Laura Jelliffe-Pawlowski

Faculty

Jelliffe-Pawlowski Headsot

Laura Jelliffe-Pawlowski

PhD MS

1 212 998 9020

433 First Ave
New York, NY 10010
United States

Laura Jelliffe-Pawlowski's additional information

Laura Jelliffe-Pawlowski, PhD, MS, is a Professor at NYU Rory Meyers College of Nursing. Prof. Jelliffe-Pawlowski’s research interests focus on understanding and addressing the drivers and consequences of adverse pregnancy outcomes with a special emphasis on preterm birth and associated racial/ethnic and socioeconomic inequities. Her work is highly transdisciplinary and looks at the interplay of biomolecular, social, and policy factors in observed patterns and outcomes. Her teaching and mentorship activities reflect this transdisciplinary approach with an emphasis on motivating the translation of research findings into action.

Jelliffe-Pawlowski leads a number of statewide, national, and international research efforts funded by the National Institutes of Health, the Bill and Melinda Gates Foundation, the March of Dimes, the State of California, and other entities. These includes, notably, the “Healthy Outcomes of Pregnancy for Everyone (HOPE)” consortium and study which focuses on understanding the experience of pregnant people and their infants pre- and post-COVID 19 pandemic. HOPE examines how biomolecular, social, and community factors affect the well-being and outcomes of mothers and infants and includes enrollment during pregnancy with outcome follow-up to 18-months after birth. Other ongoing projects include, for example, the NIH funded “Prediction Of Maturity, Morbidity, and Mortality in PreTerm Infants (PROMPT)”, study which focuses on examining the metabolic profiles of newborns with early preterm birth and associated outcomes, the “Transforming Health and Reducing PerInatal Anxiety through Virtual Engagement (THRIVE)”, randomized control trial (RCT), funded by the State of California which examines whether digital cognitive behavior therapy delivered by mobile app can assist in reducing anxiety symptoms in pregnant people and also examines participant acceptability of the application. Ongoing efforts also include leading the “California Prediction of Poor Outcomes of Pregnancy (CPPOP)” cohort study which focuses on investigating multi-omic drivers of preterm birth. The study interrogates biomolecular signals associated with preterm birth and includes full genome sequencing and mid-pregnancy biomolecular signaling related to metabolic, immune, stress, and placental function in hundreds of pregnancies with and without preterm birth.

Prior to her joining NYU Rory Meyers College of Nursing, Jelliffe-Pawlowski was a Professor of Epidemiology & Biostatistics, Chief of the Division of Lifecourse Epidemiology, a Professor in the Institute of Global Health Sciences, and Director of Discovery and Precision Health for the UCSF California Preterm Birth Initiative in the University of California San Francisco (UCSF) School of Medicine. She has a lifetime appointment as an Emeritus Professor of Epidemiology & Biostatistics in the UCSF School of Medicine and continues to work closely with the new Center for Birth Equity at UCSF. Prior to her appointment at UCSF, she was a leader at the Genetic Disease Screening Program within the California Department of Public Health.

Jelliffe-Pawlowski efforts have been highlighted in numerous academic and lay articles including in the New York Times, in WIRED Magazine, in the Atlantic, on CNN, and on MSNBC. In 2023, she was recognized by Forbes Magazine as one of the top 50 over 50 Innovators in the United States. She is also a Phase I and Phase II Bill and Melinda Gates Foundation Grand Challenges awardee for her work in the United States and Uganda which focused on the development and validation of newborn metabolic profile as a novel measure of gestational age in infants.

PhD in Human Development, University of California Davis
MS in Child Development, University of California Davis
BA in Psychology, University of California Los Angeles

Preterm Birth

Faculty Honors Awards

Forbes 50 over 50 awardee in Innovation (2023)
Delegate, African Academy of Sciences (2016)
Awardee, Bill and Melinda Bates Foundation, Gates Grand Challenges Phase I and II
Governor Brown Appointee for the California Department of Public Health, Interagency Coordinating Council on Early Intervention

