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Prenatal monitoring technology has advanced considerably over the last decade. High-resolution sonograms now offer unprecedented clarity, enabling detailed insights into fetal development. Meanwhile, innovations have transformed previously cumbersome and uncomfortable equipment into more portable and user-friendly devices, enhancing accessibility and patient comfort. However, for essential insights into fetal health and development, clinicians still rely primarily on legacy in-clinic systems and techniques, such as cardiotocography (CTG), which possess inherent challenges.

Current Challenges with Legacy Systems

The non-stress test (NST), measuring maternal-fetal heart rate and uterine activity, remains the cornerstone of prenatal monitoring. This has traditionally entailed the use of CTG, requiring frequent visits to the clinic where monitoring is performed using technology that has changed little since it was first introduced in the 1950s.

It is well-known among clinicians that CTG can require frequent adjustments from the clinical staff to ensure the fetal heart rate trace is maintained. Additionally, NSTs create logistical pressures and burdens regarding patient flow and scheduling. Most significantly, the one-to-two weekly NSTs recommended by the American College of Obstetricians and Gynecologists for the last eight weeks of pregnancy can put additional strain on patients financially, professionally, and personally. This can lead to poor patient compliance, resulting in suboptimal pregnancy management and risk of reduced health outcomes.

Meanwhile, as maternity care deserts continue to expand across the U.S., compounded by a chronic shortage of OB-GYNs and midwives, access to pregnancy care continues to become more challenging.

This situation is beginning to change, with the integration of new technologies that have the potential to enhance the accuracy of maternal-fetal monitoring and increase access to quality prenatal care.

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‍Recent Advancements

The advent of telemedicine and remote patient monitoring over the last four decades has seen increased attention given to prenatal care innovation, with a number of companies attempting to make an impact in the space. Some players are leveraging existing technologies (including CTG), relying on the current standard of care, and bringing it into the home. While adding some convenience, such solutions will still suffer from the preexisting requirements and inefficiencies of legacy systems.

Others are looking to employ newer advanced sensing technologies, including electrocardiography (ECG) and electrohysterography (EHG), which can overcome many of the inherent disadvantages associated with CTG. Meanwhile, new concepts of data collection, involving multiple synchronized wearable devices, have emerged to further move the industry forward, enabling providers to scale up monitoring sessions with the same number of clinicians.

Remote pregnancy monitoring thus has the potential to substantially improve the delivery of prenatal care and pregnancy outcomes, by democratizing care and increasing patient compliance.

The Need for Innovation in Cardiac Pregnancy Monitoring

Undetected fetal cardiac abnormalities play a significant role in perinatal outcomes. Moreover, with the maternal mortality crisis, greater attention to maternal cardiac health is also critical to improving outcomes. However, current tools to monitor fetal cardiac function are limited. They can only be performed in-clinic with devices such as echocardiograms and, where applicable, electrocardiography, which must then be interpreted by specialists.

With the general shift to home-based healthcare, there is an obvious need to provide remote access to medical-grade capabilities, enabling expectant mothers to maintain compliance and access essential care beyond the confines of healthcare facilities.

A remote solution based on a combination of technologies, such as non-invasive ECG and phonocardiography (PCG), can provide a detailed analysis of the structure and function of the fetal heart, providing a more complete picture than is currently available. It can also more accurately distinguish between the maternal and fetal heart rates to further improve the management of high-risk pregnancies and enable more timely intervention.

Staying Ahead of the Curve

The wealth of data generated from connected devices can support clinical decision-making and improve efficiency. However, this can also create a new bottleneck, with the same limited number of physicians now being asked to handle a greater workload, with exponentially more data in need of analysis.

Efforts are already underway to develop clinical decision support systems that can enhance efficiency and workflow by automating the review process based on existing guidelines. As technology continues to progress, these systems will leverage machine learning models to further streamline the review process and improve clinical decision-making.

In Steps AI

Already integrated across many healthcare disciplines, artificial intelligence has considerable potential to improve prenatal monitoring. Recently, significant advancements in AI have been made through leveraging foundation models, most notably large language models (LLMs) trained on vast amounts of data. Similar foundation models are now being applied to more diverse types of data, including physiological data such as ECG. Once calibrated to specific datasets, they can be used to perform essential tasks, such as diagnosing and even predicting previously undetectable high-risk cases in pregnancy monitoring.

