Ann Bruno, MD, MSCI
Assistant Professor
Obstetrics & Gynecology
Profile
The Utah CTSI had the privilege of talking to Ann Bruno, a Translational Innovation Pilot (TIP) program awardee. We thank her for taking the time to answer our questions about her research dealing with reducing the risk of postpartum venous thromboembolism.
What is your research area?
My broad research focus is reduction of maternal morbidity and mortality through generation of data and development of evidence-based care practices that will reduce the risk of postpartum venous thromboembolism.
What makes it relevant?
Obstetric thromboembolism contributes to nearly one in 10 maternal deaths in the United States. As a leading cause of maternal morbidity and mortality, prevention of obstetric thromboembolism is a prime target for preventative interventions. The highest risk time period for thromboembolism is in the first two weeks following delivery. Therefore, national guidelines recommend risk stratification of postpartum individuals to consider mechanical prophylaxis (with squeeze boots on the calf) and pharmacologic prophylaxis in those considered at risk for thromboembolism. For those that may be recommended to receive pharmacologic prophylaxis, the only recommended agent is an injectable blood thinner. Alternative oral medications for thinning of the blood are not well studied in breastfeeding, and therefore guidelines recommend against use until further data are generated. Therefore, we aimed to evaluate the excretion of prophylactic-dose rivaroxaban (a direct oral anticoagulant) into human milk in postpartum lactating individuals.
How does it help the world?
We hope our research will increase knowledge on the excretion of rivaroxaban into human milk across a range of lactational periods and support the development of processes and infrastructure to facilitate future human milk studies at the University of Utah.
How has the CTSI helped you?
The University of Utah CTSI has supported our research through grant funding from the Translational Innovation Pilot (TIP) program. These funds are supporting our single-center pilot study evaluating pharmacokinetics and safety of rivaroxaban excretion into human milk. Beyond this study alone, the funds and study will help build on the infrastructure and resources to support human milk research at the University of Utah. This is important because the lack of research on medication excretion into human milk propagates non-evidence-based care and recommendations. We hope this study, and other future studies, will generate additional evidence around rivaroxaban, and other medications used during lactation.