Making maternity safer

During a University of Illinois Chicago (UIC) summer round table, U.S. Senator Dick Durbin remarked upon a startling statistic. “Women of color are three times more likely than white women to die as a result of their pregnancy,” he said. “This is unacceptable, especially considering that nearly 80 percent of these deaths are preventable with the right health care interventions.”

Resolving this healthcare disparity requires gaining insight into underlying causes in order to create an effective plan to address it. In that spirit, the UIC Department of Medicine announced a new maternal research center in July. The Maternal Health Research Center of Excellence will focus on building and training an interdisciplinary research team, as well as partnering with communities to combat maternal mortality and create an equitable healthcare experience for everyone, regardless of background.

Advancing Health Research Through Innovative Collaborations

Funded by an $11 million six-year grant from the National Institutes of Health (NIH), the new center will have the resources needed to work towards discovering the root of maternal healthcare disparity. Since the announcement, UIC has been working hard to build a coalition of medical and research experts at various institutions. NCSA has long had a close working relationship with University of Illinois researchers. Its Health Innovation Program Office (HIPO) in particular aims to foster exactly these types of cross-disciplinary collaborations. That’s how Aiman Soliman, a research scientist at the Center, first met Zeynep Madak-Erdogan, a University of Illinois Urbana-Champaign professor of food science and human nutrition.

Prior to their maternal healthcare collaboration, a seed grant from HIPO and the University of Illinois  Personalized Nutrition Initiative (PNI) connected the two on an interesting cancer research collaboration. Their original work was to analyze tumors for a project PNI sponsored to develop personalized dietary plans that would help mitigate metastatic liver tumors. This research spawned a number of related projects, including one where Soliman worked on a project using his expertise in spatial mapping to help Madak-Erdogan perform molecular analysis of tumors in a study searching for links between cancer progression and stress. The number of projects spun off from this collaboration is due in large part to the novel application of spatial analysis work in tumor study. 

Building on the solid output from their prior work, Soliman and Madak-Erdogan are teaming up again to work with the new UIC maternal research center. Madak-Erdogan and Soliman were not only part of the initial proposal to start the center, but they’re also leading the main research project with the UIC team – Madak Erdogan co-leads the project and Soliman is a co-PI. Their work to help the new research center find solutions to the health inequity problem among future mothers is so promising that HIPO has recently invested more money in the project so the team can acquire additional data.

A Novel Approach to Understanding Healthcare

Soliman’s expertise is in spatial informatics, a field of study that uses computers to understand and analyze problems in terms of space and location. It’s a more complex version of how GPS works – you can ask your mapping device to take you somewhere, and it will use all the data, including roads, landmarks and addresses, to create a map for you to follow. This is a simple spatial informatics application at work. Soliman’s work includes a much deeper analysis of space and location, and he’s been expanding the application of his research into the healthcare field.

“My work will contribute to understanding how the location of individuals within a city like Chicago alters their exposure to risk factors and ultimately results in disparity in maternal morbidity and mortality,” said Soliman. “Recently, there was an advancement in the scientific knowledge about the combined effects of exposure – environmental pollutants, lifestyle, social conditions and racial background – and genetic predisposition on the disparity in maternal health outcomes between different individuals.”

Previously, we had the technical methodology to analyze molecular changes, but with Dr. Soliman’s Geographic Information System (GIS) approaches and support from the HIPO and Illinois Computes programs, we can now analyze these changes within each individual’s unique neighborhood context.

–Zeynep Madak-Erdogan, U. of I.

Soliman says there’s still more to understand about the spatial effects of exposure. Exposure is any time a person is exposed to an environmental factor that could impact their health in some way – pollution, radiation or even extreme weather. This impact can vary dramatically based on where a person is located or how they move through and use a space with the exposure.

“There is still a gap in understanding the spatial effects of exposure,” said Soliman, “The medical community has recognized in both public health and maternal health research that exposure to environmental, occupational and lifestyle factors is just as important as genetics in determining health outcomes for individuals. However, many exposure studies assess individuals’ exposure solely based on their home addresses, using a coarse spatial resolution. While this approach provides a helpful starting point, there is a need for more realistic models of human mobility that consider daily activities, such as commuting and social interactions.”

Supporting Groundbreaking Research

UIC will start recruiting patients and performing surveys that focus on maternal health, especially in the south Chicago area in December. While Soliman’s research will focus on the big data aspects of this project, Madak-Erdogan will use the methodology she developed for cancer analysis in her previous NCSA collaboration. She’s already preparing to receive samples for these patients and perform molecular analysis. “We will analyze molecular changes associated with chronic stress caused by neighborhood deprivation and examine how these changes may lead to dysregulation of inflammatory responses. Chronic stress and inflammation are known triggers for chronic diseases such as diabetes, cardiovascular disease and cancer, as well as mental health disorders. This research is groundbreaking as it will demonstrate, for the first time, the direct link between the molecular machinery that senses chronic stress and the epigenetic changes that lead to chronic disease in mothers.”

Funding for Soliman’s work comes in part from the NIH grant, but compute hours for the project were awarded through the Illinois Computes program. Madak-Erdogan’s methodology was developed using NCSA’s Delta supercomputer.

Support from Illinois Computes was essential for developing our initial ideas by addressing technical, scientific and computational challenges.

–Aiman Soliman, NCSA

The six-year grant-funded project is still in the early stages, but the hope is that the data produced by the research will help researchers find the root cause of this healthcare disparity. The level of detail and analysis of the data will tell a more nuanced story about these statistics and should help researchers develop a long-term solution to the problem.

As Soliman explains, “The research conducted within this newly established center will generate unique datasets that provide biological, psychological and social profiles of participants along with spatial tags that would allow us to incorporate the spatial aspects of the participants’ exposure to their environment and link it to the disparity in maternal health outcomes.” Soliman will also see some other benefits from his work with this project. 

“This research will provide several opportunities to leverage computational resources to bridge the gap between bioinformatics and spatial informatics,” he said. “Bioinformatics and spatial informatics are two closely related fields. However, they have emerged from distinct communities, leading to a disconnection in their data structures, methods and standards. There is a growing need to integrate tools from both disciplines. To address this, we require a systematic approach to examine the conventions in each domain. This is the focus of the collaboration that Dr. Madak-Erdogan and I have been engaged in for the past couple of years.” 

HIPO is currently providing support for additional NCSA experts to help integrate these tools and develop new tools for this emerging discipline.

“Our research will identify molecular mechanisms through which neighborhood exposures – both positive and negative – impact populations experiencing maternal health disparities,” said Madak-Erdogan. “This knowledge will contribute to two key advances: first, the identification of early epigenetic modifications before disease onset, enabling preventive interventions for chronic conditions; and second, the development of novel diagnostic tools and clinical management strategies to address health disparities. We are very grateful to NIH and NCSA for enabling this.”