This approach has the potential to dramatically improve the use of AI in medicine, by transitioning from the current foundation models to a new generation of domain-specific models requiring much smaller datasets. This new era of AI will prioritize the most informative data, enabling more precise and predictive prenatal care.

A Better Future for All

The evolution of prenatal monitoring, from outdated in-clinic systems to advanced remote capabilities, heralds a new era of more accessible and effective patient-centric care. Meanwhile, the introduction of new remote monitoring capabilities, enhanced by next-generation AI models, can address the growing challenges impacting maternity care. Through continued innovation and integration of new technologies, we can look forward to a future of improved outcomes for mothers and babies worldwide.

About Dr. Amit Reches

Dr. Amit Reches is chief technology officer of Nuvo Group, a company that is closing the gap in health disparities and social determinants of health with advanced pregnancy monitoring technology. Amit is an experienced research and development executive in the field of medical devices, with extensive experience leading multidisciplinary R&D teams. Before joining Nuvo Group, he served as VP R&D at Firefly Neuroscience, as the developer of a brain-mapping technology to improve outcomes associated with mental illnesses, and in various roles as an R&D team leader and researcher before that. Amit holds a PhD in Neuroscience from the Technion–Israel Institute of Technology and a BSc in Computer Science from Tel Aviv University.

This article originally appeared in HIT Consultant: https://hitconsultant.net/2024/10/03/prenatal-monitoring-remote-technology-provision-of-care/

Nacogdoches Women's Center has fully integrated Nuvo into their practice and conducts nearly all of their NST's remotely using the INVU by Nuvo platform. This has improved staff efficiency and patient satisfaction, while cost-effectively increasing revenue to their practice.

"The biggest impact I've seen is that we freed up space in the office so that we're able to see patients that have problems or more acute issues." - Dr. Kyle McMorries

Check out the full video here:

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Transcript: 

Dr. Kyle McMorries: Nuvo has had a positive financial impact on our practice in a couple of ways. The main benefit we've seen is by keeping patients at home, keeping patients happy and being able to reach patients who are particularly high-risk in areas that are further away from our office. We've seen upticks in the number of patients that we've been able to attract from those different markets. The biggest impact I've seen is that we freed up space in the office so that we're able to see patients that have problems or more acute issues.

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Dr. Kyle McMorries at the team at Nacodoches Women's Center (NWC) share their thoughts on how Nuvo's remote NST solution is helping their practice and patients. Here are a few quotes:

“We’re able to decrease latency and increase throughput because NST’s are out of the office in a more comfortable place for the patient.” - Dr. Kyle McMorries

“More than anything, Nuvo gives me peace of mind.” - NWC patient using Nuvo

"I can't imagine our practice without using INVU." - Alisa King, BSN, RN, CLC

Check out the full video here:

Transcript:

Dr. McMorries: We started to offer Nuvo to our patients in response to a lot of changes that were occurring geographically. We're in rural East Texas and several of the outlying hospitals that we're offering maternity services have shut down and for a lot of our patients that means they're 45 minutes to an hour and a half from the nearest delivering facility or maternal prenatal care center. 

Patient (Chelsea): I would have had to move to Nacogoches. I had not experienced pregnancy and anxiety ever before, like I just you got the blue lines and you're excited and that was it like you had a baby like you didn't have to worry about anything bad happening. So after we lost her I was very very very worried about him and just constantly worried that something was going to go wrong and so the minute that they did let me have the (Nuvo) monitor it helped so much.

Patient (Felicia): Really more than anything it gives me a piece of mind being a high-risk pregnancy. Kyle had talked to me about how often I would have to monitor the baby and so working full-time, Nuvo was an option where I could use it at work or at home and I wouldn't have to drive. I live an hour away from the clinic so I wouldn't have to drive an hour to be able to monitor the baby as much. 

Nurse (Alisa): It was very very nice for me personally as the nurse that was doing all of the NST’s. It allowed me to monitor eight patients at one time in a one hour period as opposed to having eight patients sprinkled all throughout the day and then that was that was the day and it would take up exam rooms and so for me personally it's been great. It's been good for the provider too because then that's not an exam room that's being used.

Dr. McMorries: The recommendation for Nuvo to other practices is two thumbs up and I would say as an office it's been extremely positive because of decreasing the latency of our rooms we're basically able to increase our throughput because of that (NST’s) being out of the office into a more comfortable place for the patient, so overall it's a very positive experience we very much recommend it. 

