
Laura Jelliffe-Pawlowski
MS PhD
laura.jelliffe.pawlowski@nyu.edu 1 212 998 9020433 First Ave
New York, NY 10010
United States
Laura Jelliffe-Pawlowski's additional information
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Laura Jelliffe-Pawlowski, PhD, MS, is a Professor. 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.
Prof. 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 Meyers, Prof. 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.
Prof. 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.
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BA, Psychology, University of California Los AngelesMS, Child Development, University of California DavisPhD, Human Development, University of California Davis
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Preterm Birth
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Faculty Honors Awards
Forbes 50 over 50 awardee in Innovation (2023)Delegate, African Academy of Sciences (2016)Governor Brown Appointee for the California Department of Public Health, Interagency Coordinating Council on Early InterventionAwardee, Bill and Melinda Bates Foundation, Gates Grand Challenges Phase I and II -
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Publications
Racial disparities in emergency mental healthcare utilization among birthing people with preterm infants
AbstractKarvonen, K. L., Baer, R. J., Blebu, B., Calthorpe, L., Fuchs, J. D., Jelliffe-Pawlowski, L., Karasek, D., McKenzie-Sampson, S., Oltman, S. P., Rand, L., Shannon, M. T., Washington, T. E., Woolridge, T., Rogers, E. E., & Pantell, M. S. (2022). American Journal of Obstetrics and Gynecology MFM, 4(2). 10.1016/j.ajogmf.2021.100546AbstractBackground: Birthing people of color are more likely to deliver low birthweight and preterm infants, populations at significant risk of morbidity and mortality. Birthing people of color are also at higher risk for mental health conditions and emergency mental healthcare utilization postpartum. Although this group has been identified as high risk in these contexts, it is not known whether racial and ethnic disparities exist in mental healthcare utilization among birthing people who have delivered preterm. Objective: We sought to determine if racial and ethnic disparities exist in postpartum mental healthcare-associated emergency department visits or hospitalizations for birthing people with preterm infants in a large and diverse population. Study design: This population-based historic cohort study used a sample of Californian live-born infants born between 2011 and 2017 with linked birth certificates and emergency department visit and hospital admission records from the California Statewide Health Planning and Development database. The sample was restricted to preterm infants (<37 weeks’ gestation). Self-reported race and ethnicity groups included Hispanic, non-Hispanic Black, non-Hispanic Asian, non-Hispanic White, and non-Hispanic others. Mental health diagnoses were identified from the International Classification of Diseases Ninth and Tenth revision codes recorded in emergency department and hospital discharge records. Logistic regression analysis was used to estimate the association between mental health-related emergency department visits and rehospitalizations by race or ethnicity compared with non-Hispanic White birthing people and controlling for the following characteristics and health condition covariates: age, parity, previous preterm birth, body mass index, smoking, alcohol use, hypertension, diabetes, previous mental health diagnosis, and prenatal care. Results: Of 204,539 birthing people who delivered preterm infants in California, 1982 visited the emergency department and 836 were hospitalized in the first year after preterm birth for a mental health-related illness. Black birthing people were more likely to have a mental health-related emergency department visit and hospitalization (risk ratio, 1.8; 95% confidence interval, 1.5–2.0 and risk ratio, 1.9; 95% confidence interval, 1.5–2.3, respectively) within the first postpartum year than White birthing people. Hispanic and Asian birthing people were less likely to have mental health-related emergency department visits (adjusted risk ratio, 0.7; 95% confidence interval, 0.7–0.8 and adjusted risk ratio, 0.2; 95% confidence interval, 0.2–0.3, respectively) and