Dr. Janet Catov: The MOMI Database - Better information leads to better intervention, healthier women, and healthier families
Dr. Janet Catov remembers vividly the moment she realized how powerful the opportunity was to use pregnancy as a conduit to improve a woman’s health decades into the future.
It was one of her earliest studies as an investigator at Magee-Womens Research Institute. She was interviewing women who were 80 years old, and when she asked them about their babies, they recalled their pregnancies in remarkable detail.
How much more detail, she wondered, could she gather if she talked to women at 50? At 30? 20?
“Pregnancy is this really powerful opportunity to connect with women about their own health at a time that they are deeply invested in being as healthy as they can be,” she said. “Women taught me that.”
It was a eureka moment, one of many she has experienced since: leverage this brief moment in time as an opportunity to help women become as healthy as they possibly can be, for as long as they can be.
And the chance to make a significant impact, particularly in her field of epidemiology, was literally at her doorstep: at Magee-Womens Hospital, across the street from the Magee-Womens Research Institute, 10,000 babies are born every year. By collecting as much information about those pregnancies and births as possible, Catov realized she could create a data set that, when studied, could yield answers to some of the most pressing problems in women’s health.
She had a remarkable resource in the Magee Obstetric Maternal & Infant Database & Biobank, which was created by Dr. Steve Caritis in 1995 and is now known as the Steve N. Caritis Magee Obstetric Maternal & Infant Database & Biobank. Affectionately known as MOMI, the database is now one of the largest of its kind worldwide, containing clinical data on more than 200,000 births — literally an entire generation. Today, some of the babies who were born at Magee are now giving birth there, further contributing to the longitudinal data their mothers helped to establish. Data points include birth weight and newborn Apgar scores, ultrasounds, procedures and diagnoses during pregnancy — hundreds of variables. Eventually, doctors hope to identify two or three components with common pathways that can point to such things as risk of premature birth.
Among the issues the database already has helped Catov and other scientists to explore are the link between infant birth weight and the mother’s gestational weight gain; health disparities according to race and social status, and — importantly — heart health.
For years, women were thought to be somewhat protected from heart disease, so their risk was understudied. Today, we know that exactly the opposite is true: heart disease is the number-one killer of women, and that there is some correlation between complications during pregnancy and an elevated risk for cardiovascular disease a decade after giving birth.
Currently, Catov is studying what the placenta can teach about the mother’s long-term vascular health. A temporary but understudied organ, the placenta has the potential to reveal valuable predictors of a woman’s future wellness.
“If we could marry what we know about the placenta with what we know about the clinical features of the pregnancy, we really think that could give us a unique lens into women’s long-term risks of cardiovascular disease,” she explains. “The MOMI database is where all of those data points come together and allow us to answer those kinds of questions.”
Recently, the database has also begun to include biological specimens from the births, something Catov hopes will add further dimension to the rest of the MOMI dataset. Specimens could allow research to look for things such as biomarkers that predict the onset of later health problems that were present at birth. For example, they might help establish early warning signs for future heart disease.
“Many of us now see pregnancy as maybe the first stress test for cardiovascular disease. We know that’s true for gestational diabetes. We know that’s true for pre-eclampsia. Could that also be true for other complications?” she asks.
Ultimately, her hope is that the information will lead not only to earlier diagnosis of risk, but also to more effective interventions that keep women healthy.
“Women touch the healthcare system during pregnancy in a way that they likely will not again until much later in life. So not only is it a biologic stress test, but also it’s a time when women come into the system, to it’s an opportunity,” she says. “Because at the end of the day, what we’re after is really about improving health. That’s the passion behind this, and that’s the target.”
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