Nurse (Alisa): Honestly, I can't say enough positive things about it. We're going on 2 years and I can't imagine our practice without using INVU.

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Nacogdoches Women's Center has fully integrated Nuvo into their practice and conducts nearly all of their NST's remotely using the INVU by Nuvo platform. This has improved staff efficiency and patient satisfaction, while cost-effectively increasing revenue to their practice.

"I have to admit as a labor and delivery nurse I was a little skeptical at first because I thought “how is a patient going to monitor themselves at home”, but I have been shocked and amazed at how amazing it has worked, even better than our NST machine in the office when we have to use it." - Alisa King, OB nurse at Nacogdoches Women's Center.

Check out the full video here: 

We are pleased to share this short testimonial video from Deb Henretta, C-suite level executive and former head of Proctor & Gamble's global baby care business, sharing her perspective on the value Nuvo brings to patients and pregnancy care.

Nuvo gives patients the ability to attend NST appointments from wherever they need to be - at home, at work, or anywhere else. NWC patient, Felicia, shares her experience as a patient using Nuvo:

"My experience with Nuvo has been super easy so it's been very convenient for me to use it at work." - Felicia, NWC patient using Nuvo

"It's a great patient pleaser!" - Dr. Kyle McMorries

Check out the full video here: 

Transcript:

Patient (Felicia): My experience with Nuvo has been super easy so it's been very convenient for me to use it at work. I just shut my office door get it hooked up and then I can you know cover my belly back up and I can sit at my computer and still do all of my paperwork and stuff and even have meetings and things and people never even know that I'm monitoring.

Dr. Kyle McMorries: It's a great patient pleaser! Every patient we have on it loves the fact that they're not having to miss work, they're not having to drive in, they're not having to go through parking, checkin, and all the processes. Overall it's a very positive experience and we very much recommend it.

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OBJECTIVE: Antenatal fetal surveillance is performed in high-risk pregnancies to reduce the risk of stillbirth.¹ Surveillance recommendations require numerous in-clinic appointments for nonstress tests (NSTs).¹ NST attendance is limited by transportation, childcare, and work demands.²

INVU by Nuvo is an United States food and Drug Administration–cleared, remote, self-administered maternal-fetal monitoring approach. In a prospective cohort study, 93.9% of NSTs performed remotely using INVU were clinically acceptable, and >88% were completed without in-clinic evaluation.³

In this study, we explored patient acceptability of remote fetal monitoring using quantitative and qualitative approaches to help clinicians and users understand the experience, while providing actionable insights for optimization.

STUDY DESIGN: This prospective mixed-methods study encompassed survey and qualitative portions. Patients were enrolled in 1 of 2 prospective cohorts that studied the use of INVU to remotely perform clinically indicated NSTs in high-risk pregnancies from October 2020 to March 2023. A device description and the inclusion and exclusion criteria for these cohorts are described in the Supplemental File, and the clinical data have been reported elsewhere.³ These studies were approved by the [University of Pennsylvania] Institutional Review Board.

Survey study: Cohort patients who attempted ≥1 remote NST were eligible for the weekly survey, which included a modified version of the validated Acceptability of Intervention Measure (AIM) (4-item Likert-scale measure) and open-ended questions regarding patient experience.⁴ Descriptive statistics were used, and analyses were performed using Stata, version 15.0 (StataCorp LL, College Station, TX).

Qualitative study: Beginning May 2022, after 2 attempted remote sessions, cohort patients were invited to participate in a semi-structured qualitative interview until thematic saturation was achieved. A Consolidated Framework for Implementation Research influenced interview guide⁵ elicited information on (1) experiences with in-clinic and remote monitoring, (2) barriers to or facilitators of remote monitoring, and (3) suggestions for improvement. For the analysis, an integrated approach was used in NVivo12 with excellent intercoder reliability (the Supplemental File contains detailed information on the qualitative methods).

RESULTS: A total of 56 patients enrolled in the 2 cohort studies (Table 1). Of those, 40 patients (71.4%) completed 105 surveys (median, 2; interquartile range [IQR], 1–4 surveys/person) with a median acceptability of 15 of a possible 20 (IQR, 14–16).