hospitalizations (adjusted risk ratio, 0.6; 95% confidence interval, 0.5–0.7 and adjusted risk ratio, 0.2; 95% confidence interval, 0.1–0.3, respectively). When controlling for birthing people with a previous mental health diagnosis and those without, the disparities remained the same. Conclusion: Racial and ethnic disparities exist in emergency mental healthcare escalation among birthing people who have delivered preterm infants. Our findings highlight a need for further investigation into disparate mental health conditions, exacerbations, access to care, and targeted hospital and legislative policies to prevent emergency mental healthcare escalation and reduce disparities.Residential particulate matter, proximity to major roads, traffic density and traffic volume as risk factors for preterm birth in California
AbstractCostello, J. M., Steurer, M. A., Baer, R. J., Witte, J. S., & Jelliffe-Pawlowski, L. L. (2022). Paediatric and Perinatal Epidemiology, 36(1), 70-79. 10.1111/ppe.12820AbstractBackground: While pollution from vehicle sources is an established risk factor for preterm birth, it is unclear whether distance of residence to the nearest major road or related measures like major road density represent useful measures for characterising risk. Objective: To determine whether major road proximity measures (including distance to major road, major road density and traffic volume) are more useful risk factors for preterm birth than other established vehicle-related measures (including particulate matter <2.5 μm in diameter (PM2.5) and diesel particulate matter (diesel PM)). Methods: This retrospective cohort study included 2.7 million births across the state of California from 2011–2017; each address at delivery was geocoded. Geocoding was used to calculate distance to the nearest major road, major road density within a 500 m radius and major road density weighted by truck volume. We measured associations with preterm birth using risk ratios adjusted for target demographic, clinical, socioeconomic and environmental covariates (aRRs). We compared these to the associations between preterm birth and PM2.5 and diesel PM by census tract of residence. Results: Findings showed that whereas higher mean levels of PM2.5 and diesel PM by census tract were associated with a higher risk of preterm birth, living closer to roads or living in higher traffic density areas was not associated with higher risk. Residence in a census tract with a mean PM2.5 in the top quartile compared with the lowest quartile was associated with the highest observed risk of preterm birth (aRR 1.04, 95% CI 1.04, 1.05). Conclusions: Over a large geographical region with a diverse population, PM2.5 and diesel PM were associated with preterm birth, while measures of distance to major road were not, suggesting that these distance measures do not serve as a proxy for measures of particulate matter in the context of preterm birth.Risk of early birth by body mass index in a propensity score-matched sample: A retrospective cohort study
AbstractBaer, R. J., Chambers, B. D., Coleman-Phox, K., Flowers, E., Fuchs, J. D., Oltman, S. P., Scott, K. A., Ryckman, K. K., Rand, L., & Jelliffe-Pawlowski, L. L. (2022). BJOG: An International Journal of Obstetrics and Gynaecology, 129(10), 1704-1711. 10.1111/1471-0528.17120AbstractObjective: Evaluate the risk of preterm (<37 weeks) or early term birth (37 or 38 weeks) by body mass index (BMI) in a propensity score-matched sample. Design: Retrospective cohort analysis. Setting: California, USA. Population: Singleton live births from 2011–2017. Methods: Propensity scores were calculated for BMI groups using maternal factors. A referent sample of women with a BMI between 18.5 and <25.0 kg/m2 was selected using exact propensity score matching. Risk ratios for preterm and early term birth were calculated. Main outcome measures: Early birth. Results: Women with a BMI <18.5 kg/m2 were at elevated risk of birth of 28–31 weeks (relative risk [RR] 1.2, 95% CI 1.1–1.4), 32–36 weeks (RR 1.3, 95% CI 1.2–1.3), and 37 or 38 weeks (RR 1.1, 95% CI 1.1–1.1). Women with BMI ≥25.0 kg/m2 were at 1.2–1.4-times higher risk of a birth <28 weeks and were at reduced risk of a birth between 32 and 36 weeks (RR 0.8–0.9) and birth during the 37th or 38th week (RR 0.9). Conclusion: Women with a BMI <18.5 kg/m2 were at elevated risk of a preterm or early term birth. Women with BMI ≥25.0 kg/m2 were at elevated risk of a birth <28 weeks. Propensity score-matched women with BMI ≥30.0 kg/m2 were at decreased risk of a spontaneous preterm birth with intact membranes between 32 and 36 weeks, supporting the complexity of BMI as a risk factor for preterm birth. Tweetable abstract: Propensity score-matched women with BMI ≥30 kg/m2 were at decreased risk of a late spontaneous preterm birth.Risk Factors for Dual Burden of Severe Maternal Morbidity and Preterm Birth by Insurance Type in California
