Mother-infant tandem care may improve health outcomes

Seuli Brill, MD, associate professor of Internal Medicine at The Ohio State University College of Medicine, provides care for patients as they navigate important milestones and challenges throughout their lives. As a primary care physician, board certified in both internal medicine and pediatrics, a nationally recognized researcher and educator, her roles combine service and scholarship. And those roles share the same goal – to ensure the health care system addresses complex maternal-infant health needs, including pregnancy and birth, through effective and innovative primary care.

In 2018, Dr. Brill developed a novel mother-infant program called the Multimodal Maternal Infant Perinatal Outpatient Delivery System (MOMI PODS). The goal was to provide tandem pediatric care for newborns and primary care for mothers after they developed gestational diabetes. Within a few years, Dr. Brill worked to expand the program’s reach by targeting women at risk for poor postpartum outcomes, including those with a history of mental health conditions, preterm birth, diabetes, high blood pressure and other chronic conditions. The MOMI PODS team grew to work closely with community and multidisciplinary partners around central Ohio to deliver seamless, holistic care to its patients.  

“We have the built program and the research partnerships and community infrastructure and have made strides in increasing postpartum access by integrating care into pediatric structures,” Dr. Brill says. “At Ohio State, obstetricians and gynecologists can refer their patients to the MOMI PODS program, which now has 51 doctors trained to provide primary maternal and pediatric care.”

In addition, soon-to-be moms can be referred to the program as early as the second trimester. Effective interventions such as these are a team effort and include research and organizational partnerships working to prevent death and disease, especially in populations experiencing health disparities and health inequity.

To expand this work, Dr. Brill and Shannon Gillespie, PhD, RN, a clinical and translational maternal-infant immunobiologist at the Ohio State College of Nursing, have designed a randomized controlled trial to determine if and how specific elements of postpartum care affect maternal-infant outcomes across the postpartum year. The team just received a $3.8 million grant from the National Institutes of Health, allowing them to launch their innovative study, “The mom and infant outcomes study: A trial of perinatal outpatient delivery systems (The MOMI Study),” among approximately 400 mother-infant pairs.

Dr. Gillespie’s group will collect and analyze detailed self-report, biological and clinical data, allowing them to isolate high-impact targets for maternal-infant health promotion throughout the postpartum year.

“This data will allow us to better understand and optimize current suites of services. It may also shed new light on the complex interplay between models of health care and unique maternal-infant needs,” Dr. Gillespie says.

Dr. Brill says her research has taught her the importance of communicating clearly and completely with patients so they build ownership of their health conditions and understand them. It also helps them navigate treatment in an often-complicated health care system.

“Healthy kids need healthy parents,” Dr. Brill says. “What we are doing is creating evidence that shows which interventions work, and this trial will also inform the development of the most effective processes to deliver them.”