Table 1. Demographic characteristics of participants for each study component, namely the (1) quantitative study and (2) qualitative study

[see link to original article above for table]

When asked to provide feedback about remote monitoring, the most frequently cited issue related to belt connectivity (19/105; 18.1%) or belt fit or comfort (16/105; 15.2%). Patients reported several benefits of remote monitoring, including avoiding in-clinic interactions (53/89; 59.6%), ease and speed of INVU (13/89; 14.6%), avoiding traffic or parking issues (n=6), and decreased costs (n=2). For recommendations for improvement, many reported none (41/89; 46.1%) and others relayed recommendations for improved belt fit or comfort (33/89; 37.1%).

Qualitative: Twelve patients participated in qualitative interviews. Sample interview questions with representative quotes are shown in Table 2.

Table 2. Summary of interview questions in terms of the Consolidated Framework for Implementation Research (CFIR) constructs and representative quotes

[see link to original article above for table]

Previous experiences with in-clinic monitoring: Few participants expressed positive experiences with in-clinic sessions, including a sense of ease or comfort. However, the majority spoke about coordinating childcare and frustrations surrounding travel time, public transportation, work scheduling, and parking with each factor perceived as being financially impactful.

Patient experiences with remote monitoring: The majority reported excitement for at-home monitoring, stating a belief that it would be convenient and less costly. Participants reported feeling relieved of the logistics and expenses of in-clinic monitoring. Concerns with remote monitoring were primarily hypothetical what-ifs. Yet, when probed, the majority reported reassurance about receiving similar monitoring as received in-clinic.

Participants conducted home monitoring in bed or a reclining chair. Generally, at-home sessions lasted for less than 1 hour. Participants also reported that while performing remote monitoring, some worked, whereas others watched TV. Participants reported that household members were either neutral about remote monitoring or provided enthusiastic support. One stated that remote monitoring allowed her spouse to participate, contrasting this with childcare logistics and COVID-19 restrictions.

Barriers and facilitators: Some participants mentioned the need for increased set-up support. One mentioned difficulty with staying still during the experience. For facilitators, in addition to the decreased need for childcare, transportation, and cost, several stated they appreciated clinician communication through the application.

Suggestions for future implementation: A few participants did not have suggestions for improvement, feeling that the experience was straightforward. One brought up fit, expressing body type inclusivity concerns. Other participants felt that remote monitoring may still require additional planning if the home environment includes children.

DISCUSSION: This study demonstrated patient acceptability of remote fetal monitoring using INVU with the use of quantitative and qualitative data to describe concrete barriers and suggestions for improvement. This innovation approach centered the patient, a novel step in academia-industry collaboration, and led to device modifications to improve comfort and signal reliability. These improvements have the potential to maximize the success of our ongoing randomized clinical trial, the Remote Pregnancy Monitoring to Improve Access (REACTIVE) study (https://clinicaltrials.gov/study/NCT05847790), which compares in-clinic and remote monitoring in terms of NST completion and clinical outcomes, focusing on racial and ethnic disparities.

Credit authorship contribution statement

Rebecca F. Hamm: Writing – review & editing, Writing – original draft, Validation, Supervision, Software, Resources, Project administration, Methodology, Investigation, Funding acquisition, Formal analysis, Data curation, Conceptualization. Mary C. Steele: Writing – review & editing, Project administration, Data curation. Caroline O'Brien: Writing – review & editing, Supervision, Software, Resources, Project administration, Methodology, Investigation, Formal analysis, Data curation. Hilena Gebru: Writing – review & editing, Software, Resources, Project administration, Methodology, Investigation, Formal analysis, Data curation. Janelle Purnell: Writing – review & editing, Resources, Project administration, Methodology, Investigation, Data curation. Meaghan McCabe: Writing – review & editing, Supervision, Resources, Project administration, Methodology, Investigation, Funding acquisition, Data curation, Conceptualization. Meghan B. Lane-Fall: Writing – review & editing, Supervision, Methodology, Investigation, Funding acquisition, Conceptualization. Samuel Parry: Writing – review & editing, Supervision, Project administration, Methodology, Investigation, Funding acquisition, Conceptualization. Nadav Schwartz: Writing – review & editing, Supervision, Resources, Project administration, Methodology, Investigation, Funding acquisition, Conceptualization.

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This article was originally published by Forbes here.

