WHOOP Podcast - Groundbreaking New Research: How HRV Could Predict Preterm Births with Emily Capodilupo and Dr. Patrick Carroll

Episode Date: November 9, 2022

In this episode, we discuss groundbreaking research around pregnancy that could pave the way in improving the lives and health outcomes of premature infants worldwide New research from WHOOP has uncovered a first-of-its-kind digital biomarker that can be a potential indicator of preterm delivery, all by using HRV patterns. VP of Data Science and Research Emily Capodilupo joins the show to discuss what we found in our pregnancy data (3:55), how she looked at her own data as a pregnant member (5:25), a pregnancy study conducted at West Virginia University by Dr. Shon Rowan (7:16), the HRV inflection point (9:19), how Dr. Rowan used WHOOP in his study (10:26), how WHOOP conducted a pregnancy research study with members (11:43), what you can learn from the inflection point (13:35), the impact of preterm births (16:25), the options and preventative measures regarding preterm births (18:10), and how we will incorporate this research into the WHOOP app (20:36). WHOOP Chief Medical Officer Dr. Patrick Carroll joins the show to talk about how wearables are impacting health care (27:52), providing WHOOP data to your medical provider (30:29), the power of non-invasive studies (32:52), the exclusion criteria for the study (34:00), and the overall impact on the medical field (34:49).Resources:The Locker: Understanding Every Stage of PregnancyDr. Shon Rowan's Research Study from WVUSupport the showFollow WHOOP: www.whoop.com Trial WHOOP for Free Instagram TikTok YouTube X Facebook LinkedIn Follow Will Ahmed: Instagram X LinkedIn Follow Kristen Holmes: Instagram LinkedIn Follow Emily Capodilupo: LinkedIn

this week we've got one of our most exciting episodes ever as many of you have heard me talk about research is core to everything that we do at whoop and with that in mind we are revealing some incredible new research around pregnancy we've identified heart rate variability and resting heart rate trends over the course of pregnancy that can potentially see whether a woman is going to deliver on her given due date or potentially deliver prematurely. And that's a really big deal. This is a novel finding. And to share more about this pivotal work, I'm joined by Emily Capitlupo, our senior

vice president of data science and research, and our chief medical officer, Dr. Pat Carroll. We're going to dive into how women have been historically underrepresented in performance research, the power of wearables and non-invasive data collage. The importance of HRV during pregnancy, and literally the findings from our 1,200-plus pregnant member study, including how HRV and resting heart rate can be a sign of preterm delivery. That's right. We see a profound inflection seven weeks before delivery. This is fascinating.

First finding of its kind, and we go deep on it. We also discuss how this research can help mothers, babies, and the medical community at large. So how can you make it actionable and how the research and performance industries can better serve women. Very excited about this podcast and we get into it in a second. But first, I'm excited to share a couple of big announcements. We recently released our new blue light glasses. That's right. Many of you heard me rave about blue light blockers before on this podcast or on other podcasts

and the way they improve my own sleep. I just didn't like the design of the products out there. And so we went on a deep research investigation to create our own blue light blocking glasses. Many of you will know that blue light inhibits your sleep and therefore if you can wear these glasses, you in fact will offset the negative effects of a cell phone or an iPad or a television set.

I personally saw a huge improvement. in my own REM and slow wave sleep from wearing blue light blocking glasses. We then did a ton of research on our own glasses, and we can now show that they literally increase recovery, increased sleep, and increase HRV. I wear the REME evenings about an hour before bed, so check those out. Separately, we also recently announced a groundbreaking partnership with Tier, that is TYR, the world's leader in swimwear innovation. We collaborated to create the first ever, smart swimsuit. These suits pair tiers famed performance first fit and fabrics with Whoop 4.0 Anywhere technology, allowing you to move your whoop from your wrist to your swimsuit.

