Center examines puzzling high death rate in childbirth

Strauss with blood-testing equipment.

Photo by Daniel R. Burke


Back in the year 1900, pregnancy was risky business. And for some people, it still is.

Even though maternal mortality rates have been plummeting in this country for the past century, serious problems remain — especially for African American women and women in developing countries.

Soon, all this will change, if the Center for Research on Reproduction and Women’s Health and its founding Director Jerry Strauss have anything to say about it.
The Center started out in 1992 as a research center tied to the School of Medicine’s obstetrics and gynecology department. Today, it brings together members of nearly a dozen University departments and four schools.

Oh, and it also receives more NIH funding than any other ob/gyn research facility in the country.

But the latest windfall came from the private sector. A $4.95 million grant from the Bill and Melinda Gates Foundation, awarded last May, is funding new research aimed at diagnosing and preventing maternal mortality.

Conditions like hemorrhage, infection, ectopic pregnancy — in which the fertilized egg is implanted outside the uterus — and the multi-symptom syndrome pre-eclampsia continue to claim lives every year.

In this country, African-American women are four times more likely than their white counterparts to die of childbirth-related causes. This discrepancy remains even after accounting for factors like socioeconomic status and access to health care, leading some researchers to believe there is a genetic factor to the problem.

Maternal deaths in the developing world are even more of a problem. “We believe that the death rate from ectopic pregnancy has been vastly underestimated in the developing world,” said Strauss. “A lot of women with ectopic pregnancies die before they ever reach medical attention.”

With these problems before them, Strauss and his colleagues at the center are putting the Gates money to work, searching for tools to diagnose and treat the major causes of maternal mortality.

George Gerton, associate professor of obstetrics and gynecology and cell and developmental biology, is working on developing simple blood or urine tests to diagnose ectopic pregnancies early on. Kurt Barnhart, assistant professor of obstetrics and gynecology, is looking into treating ectopic pregnancies with a drug — cheaper than surgery and simple enough for wide use in the developing world.

Meanwhile, Sam Parry, assistant professor of obstetrics and gynecology, is studying viruses to gain insight into pre-eclampsia, and Strauss is working with George Macones, director of maternal-fetal medicine at the Health System, to develop a dietary supplement that might prevent or treat blood vessel constriction associated with pre-eclampsia.

When asked about the joys of his work, Strauss talked about research that rolls over easily into clinical applications. “Everybody talks about translational research,” he said. “It’s very difficult to do it. But in our field, there are very exciting things that represent models of translational research. … It truly is amazing.”

Originally published on November 9, 2000