$4.95 Million Grant to Help Reduce Maternal Mortality

The Center for Research on Reproduction and Women's Health at the Penn Medical Center has been awarded $4.95 million from the Bill & Melinda Gates Foundation to study and develop new tools for the prevention of maternal mortality.

Medical research in the past 20 years has brought significant advances in diagnosis, therapy and access to health care, resulting in dramatic reductions of child mortality and an increase in life expectancy. However, despite the efforts of the international medical community, there has not been an associated decline in maternal mortality, especially in developing countries.

"Maternal mortality remains a global health problem despite significant international efforts to deal with this tragedy," said Dr. Jerome F. Strauss, III, professor of obstetrics and gynecology and director of the Center for Research on Reproduction and Women's Health. "While there has been a striking decline in maternal death rates in the United States during the past century, very disturbing disparities remain in deaths among racial groups and among women in developing countries."

Ectopic pregnancy and hemorrhage, preeclampsia (a combination of hypertension, edema and protein loss in the urine) and infection represent the top major killers of pregnant women worldwide. These three conditions still account for 59 percent of all maternal deaths in the United States alone.

"These are the same conditions that were responsible for the majority of maternal deaths 70 years ago," said Dr. Strauss. "The funding will be used to develop new, badly-needed methods to diagnose and treat ectopic pregnancy, prevent preeclampsia and treat it once it is diagnosed; and to identify women at risk of developing life-threatening infections in pregnancy. This substantial grant should do much to quicken the pace of discovery and clinical application."

In the United States alone, there is a striking racial disparity in maternal death rates with African American women who have a four times greater chance of dying from a pregnancy-related condition than Caucasian women. More specifically, African American women have a three-fold higher death rate from ectopic pregnancy; a three-fold greater risk of death from preeclampsia; and are two times as likely to have a premature rupture of the fetal membrane leading to infection. "Epidemiologic studies indicate that this racial disparity can be accounted for only in part by differences in socio-economic status or access to health care services," said Dr. Luigi Mastroianni, Jr., the William Goodall Professor of Obstetrics and Gynecology. "Clearly, these causes of mortality are not exclusively a problem in developing countries."

These compelling statistics also show that the current understanding of the underlying leading causes of maternal death is insufficient. "This grant will give us the greater knowledge base we need to speed up the development of superior methods to predict risk, achieve timely intervention, and develop effective therapies," said Dr. Mastroianni.

Almanac, Vol. 47, No. 1, July 18, 2000