For Eva Quackenbush ’26, an interest in maternal and fetal health that began with personal curiosity has grown into a rigorous public health research project with direct implications for how clinicians monitor and make decisions about the most vulnerable newborns.
Quackenbush, a public health major with a concentration in healthcare management in the , worked under the mentorship of , associate professor of public health, on a study examining whether patterns detected in fetal heart tracing—the monitoring of a baby’s heart rate during labor—can predict short-term outcomes for infants born between 23 and 26 weeks of gestation. These babies occupy a narrow clinical window clinicians call “periviable,” a zone where survival has improved in recent decades but where the tools guiding clinical decisions remain poorly understood.
An Understudied Population
Fetal heart tracing is a well-established tool used to signal when medical intervention may be needed in full-term pregnancies. But its predictive value in periviable births has been largely unexplored. That is the gap Quackenbush and Kmush set out to close.
Their study drew on a retrospective cohort of 90 periviable deliveries at a regional referral hospital in upstate New York between January 2017 and August 2022. In their project, two independent maternal-fetal medicine specialists reviewed four key fetal heart tracing indicators—baseline heart rate, variability, accelerations and decelerations—and compared them against an overall composite score. They analyzed those patterns against neonatal outcomes, including lung disease, eye defects, brain hemorrhage and mortality.
The findings were consistent across every model tested: none of the fetal heart tracing patterns were statistically associated with adverse birth outcomes, meaning that the patterns could not reliably predict which babies would fare worse.
“Our research concluded that the heart tracing patterns in this population of periviable infants have no predictive value,” Quackenbush says. That may sound like a null result, but it is a meaningful one, because establishing what does not predict outcomes in this population is itself a critical step toward better clinical understanding, she says.
Building New Skills
Undertaking this clinical research project required Quackenbush to build an entirely new technical skill set. She had no prior experience with coding, but with guidance from Kmush she learned R, the statistical coding language, and applied it to complex regression analyses and data modeling.
“Dr. Kmush has been an incredible mentor for the statistical analysis work that I have been conducting,” Quackenbush says. “She has been guiding my familiarization with R, as well as the process of preparing research for presentation at all levels.”
Quackenbush’s  work in the lab was made possible in part by the Syracuse Office of Undergraduate Research and Creative Engagement (SOURCE), which helped fund her project and teamed her with Kmush as a faculty mentor. Quackenbush also broadened her clinical health background through involvement with the University’s and an internship with the . And beyond coding, she built competencies in scientific writing and research communication, skills she says she will carry into her next career phase.
This spring, she and Kmush presented their findings at the conference in Baltimore, an unusual distinction for an undergraduate researcher. Quackenbush says they hope their study will serve as a foundation for expanded research in the periviable population, including studies with larger sample sizes to further validate the results.
From Data to Policy
This fall, Quackenbush will begin legal studies at the in New York. Her goal is to work in health policy, focusing on improving health outcomes through policy determinations, compliance issues and interdisciplinary collaboration.
While her future path moves her out of the lab, an experience she says has been as much about personal growth as scientific discovery, Quackenbush sees her time there as central to the work ahead. “While my career won’t be directly related to clinical public health activity, I anticipate including many concepts from the public health field into my work in health policy,” she says.
Whether it’s analyzing data or shaping health policy, Quackenbush says her goal remains to work toward better outcomes for patients. She leaves the lab having contributed one more piece of a puzzle that clinicians, families and policymakers are still working to  solve.
