By Matt Windsor | UAB News
For parents, the sound of a child’s cry can generate panic. Alan T.N. Tita, M.D., Ph.D., thinks there are few things more beautiful in his line of work. “Hearing a newborn child cry is wonderful news at birth,” said Tita, senior associate dean for Global and Women’s Health at the Heersink School of Medicine, professor in the UAB Department of Obstetrics and Gynecology, and Mary Heersink Chair for Global Health.
Tita is a sub-specialist in maternal-fetal medicine (obstetrics and gynecology) and one of the country’s leading innovators on the topic. While he was growing up in Cameroon, his mother, Agnes, was a nurse. Her example, her interesting books and exposure to the staff at the local hospital where she worked all steered him to a career in medicine.
During training at the Faculty of Medicine and Biomedical Sciences at the University of Yaoundé I he began to see the reality of the “high rates of maternal and infant mortality in Cameroon” and learned about the huge disparities in these rates between countries. “In Cameroon, women were 100 times more likely to die during childbirth compared to those in Europe and North America,” Tita said.
After medical school, Tita worked for two years at a missionary hospital in rural Cameroon, where he “faced the challenges associated with maternal health firsthand,” he recalled in an interview with the Clinical Research Forum. “When you see so many young women dying from complications of childbirth and illegal abortions, well, those images don’t just go away.”
“Area Where I Could Contribute”
Tita wanted to have an impact on these outcomes, and it was clear “this was an area where I could contribute and hopefully make a difference,” he said. That is exactly what he has done since. In 2022, Tita received one of the highest honors in science and medicine when he was elected to the National Academy of Medicine. That same year, the groundbreaking Chronic Hypertension and Pregnancy study, known as CHAP, (a nationwide collaborative effort led by Tita in association with Gary Cutter, Ph.D., and Jeff Szychowski, Ph.D., at the UAB School of Public Health) was published in the New England Journal of Medicine.
CHAP answered a question that had challenged clinicians for decades: Is it beneficial and safe — for both mothers and their babies — to treat mild chronic hypertension with medications during pregnancy? The answer was yes, with outcomes improved for mothers and babies and no obvious impairments on fetal growth. The same day CHAP was published, national guidelines began to change.
More Than 350 Peer-Reviewed Publications
In 2023, CHAP was selected as the David Sackett Trial of the Year Award winner by the Society for Clinical Trials and the Herb Pardes Clinical Research Excellence Award recipient from the Clinical Research Forum, given to the most impactful study of the year.
Another study published in the New England Journal of Medicine in 2023, led by Tita and UAB neonatologist Waldemar A. Carlo, M.D., Edwin M. Dixon Professor of Pediatrics, showed that azithromycin reduced a composite of maternal sepsis and maternal death.
That study, conducted by the NICHD Global Network for Women and Children’s Health Research with co-funding by the Bill and Melinda Gates Foundation, has also been recognized as one of the top trials of the year by the Clinical Research Forum. Tita has more than 350 peer-reviewed publications, multiple book chapters and Grand Rounds presentations at more than 30 OB/GYN departments in the United States. He has been responsible for over $70 million in research funding.
Tita’s contributions as a researcher and clinician, along with his service to UAB, have earned him recognition as the latest recipient of the 2023-2024 Distinguished Faculty Lecturer Award. This is the highest honor bestowed by UAB’s academic health center on a faculty member who has advanced the frontiers of science and made outstanding contributions to education, research and public service.
“It’s an understatement to say that his research has had a transformative impact on obstetrical care in the U.S. and worldwide,” said Warner Huh, M.D., professor and chair of the UAB Department of OB/GYN. “His research literally changed how all obstetricians practice — very few people in the world can be credited that way.”
Tita, who will deliver his Distinguished Faculty Lecture at the Hill Student Center at 4 p.m. on April 29, says he is honored to have been selected. “I express my profound appreciation to the selection committee and the chair of the Department of Obstetrics and Gynecology, Dr. Warner Huh, who nominated me,” he said.
“This recognition by my UAB peers and community is both humbling and special. I am indebted to many, including faculty and staff colleagues, my mentees and trainees in OBGYN, and other individuals within and outside UAB who have provided a supportive and stimulating work environment.”
Making An Impact Through Clinical Trials
How did he get involved with clinical trials? “This is not what I originally set out to do,” Tita said. “When I saw the high rates of maternal mortality in Cameroon and the huge disparities within countries and between regions, I thought public health training would allow me to run large programs to address these problems.”
“When I met the people, there was no question UAB was the place to be.”
In 1998, he obtained a master’s degree in international public health from the Nuffield Institute of Health at the University of Leeds in the United Kingdom and came to the United States for his residency in OB/GYN.
“To stay active in the health system while applying for OB/GYN residency, I joined the Ph.D. in Public Health program, and settled on epidemiology and statistics” at the School of Public Health at the University of Texas Health Science Center, Tita said.
He went on to complete his residency in OB/GYN at Baylor College of Medicine in Houston. Tita says that, while he was applying for fellowships in maternal-fetal medicine, he did not originally have UAB on his list. “Both the labor and delivery director at Baylor, Dr. Michael Gardner — a UAB maternal-fetal medicine trainee — and the OB/GYN chairman, Dr. Joe Leigh Simpson, advised me to look at UAB,” Tita said. “They knew I wanted to do OB/GYN global health work, and UAB was among the top-ranked OB/GYN departments in the country with a robust global health collaboration in Zambia. When I met the people, there was no question UAB was the place to be.”
Tita began his fellowship at UAB in 2005 and joined the faculty in the Department of OB/GYN in 2008. The next year, he received his first NIH funding award. “I am grateful to Drs. John Hauth, William Andrews and Dwight Rouse for their early mentorship and support that shaped my career path,” Tita said.
The hallmark of what he saw at UAB during his initial visit, and one that remains today, Tita says, is its collaborative environment. “UAB is open and nurturing, and the university wide interdisciplinary centers promote the kind of work that leads to health care innovation,” he said.
Looking Forward
Although the main CHAP trial has concluded, Tita and his fellow investigators have received additional funding from the National Heart, Lung and Blood Institute and the Eunice Kennedy Shriver National Institute for Human Development to follow the women who participated in the trial and the children born to those women, respectively, for up to 10 years after participation. He also leads the coordinating center of the American Heart Association’s Health Equity Research Network to improve maternal and infant health, a partnership with multiple universities including historically Black colleges and universities and community organizations.
“UAB is open and nurturing, and the university wide interdisciplinary centers promote the kind of work that leads to health care innovation.”
Tita and colleagues are working on additional initiatives to reduce maternal and infant mortality and morbidity, which disproportionately affect Black and other underserved populations in the United States. One example is adjunctive treatment for peripartum cardiomyopathy, which “causes a significant proportion of deaths” during childbirth, according to a 2023 paper by Tita and colleagues. The condition is more likely to cause severe consequences in Black women.
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