The suits have been rigorously tested to ensure comfort and data accuracy, so you can maximize your output and minimize your drag in the water. So that's both blue light glasses and the tier whoop swimsuits. Both can be found at Whoop.com. go to our accessories and apparel page. All right. Here we go. I'm joined by Emily Capulupo and shortly thereafter, Dr. Pat Carroll. Okay, Emily, this might be the most exciting podcast we've ever done together

because you truly have unlocked revolutionary research. I think I can call it that. I haven't been as excited about research that we've conducted at WOOP pretty much ever. And why don't you start by sharing. the headline of what you've discovered. Thanks, Will. Yeah, I'm really excited about this podcast. So what we found is that nighttime heart rate variability in pregnant people in their third

trimester looks different for women who go on to have preterm births. So deliver before 37 weeks of gestation than it does for people who go on to have full term births. So make it 37 to 42 weeks. And explicitly, what does that mean? It means... So what that means is that before somebody goes into labor, weeks before even, we have an indication about whether or not they're going to have a premature baby, which is going to potentially

need access to very different and more intensive medical support, or if they're going to have a full-term baby, though kind of the typical experience. And if you know in advance that you're going to have a premature baby, there's a lot of things that you can do that are going to make a big difference in the outcome of that baby's health. So we'll get to that in a second. This is amazing research that's been accepted for peer review. And on top of all that, you're pregnant. Like, how fitting is it that you're pregnant when you make this discovery? It's definitely been fun to work on. Have you been looking at your data very closely as a consequence? Yeah. And, you know, while I like to think that we're curious and good

researchers all the time. I think being pregnant, and when we started this, going through the process of trying to get pregnant, made us, you know, kind of clue into things that we might have been dismissive of otherwise. And so we were just really deep into the data, curious about what we were looking at. And what was so fun is, so this whole project started back in March, and I got pregnant in April. And, you know, we were trying to figure out at that time, is this something? Is this, you know, just a fluke or just kind of looking cool and, you know, is this real? And so I'd been pouring over this data for a couple weeks and all of a sudden I'm seeing that show up in my own loop data. And I remember going to my husband and I was just like, John, I'm pretty sure

I'm pregnant. And, you know, he was like, yeah, maybe, like I don't want to get your hopes up, you know, whatever. It's kind of a stressful process sometimes. And it was like four days before we could take a pregnancy test. And every day it was like, no, it's like perfectly following this pattern. And, you know, lo and behold, positive pregnancy test a couple of days later. But I think, like, gave us a lot of conviction that there is something real here and led to us, like, really digging into this. And then the comfort that it gave me, you know, knowing what normal pregnancy looks like as I was going through. Because your body's doing, like, the weirdest stuff. And so seeing, like, oh, this is actually normal.

You know, we were looking at 1,200 pregnancies on loop and seeing, you know, my data do exactly what, like, that median. of those 1,200 pregnancies was doing. I think just, like, made the whole process, like, a little bit less scary and foreign because it's our first baby, first time I've ever been pregnant. So let's go back for a second. How exactly did we, I don't want to say stumble upon this breakthrough, but it's certainly like, it wasn't like you and I hatched a plan to figure out how we can detect preterm pregnancies.

So it starts, I understand, with research out of West Virginia. Yeah. And, you know, in some ways, stumbles is not an entirely unfair thing, but it was intelligent stumbling. And a couple of years ago, Dr. Sean Rowan from West Virginia University approached us about doing a study looking at exercise in pregnancy. And so he followed 18 women from preconception through postpartum. So these were women trying to get pregnant. And before they got pregnant, he put them on whoop. He followed them through, obviously it takes different people, different amounts of time to get pregnant.

So some cases week, some cases months until they got pregnant, then throughout the whole, you know, 40-week, nine-month pregnancy process, and then into the couple months postpartum, so after delivering their baby. And the initial point of his study was to understand how differences in exercise affected vital signs in which he did explore. But one of the more interesting things that he found is sort of an incidental finding of this study is what do vital signs look like throughout pregnancy. So one thing that people don't realize about pregnancy is even really, really basic things haven't been explored yet. And so him even just looking at like what does heart rate and heart rate variability do over the course of a pregnancy was never before reported on. And so what he found in these 18 women is that throughout pregnancy, heart rate and heart rate variability consistently decline from the very beginning all the way through about 33 women. weeks. And then all of a sudden, 33 weeks into pregnancy, what he observed was that your vital signs spontaneously start to improve. And they continue to improve right up until delivery. And then