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By Eva Epker, Forbes Contributor

“How is it possible that, in the 21^st century, you can’t monitor a baby outside of a hospital?” In 2014, Oren Oz and Laurence Klein asked that very question. At the time, Mr. Oz’s wife was 37 weeks pregnant with the couple’s third child. When she went for her pre-labor and delivery ultrasound, the doctor told her that the baby was in distress and recommended an immediate emergency C-section.

Emergency Cesarean sections (C-sections) – which, despite the name, don’t refer to emergencies exclusively but rather to unplanned C-sections generally – are not unusual. In fact, C-sections, both emergency and elective, are the most common surgeries performed every year in the United States and about 17 births out of every 100 are through emergency C-sections.

However, C-sections do carry risks. About 15% of emergency C-sections have complications, such as infections, lacerations, and bleeding for the mother and neonatal respiratory distress for the baby. The maternal morality rate, the mother’s recovery time, and the costs additionally increase with C-sections compared to vaginal births. A 2022 analysis found that vaginal births in the United States cost an average of $14,768 while C-sections, both emergency and elective, average $26,280. For those with insurance, the out-of-pocket costs are $2,655 and $3,214 respectively.

Nearly ten years ago, Oren Oz and his wife decided not to undergo an emergency C-section Instead, she stayed at the hospital for 24/7 monitoring, gave birth vaginally as planned, and both she and the baby were healthy. But that medical scare - and the anxiety and hospital stay that followed - led to the founding of Nuvo Cares, which has developed a self-administered solution that enables OB clinicians and their patients to conduct medically-necessary fetal monitoring remotely: where it fits into the patients’ lives. “If no one has been able to monitor pregnancy more easily and frequently, [we as a society] don’t have data at scale on pregnancy. It’s a black box,” says Nuvo investor Laurence “Larry” Klein. The mission of Nuvo is to collect this data and to transform pregnancy for the next several generations, and, as Mr. Klein emphasizes, there is “no compromise” on that mission.

Childbirth, after all, is the single most-common cause of hospital admission in the United States and accounts for an estimated four out of every five dollars spent on maternal-newborn health care. And yet, the cost of childbirth is increasing (it jumped 22% from 2017 to 2021 alone), maternal mortality is increasing (doubling over the course of 20 years and most affecting Black, Native Alaskan, and Native American women), and the number of C-sections is rising (increasing from 5.5% in 1970 to the current 32.1%). A 2022 study found that each year of “increasing maternal age [increases] the odds of emergency [C-sections] by 6%” – and the average age of first-time mothers has been increasing steadily: from 21.4 in 1970 to 24.9 in 2000 to 27.3 years old today.

Regular OB/GYN appointments can help mitigate some of these risks. But almost half of all counties in the United States lack practicing OB/GYNs, leaving 8.2% of all women - or more than 10 million women - with little to no access to OB/GYNs and to tools, tests, and technologies such as ultrasounds. During their pregnancy, women will have at least two ultrasounds but will sometimes have more, depending on the risk level of the pregnancy. The ultrasounds confirm the number of embryos, show the baby’s sex, calculate the baby’s due date, and, as the pregnancy progresses, check for any abnormalities, such as in the baby’s heart rate or in its developing brain, limbs, organ, spine, and more.

Even if women do have access to the needed specialists and monitoring tools, they need to be physically in a doctor’s office or hospital to reap the benefits of those services: a privilege not all women can afford. A low-wage or hourly worker, for instance, may not be able to afford time off for OB/GYN appointments, and women generally - and Black and Latina women specifically - are disproportionately likely to be low-wage workers than (white) men are.

In contrast, Nuvo can help “provide care everywhere”: an underlying premise that is simple and yet is simultaneously a major advance in healthcare, according to Dr. Lawrence “Larry” D. Platt MD, who is one of the foremost maternal fetal medicine (MFM) specialists in the United States. Widely acclaimed, accoladed, and published, his affiliations include the Center for Fetal Medicine and Women's Ultrasound, the Department of Obstetrics and Gynecology at the David Geffen School of Medicine at UCLA, and Nuvo’s Advisory Board.

Nuvo’s FDA-cleared INVU™ solution provides that "care everywhere" and allows for non-invasive maternal heart rate, fetal heart rate, and uterine activity monitoring - without requiring a visit to a hospital or doctor’s office. Instead, during their clinician-prescribed timeframes, women can apply INVU™ while they’re at home or even at work, as Dr. Platt notes. The real-time data from these monitoring sessions allows their healthcare providers to assess the condition of the fetus and the urgency for delivery - especially in, though not limited to, women with high-risk conditions for whom American College of Obstetricians and Gynecologists (ACOG) guidelines recommend regular fetal monitoring. These conditions can include medical complications that can lead to abnormal fetal growth, diabetes, stillbirth, and more.