Publications

Risk of recurrent preterm birth among women according to change in partner

Baer, R. J., Yang, J., Chambers, C. D., Ryckman, K. K., Saftlas, A. F., Berghella, V., Schetter, C. D., Shaw, G. M., Stevenson, D. K., & Jelliffe-Pawlowski, L. (2017). In Journal of Perinatal Medicine (Vols. 45, Issue 1, pp. 63-70). 10.1515/jpm-2016-0207
Abstract
Abstract
There is well-established literature indicating change in partner as a risk for preeclampsia, yet the research on the risk of preterm birth after a change in partners has been sparse and inconsistent. Using a population of California live born singletons, we aimed to determine the risk of preterm birth after a change in partner between the first and second pregnancies. The risk of preterm and early term delivery in the second pregnancy was calculated for mothers who did or did not change partners between births with the referent group as women who delivered both pregnancies at term and did not change partners. Adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated. Relative to women who delivered at 39 weeks or later in the second pregnancy and did not change partners, preterm birth risks were somewhat lower for women who changed partners between the first and second pregnancies compared to those women who did not change partners. For example, 10.6% of women who did not change partners and delivered their second pregnancy before 34 weeks also delivered their first pregnancy before 34 weeks, while 8.5% of women who changed partners delivered before 34 weeks. Findings suggest partner change may alter the risk of preterm birth.

Sleep Disorder Diagnosis during Pregnancy and Risk of Preterm Birth

Felder, J. N., Baer, R. J., Rand, L., Jelliffe-Pawlowski, L., & Prather, A. A. (2017). In Obstetrics and Gynecology (Vols. 130, Issues 3, pp. 573-581). 10.1097/AOG.0000000000002132
Abstract
Abstract
OBJECTIVE: To test the hypothesis that sleep disorder diagnosis would be associated with increased risk of preterm birth and to examine risk by gestational age, preterm birth type, and specific sleep disorder (insomnia, sleep apnea, movement disorder, and other). METHODS: In this observational study, participants were from a cohort of nearly 3 million women in California between 2007 and 2012. Inclusion criteria were women with singleton neonates liveborn between 20 and 44 weeks of gestation without chromosomal abnormalities or major structural birth defects linked to a hospital discharge database maintained by the California Office of Statewide Health Planning and Development and without mental illness during pregnancy. Sleep disorder was defined based on International Classification of Diseases, 9th Revision, Clinical Modification diagnostic code (n=2,265). Propensity score matching was used to select a referent population at a one-to-one ratio. Odds of preterm birth were examined by gestational age (less than 34 weeks, 34-36 weeks, and less than 37 weeks of gestation) and type (spontaneous, indicated). RESULTS: Prevalence of preterm birth (before 37 weeks of gestation) was 10.9% in the referent group compared with 14.6% among women with a recorded sleep disorder diagnosis. Compared with the referent group, odds (95% CI, P value, percentage) of preterm birth were 1.3 (1.0-1.7, P=.023, 14.1%) for insomnia and 1.5 (1.2-1.8, P

Alpha-fetoprotein and poor pregnancy outcomes : Observed patterns, pathophysiology, and clinical utility

Jelliffe-Pawlowski, L., & Baer, R. J. (2016). In Alpha-Fetoprotein: Functions and Clinical Applications (pp. 175-192). Nova Science Publishers, Inc.
Abstract
Abstract
During pregnancy, maternal serum alpha-fetoprotein (MSAFP) is commonly used as a second trimester prenatal screening biomarker for chromosomal and structural birth defects. In the absence of birth defects, abnormal levels of mid-pregnancy MSAFP are associated with adverse pregnancy outcomes including fetal demise and preterm birth. Pregnancies ending in fetal demise or preterm birth often have unusually lower or higher mid-pregnancy MSAFP levels than pregnancies that do not. The same is true for pregnancies with specific conditions that are closely related to fetal demise and preterm birth including preeclampsia, conditions of abnormal placentation (e.g., previa, abruption, accreta), and pregnancies carrying a fetus with intrauterine growth restriction. In this chapter, we review specific studies looking at the relationship between MSAFP and fetal demise or preterm birth. In addition, we will review associations between MSAFP and conditions with close links to fetal demise and preterm birth including preeclampsia, placenta previa, placental abruption, placenta accreta, and intrauterine growth restriction. We also provide a brief review of the pathophysiological literature that underscores these relationships and we suggest next steps with respect to research and clinical use of MSAFP data.

Cell-Free DNA vs Sequential Screening for the Detection of Fetal Chromosomal Abnormalities

Norton, M. E., Baer, R. J., Wapner, R. J., Kuppermann, M., Jelliffe-Pawlowski, L., & Currier, R. J. (2016). In Obstetrical and Gynecological Survey (Vols. 71, Issues 10, pp. 576-578). 10.1097/OGX.0000000000000374
Abstract
Abstract
~

Cell-free DNA vs sequential screening for the detection of fetal chromosomal abnormalities Presented at the Society for Maternal-Fetal Medicine 34th Annual Meeting, San Diego, CA, Feb. 5-7, 2015.

