Magee-Womens Research Institute and Foundation:
Decreasing Infant Mortality in the Region
Established in 1992, Magee-Womens Research Institute (MWRI) was the first research entity in the United States to focus on women’s health and reproductive biology. MWRI’s clinical partner, UPMC Magee-Womens Hospital (Magee), is a world-class center for both women’s health and comprehensive medical-surgical care. Each year, 11,000 babies (45 percent of babies born in Allegheny County) are delivered at Magee.
MWRI serves as the lead partner with the Children’s Hospital of Philadelphia, the RAND Corporation, and Stanford University on a Foundation-funded predictive analytics project designed to reduce infant mortality in the region, particularly in low-income and African-American communities. To date, this initiative has made significant progress in large part because of a collaborative process with a range of partners, including a number of community-based organizations as diverse as Allegheny County Department of Human Services Healthy Start and the Port Authority.
Among the work underway are 12 research projects addressing issues of infant mortality; development of a database containing records of more than 200,000 deliveries at Magee since 1995 and a biobank that includes specimens from 2,000 women at different stages of pregnancy; focus on early identification of congenital heart defects, among the top causes of infant mortality, and methods to prevent or correct them; creation of an algorithm that, to date, has recorded a 92 percent predictive performance around infant mortality; creation of a causal inference model that suggests the interventions most likely to prevent infant mortality based on an existing risk score and likelihood of participation by the mother; and a ready-to-pilot app for mothers who have delivered a preterm baby at Magee or Children’s Hospital of Pittsburgh (CHP).
A $5,145,000 Foundation grant—one part of a total grant of $8,445,000—will support development and implementation of technologies and interventions for clinicians and service providers to reduce risks of infant mortality in pre-natal and post-natal care. The work centers on technology integration and a new approach to personalized medicine through deep phenotyping of pregnant women, a methodology made possible by the data records and biobank specimens previously collected. New partners joining this work—the University of Pittsburgh and Carnegie Mellon University teams, CHP, and the Institute for Systems Biology in Seattle—will bring new assets to the project.
A second Foundation grant of $300,000—also a part of the $8,445,000 total—will pioneer a new way to treat fetal aqueductal stenosis (FAS), another contributor to infant mortality. In the 1980s, physicians treated FAS in utero by draining excess fluid using a shunt inserted through the baby’s skull. This unsophisticated technique led to challenging and often disastrous results, leading to a moratorium on shunting. More recently, high-resolution ultrasound and MRI technologies have made accurate diagnoses possible, prompting the International Fetal Medicine and Surgery Society to lift the ban.
Now, after five years of work and winning a Coulter Translational Research Award in recognition of the likelihood of successful commercialization, a team led by Dr. Stephen Emery at MWRI has developed a device for in utero shunting that drains fluid from the fetus with minimal risk to the mother. In the next four years, Dr. Emery and his team expect the device to meet FDA requirements, so they can begin manufacturing it and introduce this treatment through the North American Fetal Therapy Network. The Foundation funding will support the design and advanced manufacturing methods the shunt will require, including a micro-laser process, precise thermal shape setting, and hybrid material integration technologies.
The balance of the $8,445,000 of Foundation funding—$3 million—will support the purchase of land adjacent to MWRI’s current facility, which is at capacity—forcing researchers to be scattered throughout buildings that isolate the scientists from one another and are not always suitable for patient populations. Expanding the footprint of MWRI will leverage its proximity and relationship with Magee and better enable the organization to recruit, support, and retain world-class researchers. It also will open up exciting possibilities to create a state-of-the-art research campus, merging basic sciences, novel translational research, and better clinical applications for patients, as well as increasing both federal and non-federal funding.
An expanded clinical trials unit, a center for early human development, and a genomics center are among the ideas being explored. A new building could also attract tenants who not only would bring financial support, but also bolster the life sciences ecosystem.