not super surprising, they improve a whole bunch after the baby's out because your body's not doing this incredibly hard work of building a human anymore. And so all of a sudden you see this massive recovery. In his study, all 18 women delivered full term. So let me pause there. So what started as an exercise study in pregnant women turns into, okay, actually, if we just look at heart rates and heart rate variability of pregnant women. Right. What happens? What happens? Yeah. And it turns out for 18 normal pregnancies, you see resting heart rate increased steadily up until the 33rd week. And then there's this sharp inflection and it starts to decline leading up to delivery. And then the inverse is true for heart rate variability, where your heart rate variability is very high, and then it declines

over the course of your pregnancy. You get to the 33rd week, boom, inflection, heart rate variability starts increasing leading up to giving birth, and then afterwards you've given birth, it also increases. Yeah, and it's sort of, you get this instantaneous, almost step change, and then stable. So throughout pregnancy, you see this, like, you know, it's climbing, then it falls in those last couple weeks, and then postpartum, you start to see a return to your pre-pregncy. And folks listening to this, like, I've now seen a lot of these graphs. It is a sharp V. Like when we say inflection, we're talking a profound change week over week for what your data looks like.

And just to be explicitly clear, how did Dr. Rowan collect all this information? So he collected this data using whoop straps. Okay. So that was the connection point because he used the data. He found all the data on whoop as well. Right. So this was all whoop data. So he was using whoop. They gave it to them before they got pregnant, watched the whole process of trying to conceive all through pregnancy and postpartum. So they wore whoop for over a year. And then he used the nighttime heart rate, heart rate variability data to create these graphs. Got it. Now, you learn of this research finding. Yeah. So we knew about the study because we'd been supporting it, you know, making sure that he had access to all of the data. You know, we sold him the straps to do the study. And so he'd kept us in the loop the whole way through. The paper's also now in peer review.

We'll link it in the show notes so you can see his study in addition to ours. But one of the things that was important about his study and importantly different from what we went on to do is that all of the 18 women delivered full term. And so when he saw this inflection point at that 33rd week, he interpreted it based on the data that he had that at 33 weeks gestation, vital science. inflect. And based on the data that he saw in full-term women, that was true. What we were able to do, and this is really the power of wearables and why I have so much gratitude for all of our members who participate in our research is back in March, we sent out a survey and we asked our members on WOOP if they were pregnant or if they had delivered a baby in the last year. And we identified 1,200 pregnancies. And we used those to understand on a much larger,

and two orders of magnitude larger than what Dr. Rowan had, what does a normal pregnancy look like? And so the first thing that was really... Well, let me just pause there again. I mean, that's an amazing moment for us. And I think it makes me proud in helping to build this company is the fact that it took three years to recruit 18 women. And we see an insight potentially from it. And then you're able to survey the WOOP member base, ask if they want to participate in research. and in just a week's time, get 1,200 women to participate. And all of a sudden, we have a data set of 1,200, which is quite a robust data set. And to my knowledge, the largest data set of its kind as it relates to pregnancy.

Yeah, and I think, you know, that's one of the things that's so much fun about doing research at WOOP, that we're able to do things at a pace and scale that's just totally not feasible in traditional academic routes. And so, you know, we were able to, before his paper was even public, you know, first of all, validate it on this much larger scale and then kind of go beyond it. And, you know, his paper is still in peer review, right? Like, this is just a speed that does not happen in academia because normally, you know, you spend another three years trying to get the larger data set. So walk through the learnings from the data set of 1,200.

So in our data set, we were able to see this more nationally representative distribution of pregnancy outcomes. So nationally in the U.S., about 10% of pregnancies are preterm, and our data was similar to that. We had a little bit lower, but our population is also a little bit healthier healthier. And just to be explicit, preterm means delivery before 37 weeks gestational age. So a premature delivery. A premature delivery, right? So about 8.4% of our data set was premature deliveries. So we were able to ask a question that the West Virginia study, wasn't able to because they only had one outcome, which was obviously the preferred outcome, right, full-term birth. So we were able to ask, is this inflection point that they had attributed

to the 33rd week of gestation, in fact, a marker of being 33 weeks into a process, right, something related to how a baby's growing at that stage? Or is it something related to being seven weeks away from the end of a process, right? Is this a counting forward thing, or counting backwards thing. So when all of your pregnancies are ending at 40 weeks, that's the same thing. When all of a sudden your pregnancies are ending somewhere between 32 and 42 weeks, you can separate those out. And so what we were able to see was that this inflection point actually has nothing to do with being 33 weeks, although that's the most common place to see it, and everything to do with being seven weeks away from delivery.

