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The effect of hypertensive disorders in pregnancy and HIV-infection on maternal, birth and infant outcomes in South Africa

Award Number: K43TW010683
ORGANIZATION: FOGARTY INTERNATIONAL CENTER
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Project Summary Candidate: Dr. Slogrove is unwaveringly committed to a career focused on finding solutions to maternal and child health challenges in low-middle income countries (LMIC). She ultimately envisions herself globally as a leader in HIV exposed uninfected (HEU) child research and locally as the leader of a rural maternal and child health research unit. Dr. Slogrove’s 5-year career development plan is focused on three specific areas: 1) to develop advanced epidemiologic skills building on doctoral and post-doctoral studies in epidemiology; 2) to strengthen leadership ability; 3) to expand maternal health expertise complementing pediatric specialist training to comprehensively research the maternal-child dynamic. This will be achieved through drawing on the strengths of four leading institutions with strong collaborative ties, Stellenbosch University, University of Cape Town, Columbia University and Harvard. Dr. Slogrove has assembled a highly experienced mentorship team combining expertise in maternal and child HIV clinical research with public health, epidemiology and biostatistics. Research: This study aims to understand epidemiologically whether HIV and antiretroviral therapy (ART) are associated with hypertensive disorders in pregnancy (HDP) and whether this represents a pathway to adverse maternal, birth and HEU infant outcomes. The specific aims are to determine: 1) whether maternal HIV and antenatal ART are associated with HDP; 2) the contribution of HDP in HIV-infected women to adverse maternal and birth outcomes; 3) the contribution of maternal morbidity and mortality and adverse birth outcomes to HEU neonatal and infant morbidity and mortality. This early career award study will be integrated within the NICHD-funded B-POSITIVE study, comprehensively evaluating the universal maternal ART strategy at a population level in the entire Western Cape Province of South Africa. Provincial surveillance through harmonization of existing provincial electronic routine data sources is combined with sentinel-site activities to investigate population trends in greater depth. This presents a unique opportunity to interrogate pathways of HEU infant vulnerability in a population where 19% of infants are in utero HIV and ART exposed. The current application utilizes the B-POSITIVE electronic harmonized data platform to evaluate the specific aims at a population level in the entire cohort of pregnant women in the Western Cape for a 2-year period (N˜190,000) and in greater depth at two sentinel sites (N˜17,000). Mediation analysis will be used to understand whether the adverse birth outcomes associated with antenatal ART are partly mediated by increased HDP and in turn whether they partly mediate neonatal and infant morbidity and mortality. This study will rapidly determine in an entire population whether widely used antenatal ART regimens are associated with HDP and whether this represents a pathway to adverse maternal and birth outcomes leading to excess HEU infant morbidity and mortality. Establishing the safety of ART during pregnancy is of critical public health importance for the 30% of pregnant South African women who are HIV-infected.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = -$48,058 )
2024	2021	STELLENBOSCH UNIVERSITY	ADMINISTRATION BUILDING B, VICTORIA ST	STELLENBOSCH				ZAF	International Research and Research Training	000	5	3/5/2024	NON-COMPETING CONTINUATION	-$48,058
														Subtotal = -$48,058

Issue Date FY: 2022 ( Subtotal = $0 )
2022	2021	UNIVERSITEIT STELLENBOSCH	ADMINISTRATION BUILDING B, VICTORIA STREET	STELLENBOSCH				ZAF	International Research and Research Training	001	5	8/19/2022	SUPPLEMENT FOR EXPANSION	$0
2022	2021	UNIVERSITEIT STELLENBOSCH	ADMINISTRATION BUILDING B, VICTORIA STREET	STELLENBOSCH				ZAF	International Research and Research Training	000	5	8/19/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2021 ( Subtotal = $194,397 )
2021	2021	UNIVERSITEIT STELLENBOSCH	ADMINISTRATION BUILDING B, VICTORIA STREET	STELLENBOSCH				ZAF	International Research and Research Training	002	5	7/21/2021	SUPPLEMENT FOR EXPANSION	$81,000
2021	2021	UNIVERSITEIT STELLENBOSCH	ADMINISTRATION BUILDING B, VICTORIA STREET	STELLENBOSCH				ZAF	International Research and Research Training	000	5	2/26/2021	NON-COMPETING CONTINUATION	$113,397
2021	2021	UNIVERSITEIT STELLENBOSCH	ADMINISTRATION BUILDING B, VICTORIA STREET	STELLENBOSCH				ZAF	International Research and Research Training	003	5	8/18/2021	SUPPLEMENT FOR EXPANSION	$0
2021	2021	UNIVERSITEIT STELLENBOSCH	ADMINISTRATION BUILDING B, VICTORIA STREET	STELLENBOSCH				ZAF	International Research and Research Training	001	5	7/21/2021	NON-COMPETING CONTINUATION	$0
														Subtotal = $194,397

Issue Date FY: 2020 ( Subtotal = $113,305 )
2020	2020	UNIVERSITEIT STELLENBOSCH	ADMINISTRATION BUILDING B, VICTORIA STREET	STELLENBOSCH		7600		ZAF	International Research and Research Training	000	4	3/30/2020	NON-COMPETING CONTINUATION	$113,305
														Subtotal = $113,305

Issue Date FY: 2019 ( Subtotal = $113,288 )
2019	2019	UNIVERSITEIT STELLENBOSCH	VICTORIA STREET	STELLENBOSCH		7600		ZAF	International Research and Research Training	000	3	4/19/2019	NON-COMPETING CONTINUATION	$113,288
														Subtotal = $113,288

Issue Date FY: 2018 ( Subtotal = $113,395 )
2018	2018	UNIVERSITEIT STELLENBOSCH	VICTORIA STREET	STELLENBOSCH		7600		ZAF	International Research and Research Training	000	2	6/8/2018	NON-COMPETING CONTINUATION	$113,395
														Subtotal = $113,395

Issue Date FY: 2017 ( Subtotal = $112,530 )
2017	2017	UNIVERSITEIT STELLENBOSCH	VICTORIA STREET	STELLENBOSCH		7600		ZAF	International Research and Research Training	000	1	8/17/2017	NEW	$112,530
2017	2017	UNIVERSITEIT STELLENBOSCH	VICTORIA STREET	STELLENBOSCH		7600		ZAF	International Research and Research Training	001	1	8/24/2017	NEW	$0
														Subtotal = $112,530

Grand Total All Awards = $598,857

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The effect of hypertensive disorders in pregnancy and HIV-infection on maternal, birth and infant outcomes in South Africa

Award Number: K43TW010683

ORGANIZATION: FOGARTY INTERNATIONAL CENTER

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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