Performance Monitoring for Action Ethiopia (PMA Ethiopia)Linnea ZimmermanPMA Ethiopia, a cornerstone in health research in Ethiopia, is a collaborative effort between Addis Ababa University, the Federal Ministry of Health, and Johns Hopkins University. It's more than just a survey—it's a reliable source of crucial data on maternal, infant, and reproductive health. Through this initiative, insights are gathered to drive meaningful improvements in healthcare policies and programs, all aimed at enhancing the well-being of Ethiopian women and children.
Pregnancy-associated mortality and morbidity due to drugs, self-harm, and violence in the United StatesAlison GemmillThis NIH-funded study advances clinical and public health knowledge regarding the incidence of and trends and disparities in mortality and morbidity during pregnancy and the first year postpartum due to drug use, self-harm, and violence. This research aims to change clinical practice by finding ways to identify women – in hospital- based settings – at high risk for future morbidity and mortality due to drug use, self-harm, and violence, and lay the foundation for developing preventive strategies.
Preterm Birth and Child Long-term Cardiometabolic Risk: Integrate Proteomics with Birth CohortXiaobin Wang, Xiumei Hong, Guoying WangThis prospective birth cohort study addresses critical questions regarding the preterm origin of cardiometabolic risk in a sample of predominantly US urban, low-income, Black participants who are disproportionally affected by both PTB and cardiometabolic diseases. Findings from this study may inform novel predictive biomarkers and therapeutic targets so that high-risk newborns can be identified, and effective primordial or primary prevention can be initiated during the earliest developmental windows. To learn more, please visit the Center on the Early Life Origins of Disease site.
Social and environmental determinants of fetal loss and adverse birth outcomesAlison GemmillUsing US vital statistics data from 1995-2022, this study use a structural determinants framework to document racial/ethnic differences in both preterm and infant mortality rates across place and time, in response to selection in utero, medical advances in neonatal care, and several features of structural racism. We expect that results will identify, among the high-risk group of preterm births, specific drivers of racial/ethnic differences in infant survival that may respond to intervention efforts.
The fertility, maternal health, and infant health consequences of reproductive policy changeAlison Gemmill, Suzanne BellThis study aims to evaluate the impact of the Supreme Court’s Dobbs decision on fertility; determine the impact of the Dobbs decision on severe maternal morbidity, and; assess the impact of the Dobbs decision on infant birth outcomes, including preterm birth, low birthweight, and small for gestational age. This work will produce results that can inform time-sensitive reproductive health policy decision making in states in the coming years.