Norton, M. E., Baer, R. J., Wapner, R. J., Kuppermann, M., Jelliffe-Pawlowski, L., & Currier, R. J. (2016). In American Journal of Obstetrics and Gynecology (Vols. 214, Issues 6, pp. 727.e1-727.e6). 10.1016/j.ajog.2015.12.018
Abstract
Abstract
Background Sequential and cell-free DNA (cfDNA) screening are both tests for the common aneuploidies. Although cfDNA has a greater detection rate (DR) for trisomy 21, sequential screening also can identify risk for other aneuploidies. The comparative DR for all chromosomal abnormalities is unknown. Objective To compare sequential and cfDNA screening for detection of fetal chromosomal abnormalities in a general prenatal cohort. Study Design The performance of sequential screening for the detection of chromosome abnormalities in a cohort of patients screened through the California Prenatal Screening Program with estimated due dates between August 2009 and December 2012 was compared with the estimated DRs and false-positive rates (FPRs) of cfDNA screening if used as primary screening in this same cohort. DR and FPR for cfDNA screening were abstracted from the published literature, as were the rates of "no results" in euploid and aneuploid cases. Chromosome abnormalities in the entire cohort were categorized as detectable (trisomies 13, 18, and 21, and sex chromosome aneuploidy), or not detectable (other chromosome abnormalities) by cfDNA screening. DR and FPR were compared for individual and all chromosome abnormalities. DR and FPR for the cohort were compared if "no results" cases were considered "screen negative" or "screen positive" for aneuploidy. DR and FPR rates were compared by use of the Fisher exact test. Results Of 452,901 women who underwent sequential screening during the time period of the study, 2575 (0.57%) had a fetal chromosomal abnormality; 2101 were detected for a DR of 81.6%, and 19,929 euploid fetuses had positive sequential screening for an FPR rate of 4.5%. If no results cases were presumed normal, cfDNA screening would have detected 1820 chromosome abnormalities (70.7%) with an FPR of 0.7%. If no results cases were considered screen positive, 1985 (77.1%) cases would be detected at a total screen positive rate of 3.7%. In either case, the detection rate of sequential screening for all aneuploidies in the cohort was greater than cfDNA (P

Copy-number variant analysis of classic heterotaxy highlights the importance of body patterning pathways

Hagen, E. M., Sicko, R. J., Kay, D. M., Rigler, S. L., Dimopoulos, A., Ahmad, S., Doleman, M. H., Fan, R., Romitti, P. A., Browne, M. L., Caggana, M., Brody, L. C., Shaw, G. M., Jelliffe-Pawlowski, L., & Mills, J. L. (2016). In Human Genetics (Vols. 135, Issues 12, pp. 1355-1364). 10.1007/s00439-016-1727-x
Abstract
Abstract
Classic heterotaxy consists of congenital heart defects with abnormally positioned thoracic and abdominal organs. We aimed to uncover novel, genomic copy-number variants (CNVs) in classic heterotaxy cases. A microarray containing 2.5 million single-nucleotide polymorphisms (SNPs) was used to genotype 69 infants (cases) with classic heterotaxy identified from California live births from 1998 to 2009. CNVs were identified using the PennCNV software. We identified 56 rare CNVs encompassing genes in the NODAL (NIPBL, TBX6), BMP (PPP4C), and WNT (FZD3) signaling pathways, not previously linked to classic heterotaxy. We also identified a CNV involving FGF12, a gene previously noted in a classic heterotaxy case. CNVs involving RBFOX1 and near MIR302F were detected in multiple cases. Our findings illustrate the importance of body patterning pathways for cardiac development and left/right axes determination. FGF12, RBFOX1, and MIR302F could be important in human heterotaxy, because they were noted in multiple cases. Further investigation into genes involved in the NODAL, BMP, and WNT body patterning pathways and into the dosage effects of FGF12, RBFOX1, and MIR302F is warranted.

