Institute for Environmental Health Solutions
Perinatal Health Division

Dr. Tracy Manuck

“I am excited to launch the perinatal health division within the IEHS to work towards finding tangible solutions that can be brought to our patients to minimize the risks of environmental-associated disease during pregnancy. This is a critical time period for both moms and babies because common pregnancy complications such as preterm birth and pre-eclampsia often result in serious short- and long-term problems. Our multidisciplinary, collaborative efforts through the IEHS will have a positive impact for both families and society.”

About Dr. Manuck
Tracy Manuck, MD, MS, is a professor in the Department of Obstetrics and Gynecology at the University of North Carolina at Chapel Hill in the Division of Maternal-Fetal Medicine where she serves as medical director of the Prematurity Prevention Program. She is a two-time award winner of the National March of Dimes award for the Best Research in Prematurity. Dr. Manuck is nationally and internationally renowned for her work and served on multiple Society for Maternal-Fetal Medicine committees and special task forces and given invited lectures worldwide. She also is the director of the UNC Preterm Birth Biobank Project, a comprehensive clinical and biologic specimen collection effort that has been ongoing since 2015 and is actively enrolling women at highest risk for preterm birth. Dr. Manuck is actively involved in teaching and mentoring and serves as co-Director of Maternal-Fetal Medicine fellow research. Her clinical interests and expertise include preterm labor, cervical insufficiency, and preterm premature rupture of membranes. She specializes in providing care for women at highest risk for preterm birth, including those with multiple previous preterm deliveries and preterm deliveries before fetal viability. Dr. Manuck’s current NIH-funded research collaborations focus on developing biomarker tests to better detect women at highest risk for preterm birth and evaluating maternal and fetal genetics and epigenetics to help predict which women will respond most favorably to medications used to prevent and treat preterm labor. This NIH-funded work is a joint effort with Dr. Fry (IEHS Director) and integrates environmental exposures to optimize outcomes for mothers and babies.

About the Division
This division will focus on identifying solutions that optimize the health of those vulnerable to adverse perinatal health outcomes such as preterm birth, pre-eclampsia, and fetal growth restriction. Nearly half a million babies are born too soon each year in the United States. Preterm birth (delivery before 37 weeks of pregnancy), is a serious health problem and is the leading cause of newborn death. Preterm birth can occur if labor begins too soon (premature labor) or if serious complications arise for mother or baby (pre-eclampsia, fetal growth restriction, others). Babies who survive after an early birth often face lifelong health challenges, including breathing problems, cerebral palsy, intellectual disabilities and others. Even babies born just a few weeks early have higher rates of hospitalization and illness than full-term infants.

Using clinical and biospecimens from our ongoing studies and retrospective databases at UNC, the initial IEHS perinatal section research will focus on investigating specific factors associated with spontaneous preterm birth and pre-eclampsia in women at highest risk for these pregnancy complications. Dr. Manuck and her team plan objective assessments of environmental exposures by assessing the accumulation of toxic metals and other environmental pollutants in maternal biologic samples, evaluating the underlying biology through investigations of resultant changes in gene expression in response to these exposures, and then testing solutions to reduce harmful exposure(s) with the ultimate goal of minimizing disease risk and improving the health of mothers and their babies.

The first major initiative of the perinatal section of the IEHS is the EPOCH (Environment, Perinatal Outcomes, & Child Health) study. Led by Drs. Manuck and Fry and maternal-fetal medicine fellow Dr. Kartik Venkatesh, this study is currently recruiting women during pregnancy who are at high risk for preterm birth or pre-eclampsia. Participants answer questions regarding environmental exposures during pregnancy, provide urine samples and vaginal swabs, and send in a sample of their drinking water from home. After delivery, the investigative team collects a sample of cord blood and the placenta. This study will provide a comprehensive and objective assessment of environmental exposures and correlate these findings with pregnancy outcomes, and lay the foundation for future studies by the IEHS perinatal section.