AbstractEl Ayadi, A. M., Baer, R. J., Gay, C., Lee, H. C., Obedin-Maliver, J., Jelliffe-Pawlowski, L., & Lyndon, A. (2022). Maternal and Child Health Journal, 26(3), 601-613. 10.1007/s10995-021-03313-1AbstractObjectives: Among childbearing women, insurance coverage determines degree of access to preventive and emergency care for maternal and infant health. Maternal-infant dyads with dual burden of severe maternal morbidity and preterm birth experience high physical and psychological morbidity, and the risk of dual burden varies by insurance type. We examined whether sociodemographic and perinatal risk factors of dual burden differed by insurance type. Methods: We estimated relative risks of dual burden by maternal sociodemographic and perinatal characteristics in the 2007–2012 California birth cohort dataset stratified by insurance type and compared effects across insurance types using Wald Z-statistics. Results: Dual burden ranged from 0.36% of privately insured births to 0.41% of uninsured births. Obstetric comorbidities, multiple gestation, parity, and birth mode conferred the largest risks across all insurance types, but effect magnitude differed. The adjusted relative risk of dual burden associated with preeclampsia superimposed on preexisting hypertension ranged from 9.1 (95% CI 7.6–10.9) for privately insured to 15.9 (95% CI 9.1–27.6) among uninsured. The adjusted relative risk of dual burden associated with cesarean birth ranged from 3.1 (95% CI 2.7–3.5) for women with Medi-Cal to 5.4 (95% CI 3.5–8.2) for women with other insurance among primiparas, and 7.0 (95% CI 6.0–8.3) to 19.4 (95% CI 10.3–36.3), respectively, among multiparas. Conclusions: Risk factors of dual burden differed by insurance type across sociodemographic and perinatal factors, suggesting that care quality may differ by insurance type. Attention to peripartum care access and care quality provided by insurance type is needed to improve maternal and neonatal health.Risk factors for neonatal encephalopathy in late preterm and term singleton births in a large California birth cohort
AbstractBandoli, G., Suttner, D., Kiernan, E., Baer, R. J., Jelliffe-Pawlowski, L., & Chambers, C. D. (2022). Journal of Perinatology, 42(3), 341-347. 10.1038/s41372-021-01242-zAbstractObjective: The objective was to investigate maternal and pregnancy characteristics associated with neonatal encephalopathy (NE). Study design: We queried an administrative birth cohort from California between 2011 and 2017 to determine the association between each factor and NE with and without hypothermia treatment. Results: From 3 million infants born at 35 or more weeks of gestation, 6,857 cases of NE were identified (2.3 per 1000 births), 888 (13%) received therapeutic hypothermia. Risk factors for NE were stronger among cases receiving hypothermia therapy. Substance-related diagnosis, preexisting diabetes, preeclampsia, and any maternal infection were associated with a two-fold increase in risk. Maternal overweight/obesity, nulliparity, advanced maternal age, depression, gestational diabetes or hypertension, and short or long gestations also predicted NE. Young maternal age, Asian race and Hispanic ethnicity, and cannabis-related diagnosis lowered risk of NE. Conclusions: By disseminating these results, we encourage further interrogation of these perinatal factors.The risk of preterm birth among women with a history of leukemia or lymphoma