And that's really exciting because everybody knows that they're 33 weeks in, or 32, or wherever you are. But most people don't know until they're in labor, you know, what the gestational age or how far into pregnancy they're actually going to deliver. Yeah, I mean, it's amazing. You're saying essentially that looking at heart rate variability over the course of a pregnancy could help predict within seven weeks out when someone's going to give birth. It can give you a heads up, yeah. Let's play this out for a second. Your inflection on heart rate variability would be steadily declining if you're a normal pregnancy leading up to the 33rd week, at which point you'd start seeing the increase, that inflection, right, where your heart rate

variability is going up. And that inflection at the 33rd week would signal, okay, you're going to give birth at the 40th week. You're on pace for a normal pregnancy. If you started to see that inflection at the 29th week where all of a sudden your heart rate variability is no longer declining, it was increasing, and the inflection happened to you. four weeks earlier. Whoop can now help you understand you're very likely to give birth four weeks early. That's what the data seems to suggest. Which is pretty amazing. I mean, how big of a problem is premature delivery in the United States, let's just say? So almost 10% of pregnancies result in premature birth. So this is not a rare edge case by any means. And what that means in terms of

the health outcomes of the baby have a lot to do with how premature you are. So babies born, you know, 36 weeks are often, you know, look every bit the same as a full-term baby. One thing that's also a little bit complicated with this is it's not a perfect science for figuring out the gestational age of a baby. And so you might think you're at 36 weeks and actually be at 37 and vice versa. But, you know, typically we see the babies that are born earlier tend to have more complications because they're not fully done baking. So a lot of systems aren't fully developed. And specifically, our lungs are one of the last systems to develop, mostly because we don't need them.

You know, our heart starts beating at somewhere around five weeks and, you know, is actually critical to keeping us, you know, the fetus alive throughout all of pregnancy. But you're getting all the oxygen from the placenta, so from the mother. So your lungs aren't actually doing anything. There's no air in there. So we kind of, you know, we build them last. And so premature babies are disproportionately. have underdeveloped lungs. And so that's one of the main reasons why they tend to end up in the NICU and the neonatal intensive care unit where they end up on respiratory therapy. And the ones that are significantly premature often have complications throughout their entire

lives. It's not just those first couple weeks that they're spending in the NICU. And if a woman is able to then identify Emily that she's going to give birth in seven weeks, and frankly, that's three or four weeks earlier than expected. What can then happen? Yeah. So I think an important thing to mention is that there's very little you can do almost nothing really to make that baby not premature. The science isn't there yet. You can't stop that process. But that doesn't mean that you can't do things that are extremely valuable. So like I mentioned, the lungs are one of the last systems to develop. And there's a

tremendous amount of research around giving the mother antinatal cortical steroids that actually accelerate lung development. So before the baby comes out, you start kind of basically accelerating their lung development so that they can get, you know, an extra couple weeks worth of growth in a few days. And so when they come out, even though they're premature, their lungs are further along. And so doing that can reduce NICU time and reduce lifetime complications related to being premature. And just that ability to get those steroids, which are very low risk to the mother and baby and extremely inexpensive to deliver, changes the lifetime health trajectory and therefore like life expectancy for these babies. You know, just listening to this is part of what gets me so

excited about health monitoring for health care in general, like the notion that you can identify something early, and then there's something inexpensive or preventative that an individual can take or do, that all of a sudden then puts them on a very different health path or health outcome path. I mean, that's really profound, right? And it's going to improve people's lives, and it's going to dramatically reduce costs. Yeah, and I think that's one of the things that gets me really excited about Oop and why I love my job so much, because these preventative things and these early things are often so much

easier on your body, so much cheaper on the system, just so much better for everyone involved than like treating problems after they crop up. But we don't really get screened for these things. Like there are actually tests that exist that can tell you if you're going to be premature. They work about a week to two weeks out and with pretty decent performance can tell you if you're going to have a premature baby. But they're not routinely administered. They're pretty much limited to women who have had a prior premature baby or for whatever reason are identified as high risk. And so women in their first pregnancies, so they don't have any medical history that would be relevant, don't get these tests, even if they're getting, you know, all of the