For example, women who have previously had a stillbirth have higher risks of having pregnancy complications and of having another stillbirth – and are, therefore, tested more frequently, require more monitoring and come to the hospital more frequently out of concern – than women who have had a live birth. They are also five times more likely to develop anxiety, more than four times more likely to have post-traumatic stress disorder, and two times more likely to have depression than women who have had a live birth. With INVU™, women can have a monitored session with their healthcare provider in the convenience of their home, office, and daily life rather than having to leave their work, leave their children, and/or generally go out of their way to a hospital. But they still have the benefits of remaining connected to their healthcare provider and having their pregnancy monitored – including tracking fetal movement, which one of the most inexpensive ways to prevent stillbirth – just as they would in that healthcare setting. “In this process [INVU™] alleviates anxiety in that one group of pregnant women, not to mention many others,” Dr. Platt concludes.

That INVU™ uses different sensor technologies (ECG and acoustic sensors) than the ones used in traditional pregnancy monitors in hospitals and doctors’ offices allows it both to be an additional source of data and monitoring to ultrasounds and to provide unique physiological insights into the health of the mother and baby. As long as women are wearing their device, their healthcare providers can interact with and evaluate them at any time or place.

In turn, INVU™ can provide information and achieve milestones that otherwise may not have been possible – much less appreciated by, accepted by, and advantageous for providers and patients – such as those seen in Israel’s Sheba Hospital. Sheba Hospital, also known as Tel HaShomer Hospital, is the largest hospital in Israel, the largest medical center in the Middle East, and one of the top 10 best hospitals in the world. In addition, it cares for more injuries caused by the war than all of Israel’s other hospitals combined.

After the attack on Israel on October 7, 2023, Sheba Hospital moved some of its patients out of the hospital to free up space and resources for those injured during the war. One of the wards it moved was for geriatrics. Another was for high-risk pregnancies: pregnant women who, due to medical complications, diabetes, a previous stillbirth or another reason entirely, were mandated to be in the hospital for continuous monitoring. Sheba Hospital sent those patients home and used INVU™ to monitor them instead: a decision that, as Mr. Klein explains, would have been impossible if Sheba Hospital hadn’t believed that Nuvo could provide medical care equivalent to that of the hospital itself. Now, several months into the war, Mr. Klein calls the operation a “phenomenal success”: groundbreaking both because of the scale of the operation and because the involved pregnant women maintained, or even improved, their health, despite this move from hospital to home. In one case, a mother at Sheba whose doctors thought she would give birth at 34 weeks didn’t give birth until 37 weeks: out of the premature birth range and to the benefit of the baby.

Nuvo’s success in high-risk mothers in Israel, as Mr. Klein observes, is representative of the benefits that Nuvo can provide, even in places that are not war-struck. “I believe that healthcare will change fundamentally when the patient says, ‘I want this,’” he says. Dr. Platt agrees, calling Nuvo “one of those innovations that will change care”. Nuvo’s INVU™ solution can be that care-changing, transformative tool that patients “want”. It can help address the issues of accessibility, cost, inequality, and risk that come with pregnancies without requiring only in-hospital monitoring: the same thesis that inspired the founding of Nuvo nearly ten years ago.

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ATLANTA, GA, USA, December 14, 2023 /EINPresswire.com/ -- In a major stride towards unraveling the complex links between racism and health disparities, Georgia State University has launched a multisite, NIH-funded study titled “Advancing understanding of racism-related health disparities beginning before birth.” Led by Dr. Sierra Carter, the pioneering study will utilize Nuvo’s FDA-cleared remote pregnancy monitoring platform in researching how racism-related stressors experienced by pregnant Black and Latina women impact maternal and fetal health and development.

This multisite study aims to break new ground by examining whether experiences of racism prenatally affect fetal health and development. This will be studied through exploring a process of “biological embedding” of racism measured daily during pregnancy, affecting the health trajectory of not only Black and Latina women but also their offspring. Georgia State University’s collaboration with Nuvo is central to this endeavor. Utilizing Nuvo’s INVU platform, a sophisticated maternal and fetal health monitoring technology, researchers will study maternal and fetal heart rate variability among 400 women in their third trimester of pregnancy. The participants will be assessed once a day for two weeks to gather comprehensive physiological data.

