AUSTIN — Jill Birt, who has experience as a registered labor and delivery nurse, and teaches prenatal yoga at Soul Strong Yoga, knows the challenges of pregnancy. She is always seeking additional education.
“I’ve done a lot of physical activity in my life,” she said. “I’ve ran marathons. I’ve done a lot of training. Labor is the hardest physical work I’ve ever done and I don’t believe we’re preparing ourselves for that as well as we could be.”
Through her work in prenatal yoga, she’s seen the impact of how individualized care can impact a woman throughout her pregnancy.
“The beautiful thing is if they stay regular with it, I’ve watched women get stronger,” she said.
Improving maternal care remains a focus for experts in Texas. The National Science Foundation (NSF) has awarded the University of Texas at Austin a $1.2 million Smart and Connected Health grant to help with research using smartphones to track the activity and behavior of 1,000 pregnant women in the Austin area.
A team of researchers and physicians from Dell Medical School’s Department of Women’s Health, the Texas Advanced Computing Center, and the Institute for Computational Engineering and Sciences will be leading this project. They hope that through the information collected, they’ll be able to develop digital profiles.
“Pregnancy is actually a very good place to start because within nine months we know what the outcomes of a particular pregnancy are,” Radek Bukowski, associate chair for investigation and discovery with the Department of Women’s Health at Dell Medical School at the University of Texas at Austin, said.
The app, originally developed at Harvard University, will be modified by this research team so it can track physical, social and behavioral information.
“We’re hoping to track women passively meaning that it’ll be on their smartphones once they opt into the study,” Kelly Gaither, director of health analytics and senior research scientist at the Texas Advanced Computing Center and associate professor at Dell Med, said. “We’re going to passively track them from the time they first come in at their first appointment until six weeks postpartum.”
Gaither said looking at the current, quantitative data available on pregnancy, doesn’t tell the whole story.
“We know that lived experiences and disparities in health certainly play a significant role,” she said.
The app will run in the background of the patients’ phones.
“We’ll be able to tell whether they’re more or less active, we’ll know if they’re being more or less social and we’ll also have the ability to track whether they’re up in the middle of the night and if they have their phone in their hand,” Gaither said.
The goal is to research adverse outcomes of pregnancy, such as stillbirth, neonatal death, maternal mortality, and pre-term birth and identify risk factors and health benefits for doctors and patients to understand. In August 2018, the Texas Department of State Health Services released a report after in-depth case reviews by the Texas Maternal Mortality and Morbidity Task Force and a deeper analysis of maternal death data. The task force studied medical, autopsy and other records for 89 maternal deaths that took place in 2012. According to DSHS, the review showed four out of five pregnancy-related deaths in 2012 would have had at least some chance of being prevented with the proper intervention. Further data analysis of maternal deaths from 2012 to 2015 showed women dealing with chronic health conditions had an increased risk of maternal death.
“We need more individualization of care,” Bukowski, who is also a doctor of maternal-fetal medicine, said.
Birt also hopes a deeper understanding of risks and possible health benefits between doctors and patients can help identify specific needs for care and the appropriate physical activity levels that can benefit a mother.
“I am definitely really interested in learning how physical activity affects the body,” she said. “Personally, I would like to, at times, really work the women who are pregnant in my classes a little bit harder, knowing what’s ahead of them. I would like to challenge them more physically so they can have that practice of being physically challenged. But there’s not a lot of research and there’s conflicting research out there about what’s a safe heart rate for a pregnant woman, how high their heart rate can go up.”
Data-driven visualization and science are a critical component in rounding out this research. Frontera, the new supercomputer at the Texas Advanced Computing Center, will be used to compute the data after the patients exit the study.
“We’ll know the outcomes for all of these patients,” Gaither said. “We’ll have their clinical records. We’ll be able to see if there’s something that tells a story with the passive monitoring. But to be able to do that is very computationally intensive.”
The grant for the app and research will last four years. The team will start recruiting patients and collecting data beginning 2019.