recommended prenatal care, let alone all of the women in maternal care deserts who don't have access to regular obstetric care throughout their pregnancies who would never be screened for these things. Well, I think it's so amazing. And the promise I have to our members is that we're now building this research directly into the WOOP app. So much of the way we did a lot of research on respiratory rate and COVID-19, we added features around it. Okay, we've now got a new research breakthrough. It's understanding heart rate variability over the course of pregnancy, resting heart rate

over the course of pregnancy, and using those statistics to help you understand if you're having a normal pregnancy or if you may be on a path to deliver early. And within the WUP app, Emily, as you and I have observed, we now have a feature that will allow a pregnant woman to see how her arresting heart rate is increasing over the course of a pregnancy and following what we would deem to be a typical increase for her baseline. We also have a graph around heart rate variability that is declining over the course of her pregnancy and we're able to demonstrate what is the typical range for that. decline. And we're also building out the whoop inflection point, which is going to signal that moment when your heart rate variability starts increasing again and your resting heart rate starts decreasing hand, which, by the way, correlates with like a fitness gain. So in some ways, this whole thing makes sense, right? Your body's getting fit as it's about to undertake an enormous, enormously intense

moment. And it can signal for you whether or not your pregnancy is following a typical pregnancy or whether you may be on path to be delivering early. And that's a seven-week head start for your due date. What did I miss in the feature? What else has got you excited about it? Well, I think for me the thing that you're actually a full-blown user of the feature now, which is really on brand. The first user of the feature, which has been super fun for me. And I think working with our product team, what's been so fun about this is I've been using this data to stay sane and calm throughout my pregnancy. And so a lot of what went into the initial designs. And of course, then we workshopped it with other pregnant people as well. But a lot of what went into the original

thought behind it is your body is changing in ways that in other contexts could be concerning, right? Seeing your resting heart rate climb like 10 beats over the course of three months, like might feel like a cause for alarm. And so for me, seeing that that's actually just what happens with pregnancy allowed me to kind of stay calm through it and be like, oh, that's actually, you know, my body's working really hard. I'm growing new organs. I'm growing a human. That's what this looks like, not, oh, I'm getting sick or, you know, what's going on here.

And so what we're really hoping to deliver through this feature is really a lot of peace of mind, right? Like, I think there's a lot of power in numbers and power and community and power and knowing that like when everything feels funky and your body's doing all these strange things and shout out to all the first time moms in particular, because I think it is really wonky, but to just be able to kind of see that this is normal or this is expected in some ways, I think, is really missing because, like we said, right, Dr. Rowan was the first person to ever show, and the paper's still in review, right, that the vital signs change in this way. So you can't Google this, right?

Your doctor's not going to tell you this. And so all these people on wearables are, like, seeing their data and wondering what's going on. And so to be able to put context around that and build a feature and community and product that sort of helps you understand what's going on in this really, really critical life phase, I think is really going to change, you know, the way people, like, interact with their data during pregnancy. And part of what I find exciting just from the product experience is if you're a pregnant woman and you are seeing all these red recoveries on whoop and you're seeing your, you know, your baselines changing dramatically without knowing why. that actually could be a little alarming, whereas on the flip side now, we're able to show you that

these things are changing, but they're changing in a normal or a typical way. And I think that's so valuable. And to your point, it must offer a meaningful peace of mind. The other thing I'll add, which I think is a cute plug for the community features, is we now have the ability for pregnant women to join teams with other women who are giving birth around the same due date. Yeah, the same month. So that's, I think, a clever innovation on our team's functionality, and we've seen really powerful engagement amongst those teams, women really coming together to talk about what their bodies were experiencing at various trimesters. And look, I think you have a commitment from me that we're going to continue to invest in this category of women's health and particularly

pregnancy. Yeah. And, you know, I so appreciate that. And I think it's so important because traditional academic research really has ignored pregnancy. And there's so many open questions. And so it's exciting to be in a position, not just to have your support, which I'm so grateful for, but also just to have the data in this incredible research engine that WOOP has created that can allow us to answer questions that wouldn't be possible to answer. This isn't the kind of finding that was possible with an 18-person study. And that was Virginia study. expensive and it took three years, right? You kind of see why we're the ones figuring this stuff out because the infrastructure that's existed for hundreds of years or whatever to do research

just can't really support stuff like this. And so it takes a new approach to research that wearables can provide to find these types of things. Yeah, big shout out to our WOOP community and the 1,200 women who participated in this study. I mean, it's worth acknowledging this is completely de-identified, it's anonymized, the data is entirely secure. These are women who opted into sharing their data, their health data over the course of their pregnancy for research purposes, and look at the result. Like now we have this massive research breakthrough, and we've got functionality in the WOOP app that's going to help women identify whether they're having a typical pregnancy or whether they're delivering early. So I think it's groundbreaking. I'm so excited about it.