First trimester pregnancy-associated plasma protein-A and birth weight

Baer, R. J., Lyell, D. J., Norton, M. E., Currier, R. J., & Jelliffe-Pawlowski, L. (2016). In European Journal of Obstetrics and Gynecology and Reproductive Biology (Vols. 198, pp. 1-6). 10.1016/j.ejogrb.2015.12.019
Abstract
Abstract
Objective To evaluate first trimester pregnancy-associated plasma protein-A (PAPP-A) and birth weight percentile. Study design Included were women who underwent first trimester prenatal screening through the California Prenatal Screening Program with expected dates of delivery between August 2009 and December 2010, linked birth certificate and hospital discharge records, known birth weight, and no chromosomal abnormality (n = 134.105). PAPP-A results were reported as multiples of the median. The frequency of small or large for gestational age (SGA, ≤10%; LGA, ≥90%) versus appropriately grown for gestational age birth was examined by PAPP-A percentile. Patterns were studied by gestational age at delivery. Relative risks (RRs) and their 95% confidence intervals were adjusted for race/ethnicity. Results Women with PAPP-A ≤10th percentile and an infant born after 32 weeks were increasingly more likely to have an SGA infant ( adj RRs 1.5-4.6) as the PAPP-A percentile declined, and were increasingly less like to have an LGA infant born at term ( adj RRs 0.5-0.7) compared to women with PAPP-A measurement >10th to

Gestational dating by metabolic profile at birth : A California cohort study

Jelliffe-Pawlowski, L., Norton, M. E., Baer, R. J., Santos, N., & Rutherford, G. W. (2016). In American Journal of Obstetrics and Gynecology (Vols. 214, Issues 4, pp. 511.e1-511.e13). 10.1016/j.ajog.2015.11.029
Abstract
Abstract
Background Accurate gestational dating is a critical component of obstetric and newborn care. In the absence of early ultrasound, many clinicians rely on less accurate measures, such as last menstrual period or symphysis-fundal height during pregnancy, or Dubowitz scoring or the Ballard (or New Ballard) method at birth. These measures often underestimate or overestimate gestational age and can lead to misclassification of babies as born preterm, which has both short- and long-term clinical care and public health implications. Objective We sought to evaluate whether metabolic markers in newborns measured as part of routine screening for treatable inborn errors of metabolism can be used to develop a population-level metabolic gestational dating algorithm that is robust despite intrauterine growth restriction and can be used when fetal ultrasound dating is not available. We focused specifically on the ability of these markers to differentiate preterm births (PTBs) (

Inflammatory biomarkers and spontaneous preterm birth among obese women

Wallenstein, M. B., Jelliffe-Pawlowski, L., Yang, W., Carmichael, S. L., Stevenson, D. K., Ryckman, K. K., & Shaw, G. M. (2016). In Journal of Maternal-Fetal and Neonatal Medicine (Vols. 29, Issues 20, pp. 3317-3322). 10.3109/14767058.2015.1124083
Abstract
Abstract
Objective: To identify associations between second-trimester serum inflammatory biomarkers and preterm birth among obese women. Methods: In this nested case-control study, we compared 65 serum inflammatory biomarkers in obese women whose pregnancies resulted in early spontaneous preterm birth (

Population-based risks of mortality and preterm morbidity by gestational age and birth weight

Jelliffe-Pawlowski, L., Baer, R. J., Rogers, E. E., Partridge, J. C., Anderson, J. G., Morris, M., Kuppermann, M., Franck, L. S., Rand, L., & Jelliffe-Pawlowski, L. L. (2016). In Journal of Perinatology (Vols. 36, Issues 11, pp. 1008-1013). 10.1038/jp.2016.118
Abstract
Abstract
Objective: The objective of this study is to examine the effect of small or large for gestational age (SGA/LGA) status on mortality and morbidity by gestational age. Study design: Logistic binomial regression was used to calculate relative risks (RRs) and 95% confidence intervals for infant mortality and preterm morbidities for SGA or LGA compared with appropriately grown (AGA) deliveries stratified by gestational age group. Results: Compared with AGA infants of similar gestational age, SGA infants were at increased risk for infant mortality. Mortality risk was decreased for LGA infants born between 25 and 27 weeks (RR: 0.6) but increased for LGA infants born between 28 and 31 weeks (RR: 1.9). Risk of preterm morbidity was increased for SGA infants born between 28 and 38 weeks, but decreased for LGA infants born before 37 weeks. Conclusion: This study demonstrates the importance of considering birth weight for gestational age when evaluating morbidity and mortality risks.

Media