Early Career Tenure-track Researcher, University of Arizona
1 active project
Scientific Questions Being Studied
This study focuses why some females who have given birth bleed heavily afterwards, called postpartum hemorrhage (PPH). One of the leading causes of PPH is uterine atony, when the uterus does not contract after birth. I have conducted prior studies examining epigenetic and genetic differences associated with uterine atony. The gene I have studied is the oxytocin receptor gene. This gene tells the body to make oxytocin receptors, which is what the uterus uses to help ensure a strong contraction during and after childbirth. When this gene has a slightly different code or has certain DNA changes (epigenetic changes) it was associated with more bleeding and need for more oxytocin (the drug) to be needed during the birth process. I hope to understand this problem further in All of Us. PPH is a major contributor to maternal morbidity and is often hard to predict. I hope this research will aide in our ability to develop more personalized care practices to better prevent and treat PPH.
- Disease Focused Research (postpartum hemorrhage)
- Population Health
- Social / Behavioral
I will use All of Us to look at rates of uterine atony and postpartum hemorrhage among childbearing females. We will examine differences in the oxytocin receptor gene, and genes associated with oxytocin responses in relationship to people having PPH and compare to those without PPH but are similar in other regards (age, gestational age, complications in pregnancy etc.). We will also examine other causes of PPH including anemia in pregnancy, known coagulation diseases, preeclampsia, labor induction etc. We will consider the role of genetic ancestry in this analysis as well, considering to what extent this variant predicts PPH within ancestral populations, if an associate exists at all. Further, we will consider how social determinants of health are associated with PPH. Finally, we will use a phenotype analysis for exploring other conditions also linked to the oxytocin receptor variant, to see if there are other useful risk factors in predicting PPH that are not yet recognized.
Currently, caring for people right after birth can be challenging--as females sometimes have uterine atony without any risk factors being present. In fact, about 40% of PPH cases occur in those without previously identified risks being present. This lack of precision could be improved with more knowledge about oxytocin works in the body by studying differences in how the gene for the receptor works. If oxytocin works better in some people than others, we can develop more personalized strategies for prevention or treatment of PPH. Currently everyone is recommended to receive oxytocin after birth (as an infusion or injection) to prevent PPH, however, rates of PPH are continuing to climb--which is probably linked to more labor induction and other pregnancy conditions. However, given that our current first line prevention strategy doesn't work equally across the population, practitioners and childbearing females would benefit from learning more about how oxytocin works in the body.
Demographic Categories of Interest
- Race / Ethnicity
- Access to Care
- Education Level
- Income Level
Data Set UsedControlled Tier
- Elise Erickson - Early Career Tenure-track Researcher, University of Arizona
- Jason Karnes - Early Career Tenure-track Researcher, University of Arizona
- Jingjing Liang - Early Career Tenure-track Researcher, University of Arizona
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