DESCRIPTION (provided by applicant): In response to the NICHD RFA-HD-16-019, the Division of Maternal Fetal Medicine at Stanford University submits this application for continued participation in the Maternal Fetal Medicine Units Network. This application represents a longstanding collaboration between two institutions - Stanford University Medical Center and Santa Clara Valley Medical Center (SCVMC) - under the stable leadership of Dr. Yasser El-Sayed (Center PI), Dr. Deirdre Lyell (Alternate PI), Cynthia Willson RN (Nurse Coordinator) and Dr. James Byrne (SCVMC Site PI). The Division of Maternal Fetal Medicine (MFM) at Stanford has a long history of completing prospective randomized clinical trials, many accomplished with SCVMC under the umbrella of the Stanford-SCVMC Research Collaboration that was officially founded in 1999 by Dr. El-Sayed. The Division of MFM at Stanford resides in the Lucile Packard Children's Hospital Stanford (LPCHS) which is physically connected in a seamless way to the adult Stanford Hospital by a short hallway. In addition, the Division of MFM and the Division of Neonatal and Developmental Medicine have a long history of close collaboration. In 1997, this relationship culminated in the establishment of The Charles B. and Ann L. Johnson Center for Pregnancy and Newborn Services, a unique, fully integrated clinical service line for Maternal-Fetal Medicine and Obstetrical services as well as Neonatology and Developmental Medicine services. Stanford has been a member of the Neonatal Research Network (NRN) since 1991, and through our joint participation in these Networks, we have contributed to a robust number of clinical protocols. Stanford University is world-renowned for its innovative research endeavors, and contributes unique strengths in imaging, genetics, placental function and analysis, genomics and proteomics, pharmacogenomics, infectious disease, and simulation, thus expanding the productivity and diversity of projects available to the MFMU Network. We share the aims of the MFMU Network to investigate questions in clinical obstetrics, particularly those related to prevention of low birth weight, prematurity, and medical problems of pregnancy, and our goal is to be a center within this network that is recognized for excellence in conducting impeccable research. In summary, we will continue to bring to the MFMU a large, uniquely diverse patient population, a productive, integrated and proven research team with stable leadership and an established history of conducting randomized clinical trials across both sites (Stanford-SCVMC), the Stanford NRN partnership, and access to the exceptional programs and expertise available through Stanford and its collaborators. We are currently the only west coast site in the Network, and look forward to ongoing productive participation.

PUBLIC HEALTH RELEVANCE (provided by applicant): The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal- Fetal Medicine Units (MFMU) Network's mission is to improve public health through the advancement of the care of pregnant women and newborns. This mission is consistent with the decades' long research collaboration between the Divisions of Maternal-Fetal Medicine at Stanford University and Santa Clara Valley Medical Center. Together we have conducted multiple randomized clinical trials with the objectives of improving maternal and obstetric outcomes, and reducing prematurity and low birth weight. Since we joined the MFMU Network in 2011, we have progressively refined and enhanced our longstanding research infrastructure, and continued to generate critical questions that can optimally be answered within this network. A 1 million dollar gift in May 2015 (See letter of support) from a grateful patient for MFM and Stanford MFMU Network research, to Dr. Yasser El-Sayed, the MFMU Stanford PI, will allow us to further enhance these efforts rapidly.