Clinical and Epidemiologic Research Division

Ellice Lieberman MD, DrPH, Director
Professor, Harvard Medical School

Center Members

  • Ann Celi, MD, MPH (Investigator)
  • Gail Williams, BA (Center Coordinator)
  • Manuel Chinchilla, MA (Programmer Analyst)
  • Amy Zolit, RN (Medical Record Abstractor)
  • Claudia Stearns, BA (Research Assistant)

Mission

The mission of the Center for Clinical and Epidemiologic Research is to perform high quality, innovative research that will increase our understanding of women’s reproductive health outcomes. Optimizing care and outcome for women and their infants during pregnancy and labor is a major goal. The Division also provides training and mentoring in clinical epidemiologic research to residents, fellows and other health care professionals.

Accomplishments

Research

The Center is involved in research projects covering a broad spectrum of important issues in obstetrics and reproductive health. These include the effects of labor management on maternal and neonatal infection outcome and preterm birth and predictors of outcome in in vitro fertilization.

  • Dr. Lieberman is principal investigator of the PACE/LABOR Study, a 4-year, multi-center federally funded randomized trial examining the clinical consequences and physiologic correlates of epidural-related intrapartum fever for mother and neonate.
  • The LABOR Study will assess the neurologic status of infants with and without epidural-related fever. The PACE/LABOR Study has concluded the enrollment and delivery phase, with 799 women completing the protocol and 101 infants, born to LABOR mothers, examined. Dr. Lieberman and collaborators, Drs. Laura Riley, Drucilla Roberts, Lise Johnson and Ann Celi, are reviewing data analysis and preparing publications. A number of follow up studies are planned.
  • Dr. Lieberman was also principal investigator of the FOCUS study, an NIH funded project to elucidate factors contributing to fetal malposition at delivery. This work has demonstrated that fetal head position changes frequently during labor with the final position of the fetal head not determined until very close to delivery and that epidural use appears to contribute to an increase in occiput posterior position of fetus.
  • Dr. Lieberman is actively involved in other projects. She is conducting research on infant outcome following IVF and collaborates with Dr. Patricia Finn and Dr. Ann Celi to investigate the immunologic impacts of labor management practices on the neonatal immune system. In addition, she is collaborating with gynecologic oncology colleagues to study trophoblastic disease.

Research Mentorship

In keeping with our teaching mission, faculty who work in collaboration with the Center serve as research mentors for residents, fellows, medical students and public health students.

  • Whitfield Growdon, MD is conducting a series of evaluations examining predictors of outcome for women with trophoblastic disease in close collaboration with Dr. Ross Berkowitz, Dr. Donald Goldstein, Dr. Beth Garner, Dr. Colleen Feltmate and Dr. Adam Wolfberg.
  • Dr. Wolfberg was lead author on a publication in Obstetrics and Gynecology describing the predictive value of hCG levels on risk of recurrence of gestational trophoblastic neoplasia.
  • Dr. Growdon was lead author on a publication in the Journal of Reproductive Medicine reporting on postevacuation hCG levels and risk of gestational trophoblastic neoplasia among women with partial molar pregnancy.
  • Dr. Feltmate was lead author on a publication in the Journal of Reproductive Medicine describing clinical characteristics of persistent gestational trophoblastic neoplasia after partial hydatidiform molar pregnancy.
  • Cara Osborne, CNM and Elizabeth Greenwell, RN are performing doctoral research under Dr. Lieberman’s supervision. Cara Osborne has performed studies examining the effect of maternal temperature elevation on fetal position among women receiving epidural, evaluating the impact of first birth cesarean on subsequent stillbirth and examined the effects of maternal SSRI use on neonatal outcomes. Cara Osborne successfully defended her thesis in April 2007.
  • Ann Celi, MD, MPH, an Instructor in Medicine and an active member of the PACE/LABOR investigative group, is working on studies related to the effect of labor exposures on maternal and pediatric outcome.
  • Lisa Dunn-Albanese, MD has submitted a manuscript examining the rate of maternal intrapartum fever associated with the use of low dose epidural.

Goal

We plan to continue advancing our research and training agenda.

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