Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA.
J Womens Health (Larchmt). 2024 May;33(5):565-572. doi: 10.1089/jwh.2023.0750. Epub 2024 Apr 3.
The United States has high and increasing rates of maternal morbidity and mortality, large proportions of which are related to cardiovascular health (CVH). We searched for National Institutes of Health (NIH) supported research as well as that of two other Agencies in the U.S. Department of Health and Human Services (DHHS) for fiscal years (FY) 2016-2021. Grants included maternal health conditions or exposures across all pregnancy stages, but excluded grants that focused entirely on birth, neonatal, infant/childhood outcomes. Results were manually curated by reviewing the abstract and specific aims. Grants deemed to be relevant were grouped by category. Between FY 2016-2021, overall Maternal Health grants remained unchanged at an average of 1.4% of total DHHS grant funding. Maternal CVH-specific (MCVH) funding amounted to $278,926,105 for 755 grants, $191,344,649 was for 534 Type-1 grants, representing a twofold increase. Non-NIH DHHS agencies most commonly funded general Maternal Health related to CVH; NIH focused funding classified as hypertensive disorders of pregnancy, maternal morbidity and mortality, obesity, and diabetes. Non-NIH DHSS Agencies most commonly funded clinical applied research. In addition to clinical applied grants, NIH funded substantial proportions of grants classified as basic research, clinical trials, and/or translational. National Heart, Lung, and Blood Institute (NHLBI) MCVH grants studied participants in the pre-partum period (78.5%), followed by the post-partum period (50.5%), with relatively few in pre-pregnancy and peri-partum periods (10.8% and 9.7%, respectively); at the NIH level, the peri-partum period had better representation at 20.3%, whereas the pre-pregnancy period remained low at 9.9%. Federal grant funding for maternal health including MCVH increased at the same rate as its funding for overall research, and represented only 1.4% of overall total funding. The pre-pregnancy period was understudied in overall NIH funding and represents a gap area whereby funding agencies could further foster research advances.
美国的孕产妇发病率和死亡率居高不下且呈上升趋势，其中很大一部分与心血管健康 (CVH) 有关。我们在美国国立卫生研究院 (NIH) 及美国卫生与公众服务部 (DHHS) 的另外两个机构中搜索了 2016-2021 财年的研究资金。这些拨款涵盖了所有妊娠阶段的孕产妇健康状况或暴露情况，但不包括完全关注分娩、新生儿、婴儿/儿童结局的拨款。通过审查摘要和具体目标，对拨款进行了人工策展。被认为相关的拨款按类别分组。在 2016-2021 财年期间，总体孕产妇健康拨款保持不变，占 DHHS 拨款总额的平均 1.4%。专门针对孕产妇 CVH（MCVH）的拨款为 755 项拨款提供了 278,926,105 美元，534 项拨款为 191,344,649 美元，增长了两倍。非 NIH DHHS 机构最常资助与 CVH 相关的一般孕产妇健康；NIH 重点资助妊娠高血压疾病、孕产妇发病率和死亡率、肥胖和糖尿病。非 NIH DHSS 机构最常资助临床应用研究。除了临床应用拨款外，NIH 还为归类为基础研究、临床试验和/或转化研究的拨款提供了相当大的比例。国家心肺血液研究所 (NHLBI) 的 MCVH 拨款研究了产前（78.5%）和产后（50.5%）阶段的参与者，而在妊娠前和围产期阶段的参与者相对较少（分别为 10.8%和 9.7%）；在 NIH 层面，围产期的代表性更好，为 20.3%，而妊娠前阶段仍然很低，为 9.9%。包括 MCVH 在内的孕产妇健康联邦拨款与整体研究的拨款增长速度相同，仅占总拨款的 1.4%。在 NIH 整体拨款中，妊娠前阶段的研究不足，这是一个空白领域，资助机构可以进一步推动研究进展。
