UAMS awarded $15 million for postpartum care study

A research team at the University of Arkansas for Medical Sciences (UAMS) has been approved for a five-year, $15 million funding award by the Patient-Centered Outcomes Research Institute (PCORI) to study the best mechanisms for postpartum follow up with new mothers to reduce maternal mortality and morbidity.

The UAMS study will compare two postpartum care models — the Telehealth Multicomponent Optimal Model (Telehealth MOM) and enhanced standard of care — by conducting a comparative evaluation with 1,500 low-income and ethnically diverse women. Eligible patients will be pregnant women 18-44 years of age and will include women who speak English, Spanish or Marshallese.

According to the Centers for Disease Control and Prevention (CDC), 1,205 women died of maternal causes in the U.S. in 2021, compared with 861 in 2020 and 754 in 2019. The U.S. has a higher maternal mortality ratio than most other high-income nations, with more than half of maternal deaths occurring postpartum after hospital discharge.

The UAMS study will address critical gaps in knowledge about how best to deliver comprehensive postpartum care that ensures timely identification and treatment of complications and meets the needs and preferences of diverse patients including disproportionately impacted racial groups and rural residents.

“The predominant model of care following discharge from delivery is an in-person visit scheduled around six weeks postpartum,” said Jennifer Callaghan-Koru, Ph.D., MHS, one of the principal investigators on the study and an associate professor in the UAMS Department of Internal Medicine. “However, most postpartum maternal morbidity happens within the first six weeks after delivery, often within the first two weeks. Therefore, care at six weeks or later may be too late to prevent severe maternal morbidity and mortality.”

The study will take place through UAMS’ Rural Research Network, which was established in 2020 by Pearl McElfish, Ph.D., MBA, the other principal investigator on the study and division director of the UAMS Office of Community Health & Research.

Callahan-Koru and McElfish will lead all engagement activities. Callahan-Koru has six years of engagement experience, and McElfish has 25 years of engagement experience and is a national and international expert in community, patient and stakeholder engagement with more than 100 articles on the art, science and practice of engagement.

“Results from this study have great potential to benefit the quality of postpartum care received by women in the United States,” McElfish said. “Given the importance of early detection and treatment of complications in the postpartum period for reducing maternal mortality and morbidity, this study fills a critical gap in knowledge for clinical decision-making.”

The UAMS study was selected through a PCORI funding announcement specifically focused on research to assess the comparative clinical effectiveness of multicomponent strategies to improve early detection of, and timely care for, complications up to six weeks postpartum for Black, American Indian/Alaska Native, Hispanic, rural, and low socioeconomic status populations.

PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better informed health care decisions. The Rural Research Network is supported by the UAMS Translational Research Institute.