I'm really, I admire the work that you do here, Emily, day and day out. So I'm excited to see where we take this. Thanks, well. Okay, big thank you there to Emily. And I'm now about to be joined by Dr. Pat Carroll, our chief medical officer, to talk more about this research. Okay, Dr. Pat, this is exciting, officially welcoming you to the WOOP podcast. Yeah, great to be here.

So you've hit the ground running at Woop. You've been here for, I think, a little bit over a month now. And I know so much of what got us excited about working together is the potential for wearable technology. Now, I didn't know when you'd be joining the company that we'd immediately have a research breakthrough, frankly, around pregnancy. So we've just had Emily on the podcast. We just talked about all that research and what we're excited about. I wanted to get your perspective. Like, what do you think of our ability to use heart rate variability as something that can help women really understand their due date and also in their bodies over the course of

pregnancy. Yeah, you know, even backing up a bit, wearables are a tremendous opportunity to bring in data, information to really make an impact in health care. And this is just one very interesting, I think very significant offshoot of that. What we found with heart rate variability, looking at a large cohort of women who wear who werewooped during pregnancy, there is definitely an inflection point in most cases, not all, but in most cases around heart rate variability. So what we've discovered in this study is that seven weeks prior to delivery, there's a trough, a low point on heart rate variability, which then climbs up

over the next seven weeks in a fairly accurate predictor in most cases of when you're going to deliver. The significance of that is that if that trough occurs, let's say, at 24 weeks, 23 weeks, it's an indicator that you may be at risk to have a preterm delivery at the seven weeks on at 30, 31, 32 weeks. So what we look at it as, it's a screener that can actually lead to some interventions and actions, alerting your OB, that you may be at risk, perhaps even getting some studies to further confirm that you're at risk for preterm labor, that's something called a fetoprotein or a cervical lengthening score. And that actually informs your provider that you need to be classified and put into a category of a higher risk patient. And so the resources

are then gathered to both screen further, but also to have facilities and monitoring in place if you are going to go into preterm labor. Fascinating. I mean, I didn't really know all that much, frankly, about pregnancy and pregnancy research before this discovery and before talking to our team about it. But it's an amazingly underrepresented area of research. First of all, women's health is underrepresented. And then if you think about pregnancy within that, they're just has not been that much data on it. So it's actually not that surprising that when you take a huge cohort of data, you learn some fascinating things. If a WOOP member is looking at their data and following some of the trends that we're now going to be showing in the WOOP app,

what would you recommend is the best way for a WOOP member to use that data? So we don't want to operate in a silo. We want to bring in, obviously, that members provider and inform them. So the first step that we're doing is we're actually going to provide off of our site literally a PDF for providers and saying this is what heart rate variability is. This is what it means. So really kind of a cheat sheet. Yeah, heart rate variability 101. Sure. And so they are aware of the significance of heart rate variability and some of the implication. So that's the first step. The next step is once we start seeing that pattern of an early trough or inflection point, if that does occur, to again bring the provider in and say,

you know what heart rate variability, here's what our study shows. We're doing further studies on it, but it's just a indicator that we may want to look into for your patient, the risk for preterm labor a little bit deeper. So it is a really interesting, informative, and valuable point of information, data point for providers and for the patients. We don't want either the patient or the provider to get overly concerned, but we want to use this as kind of one of those alert points to kind of, let's look a little carefully what's going on here. And what's exciting about it too is we've actually talked to several OBs.