AbstractAnand, S. T., Chrischilles, E. A., Baer, R. J., Charlton, M. E., Breheny, P. J., Terry, W. W., McLemore, M. R., Karasek, D. A., Jelliffe-Pawlowski, L. L., & Ryckman, K. K. (2022). Journal of Maternal-Fetal and Neonatal Medicine, 35(25), 6115-6123. 10.1080/14767058.2021.1907332AbstractObjective: Leukemia and lymphoma are top cancers affecting children, adolescents and young adults with high five-year survival rates. Late effects of these cancers are a concern in reproductive-age patients, including pregnancy outcomes such as preterm birth. Our study aimed to evaluate whether diagnosis of leukemia or lymphoma prior to pregnancy was associated with preterm birth (<37 weeks gestation). Methods: We conducted a cross-sectional study using a population-based dataset from California with linked birth certificates to hospital discharge records and an Iowa-based sample that linked birth certificates to Surveillance, Epidemiology, and End Results (SEER) cancer registry data. Preterm birth was defined using birth certificates. We ascertained history of leukemia and lymphoma using discharge diagnosis data in California and SEER registry in Iowa. Results: Prevalence of preterm birth in California and Iowa was 14.6% and 12.0%, respectively, in women with a history of leukemia/lymphoma compared to 7.8% and 8.2%, respectively, in women without a cancer history. After adjusting for maternal age, race, education, smoking, and plurality, Women with history of leukemia/lymphoma were at an increased risk of having a preterm birth in California (odds ratio (OR) 1.89; 95% confidence interval (CI) 1.56–2.28) and Iowa (OR 1.61; 95% CI 1.10–2.37) compared to those with no cancer history. Conclusion: In both California and Iowa, women with a history of leukemia or lymphoma were at increased risk for preterm birth. This suggests the importance of counseling with a history of leukemia/lymphoma prior to pregnancy and increased monitoring of women during pregnancy.Targeted newborn metabolomics: prediction of gestational age from cord blood
AbstractJasper, E. A., Oltman, S. P., Rogers, E. E., Dagle, J. M., Murray, J. C., Kamya, M., Kakuru, A., Kajubi, R., Ochieng, T., Adrama, H., Okitwi, M., Olwoch, P., Jagannathan, P., Clark, T. D., Dorsey, G., Ruel, T., Jelliffe-Pawlowski, L. L., & Ryckman, K. K. (2022). Journal of Perinatology, 42(2), 181-186. 10.1038/s41372-021-01253-wAbstractObjective: Our study sought to determine whether metabolites from a retrospective collection of banked cord blood specimens could accurately estimate gestational age and to validate these findings in cord blood samples from Busia, Uganda. Study Design: Forty-seven metabolites were measured by tandem mass spectrometry or enzymatic assays from 942 banked cord blood samples. Multiple linear regression was performed, and the best model was used to predict gestational age, in weeks, for 150 newborns from Busia, Uganda. Results: The model including metabolites and birthweight, predicted the gestational ages within 2 weeks for 76.7% of the Ugandan cohort. Importantly, this model estimated the prevalence of preterm birth <34 weeks closer to the actual prevalence (4.67% and 4.00%, respectively) than a model with only birthweight which overestimates the prevalence by 283%. Conclusion: Models that include cord blood metabolites and birth weight appear to offer improvement in gestational age estimation over birth weight alone.The association between preterm birth and postpartum mental healthcare utilization among California birthing people
AbstractCalthorpe, L. M., Baer, R. J., Chambers, B. D., Steurer, M. A., Shannon, M. T., Oltman, S. P., Karvonen, K. L., Rogers, E. E., Rand, L. I., Jelliffe-Pawlowski, L. L., & Pantell, M. S. (2021). American Journal of Obstetrics and Gynecology MFM, 3(4). 10.1016/j.ajogmf.2021.100380AbstractBACKGROUND: While mental health conditions such as postpartum depression are common, little is known about how mental healthcare utilization varies after term versus preterm delivery. OBJECTIVE: This study aimed to determine whether preterm birth is associated with postpartum inpatient and emergency mental healthcare utilization. STUDY DESIGN: The study sample was obtained from a database of live-born neonates delivered in California between the years of 2011 and 2017. The sample included all people giving birth to singleton infants between the gestational age of 20 and 44 weeks. Preterm birth was defined as <37 weeks’ gestation. Emergency department visits and hospitalizations with a mental health diagnosis within 1 year after birth were identified using International Classification of Diseases codes. Logistic regression was used to compare