Dr. Carter and her team plan to correlate these heart rate measurements with the health outcomes of the mothers and their babies. The goal is to test the hypothesis that racism, as an enduring stressor, could critically influence the physiological processes of pregnant women and may extend its impact to the next generation through biological pathways.

“By integrating Nuvo’s INVU platform into our research design, we have the unprecedented opportunity to quantify the acute and chronic effects of racism,” Dr. Sierra Carter, Georgia State University principal investigator on the study, explains. “This partnership enhances our ability to measure what was previously intangible—capturing real-time data on how the stress of racial discrimination may be transferred from a mother to her child even before birth.”

Nuvo’s INVU platform, an advanced remote monitoring system, represents a leap forward in fetal and maternal medicine, enabling non-invasive, accurate, and user-friendly data collection. The technology allows for an in-depth analysis of heart rate patterns that may shed light on the health disparities faced by racial and ethnic minorities.

INVU has been used within research projects before, including other principal investigators on the study team, including Dr. Elisabeth Conradt and Dr. Sheila Crowell. Dr. Conradt and Dr. Crowell used INVU in the context of a separate NIH-sponsored trial that investigated the nature of emotion dysregulation within pregnancies. The study sought to understand how prenatal maternal distress is related to children’s health outcomes and used physiological measurements via INVU across more than 200 women in their third trimester of pregnancy to seek biomarkers and patterns.

“We are proud to partner with Georgia State University in this groundbreaking study. The racial disparities in maternal and fetal outcomes are unacceptable,” said Kelly Londy, Nuvo CEO. “Addressing maternal health inequities begins with understanding their origins and we hope this research provides insights on whether racial stressors can have intergenerational effects on mothers’ and babies’ health.”

This comprehensive research initiative, with its blend of rigorous scientific methodology and advanced technology, aspires to move beyond simply documenting disparities. It seeks to elucidate the pathways by which racism-related stress may become biologically ingrained, impacting birth outcomes and potentially predisposing infants to lifelong health challenges.

As Dr. Carter’s team at Georgia State University works closely with Nuvo to navigate this complex research terrain, the implications for public health could be far-reaching. This study holds the promise of informing more culturally sensitive and equitable healthcare practices, fostering early interventions, and ultimately contributing to the eradication of health disparities rooted in racial discrimination.

About Georgia State University
Georgia State University (GSU) is uniquely well-suited to support the GLOW study research. Founded in 1913, Georgia State is a public research university located in Atlanta, Georgia, the capital and largest city in the state, with a metropolitan regional population of more than 5.4 million. Atlanta provides a large and diverse population for conducting behavioral and clinical research. In recognition of GSU’s commitment to research, the State of Georgia has designated it as one of four research universities of the University System of Georgia. GSU is also classified as a Doctoral/Research Extensive University by the Carnegie Foundation for the Advancement of Teaching. GSU is the largest research institution of higher learning in the University System of Georgia. GSU has created a college and graduate school experience in a vibrant urban environment and has been ranked as a top public university for researchers.The Department of Psychology at Georgia State University also offers a rich environment for the GLOW research to thrive and for Dr. Carter and her team to engage in translational research work in multiple settings and systems.

About Nuvo
Nuvo is committed to reinventing pregnancy care for the 21st century through new technology, tools, and practices for providers and expectant mothers, including the INVU by Nuvo™ platform, an FDA-cleared, prescription initiated remote pregnancy monitoring and management system. The INVU™ sensor band enables the delivery of remote non-stress tests and maternal & fetal heart rate monitoring today while pioneering new data-driven personalized pathways that Nuvo believes will help improve health outcomes for all women in the future. The technology and patent estate that underpin the INVU platform have been awarded a variety of industry recognitions, including Fast Company's Next Big Things in Tech (2021), CB Insights' Digital Health 150 (2020, 2022), and MedTech Innovator's Top 50 MedTech Startups (2021), as well as multiple grants from some of the world's leading academic medical centers and scientific bodies. Nuvo is led by a diverse team of experienced business and medical professionals, dedicated data engineers, software designers and proud parents who embrace a collective mission to give every life a better beginning. For more information and complete indications, contraindications, warnings and precautions along with instructions for use, visit: www.nuvocares.com.

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