One of the, Dr. Sean Rohn was part of this initial study, and then we have a large group we're working with who's going to do a further study, and the obstetrician chief medical officer of that group has looked at the data. She's very excited about it. Both Dr. Ron and this physician who leads this group is going to really help us to message to both our members, but also to providers, about the implication of this HRV inflection point. So we're going to be informative. We're going to give good information. It's going to be responsible information. And we're going to make an impact, I really believe in terms of alerting folks about risk for preterm labor and the individual. Yeah, I think it's such important research. And the important thing, too, is sharing these

resources that you just outlined. So if you're a Woot member listening to this, you want to better understand the research, or you even feel like you need to bring that research to your doctor, we're going to have those materials for you to be able to provide all of that data. This is going to be a published study. So it's going to be out there in academic literature. and we're excited about that. One of the areas that enthused me the most about it, this is a non-invasive study, right? It's a wearable. I think that's the issue in terms of the dearth of research in pregnancy is historically physicians and researchers are very reluctant to do much work in research around the state of pregnancy because they consider pregnant women a high-risk population

in terms of being vulnerable, in terms of complex physiologic changes that are occurring during pregnancy. So what we bring to the table is really a non-invasive, potentially powerful screening tool that is going to be well researched. So it's exciting. It's really exciting. If you're a woman who is observing this inflection point early, and obviously we've seen this now for a large population of people. Are there examples or maybe changes in someone's lifestyle that could trigger this change that don't necessarily signal preterm delivery? Exactly. So we are going to have some exclusion criteria. If you have twins, for example, they're not going to be in that same category. So they get excluded out members with diabetes in pregnancy. Today, we don't correct for that in terms of the

inflection point. In the future, we probably will be able to. So this, This is really for the standard labor pattern, singleton delivery, not multiple, and not with significant complications that go along with it. Okay, great. Well, I think that's very helpful. Lastly, let's just talk about what impact this might be able to have. What are some of the problems with NICUs and even if we think about the number of locations across just the U.S. alone, but I'm sure around the world, where women don't readily have access

to giving birth. Yeah, the March of Dimes actually came out with a study stating that the incidence of what we call obstetric deserts is actually increasing. 36% of the counties in this country do not have facilities to do deliveries or providers to perform those deliveries. Wow. And that is actually increasing significantly year over year. So when you think about what we can offer is this screening tool to identify our higher risk folks or preterm labor and actually get them plugged in to not only providers, but also, you know, the physical localities where preterm delivery can occur in a safe manner. And the facilities such as, you know, NICUs, needle intensive care units, and all of the resources that are needed to support

a preterm birth. It's a significant public health problem, not only because of the obstetric deserts, but honestly, the cost to health care is significant. It's $26 to $28 billion impact due to preterm deliveries. A lot of that is around neonatal intensive care unit days. So definitely we feel we can contribute to reducing the cost, but more importantly, improving the quality of care for these members. It's worth noting, right, if you identify seven weeks out that you're tracking towards a preterm delivery, there are a lot of steps that you can take and a lot of follow-up conversations you can have with your doctor. Absolutely. So there's two particular tests. One is on the cervical lengthening that can occur. And the other is this cervical swab.

Both of those are fairly accurate in terms of predicting whether, in fact, you're going to go into preterm labor in the next two to four weeks. So what our tool will do is actually probably lead to the next level of screening and intervention. If those show that, in fact, you are headed down that road to a preterm delivery. Things like steroid administration to the mom, which can help with fetal lung maturity, can be administered. So there are things that can occur to just make it a safer, better environment for that fetus who's going to be born in a preterm time frame. Well, Dr. Pat, I think this is the beginning of a lot of exciting work together. And of course, you're going to be on this podcast a lot more going forwards. I look forward to the next research breakthrough. And I look

forward to talking more with you about how WOOP can impact the health and medical space. Absolutely. Exciting to be here and glad that we can make a contribution. Big thank you to Emily and Dr. Carroll for joining me today and sharing insights on our amazing pregnancy research. We're very excited about this and look for features in the WOOP app that leverage this research. If you've enjoyed the episode of the WOOP podcast, don't forget, leave us a rating or review. Please subscribe to the WOOP podcast.

Check us out on social at WOOP. at Will Ahmed. If you have a question, you want to see answered on the podcast, email us, podcast at whoop.com. Call us 508-443-4952. New members can use the code, Will. That's W-I-L-L. And that's a wrap. You can learn more also about the pregnancy research at the locker. That is Woop.com slash locker. I encourage you to check out all the research we've published there. And with that, I wish you a great week. We'll be back next week. Stay healthy. And stay the grid.