My clinical and epidemiological research has predominantly focused on investigating strategies to optimize the preventive and treatment of postpartum hemorrhage (PPH), a leading cause of maternal morbidity and mortality in the US. I have also performed health services and outcomes-based research studies related to the use of epidural labor pain relief, the most common method for providing pain relief in labor, and maternal complications including hypertensive disorders of pregnancy and depression. I have also clinical studies examining peripartum changes in maternal hematological and coagulation profiles using advanced point-of-care technologies, such as thromboelastography and clinical investigations of blood product usage in low and high-risk obstetric patients.
My prior epidemiological research related to PPH has involved NIH-funded work investigating risk factors for severe PPH after cesarean delivery, the epidemiology of severe postpartum anemia, and population-based studies exploring the association between important clinical characteristics, such as body mass index and gestational age, and PPH risk. This body of work has required detailed epidemiological analyses of large-scale population-wide datasets involving claims, birth certificate, and clinical data.
I have also led studies that have greatly expanded knowledge of epidural labor analgesia use in the United States. One of our landmark studies utilized national vital statistics (birth certificate) data to reveal substantial variation in the prevalence of epidural labor analgesia across US states, identifying a two-fold difference between the highest and lowest prevalence states, even after adjusting for patient case-mix and select state factors. This work provided crucial insights into regional disparities and informing policy discussions. We were also the first group to refute a purported association between epidural labor analgesia and autism spectrum disorder in the offspring.
Our investigations into PPH, other major maternal morbidities such as eclampsia, and epidural labor analgesia have been published in leading journals, including JAMA Pediatrics, Anesthesiology, and the American Journal of Obstetrics and Gynecology. These publications have significantly contributed to the body of knowledge in obstetric anesthesiology and maternal health, and has received recognition by the lay media, including the New York Times.