relative risks of healthcare utilization among people giving birth to preterm infants vs term infants, adjusting for the following covariates: age, race or ethnicity, parity, previous preterm birth, body mass index, tobacco use, alcohol or drug use, hypertension, diabetes mellitus, adequacy of prenatal care, education, insurance payer, and the presence of a mental health diagnosis before birth. Results were then stratified by mental health diagnosis before birth to determine whether associations varied based on mental health history. RESULTS: Of our sample of 3,067,069 births, 6.7% were preterm. In fully adjusted models, compared with people giving birth to term infants, people giving birth to preterm infants had a 1.5 times (relative risk; 95% confidence interval, 1.4–1.7) and 1.3 times (relative risk; 95% confidence interval, 1.2–1.4) increased risk of being hospitalized with a mental health diagnosis within 3 months and 1 year after delivery, respectively. People giving birth to preterm infants also had 1.4 times (95% confidence interval, 1.3–1.5) and 1.3 times (95% confidence interval, 1.2–1.4) increased risk of visiting the emergency department for a mental health diagnosis within 3 months and 1 year after birth, respectively. Stratifying by preexisting mental health diagnosis, preterm birth was associated with an elevated risk of mental healthcare utilization for people with and without a previous mental health diagnosis. CONCLUSION: We found that preterm birth is an independent risk factor for postpartum mental healthcare utilization. Our findings suggest that screening for and providing mental health resources to birthing people after delivery are crucial, particularly among people giving birth to preterm infants, regardless of mental health history.Association between Z-score for birth weight and postoperative outcomes in neonates and infants with congenital heart disease
AbstractSteurer, M. A., Peyvandi, S., Costello, J. M., Moon-Grady, A. J., Habib, R. H., Hill, K. D., Jacobs, M. L., Jelliffe-Pawlowski, L. L., Keller, R. L., Pasquali, S. K., Reddy, V. M., Tabbutt, S., & Rajagopal, S. (2021). Journal of Thoracic and Cardiovascular Surgery, 162(6), 1838-1847.e4. 10.1016/j.jtcvs.2021.01.065AbstractObjective: We hypothesized that infants with fetal growth restrictions have increased mortality and morbidity after congenital heart disease surgery. Methods: The study included patients in The Society of Thoracic Surgeons Congenital Heart Surgery Database (2010-2016) who underwent cardiac surgery at a corrected gestational age of ≤44 weeks. Patients were classified as severely (birth weight Z-score −4 to −2), moderately (Z-score −2 to −1), and mildly growth restricted (Z-score −1.0 to −0.5) and compared with a reference population (Z-score 0-0.5). Multivariable logistic regression clustering on center was used to evaluate the association of birth weight Z-score with operative mortality and postoperative complications and its interaction with gestational age was assessed. Results: In 25,244 patients, operative mortality was 8.6% and major complications occurred in 19.4%. Compared with the reference group, the adjusted odds ratio (AOR) of mortality was increased in infants with severe (AOR, 2.4; 95% confidence interval [CI], 2.0-3.0), moderate (AOR, 1.7; 95% CI, 1.4-2.0), and mild growth restriction (AOR, 1.4; 95% CI, 1.2-1.6). The AOR for major postoperative complications was increased for severe (AOR, 1.4; 95% CI, 1.2-1.7) and moderate growth restriction (AOR, 1.2; 95% CI, 1.1-1.4). There was significant interaction between birth weight Z-score and gestational age (P = .007). Conclusions: Even birth weight Z-scores slightly below average are independent risk factors for mortality and morbidity in infants who undergo cardiac surgery. The strongest association between poor fetal growth and operative mortality exists in early-term infants. These novel findings might account for some of the previously unexplained variation in cardiac surgical outcomes.The association of COVID-19 infection in pregnancy with preterm birth: A retrospective cohort study in California
AbstractKarasek, D., Baer, R. J., McLemore, M. R., Bell, A. J., Blebu, B. E., Casey, J. A., Coleman-Phox, K., Costello, J. M., Felder, J. N., Flowers, E., Fuchs, J. D., Gomez, A. M., Karvonen, K., Kuppermann, M., Liang, L., McKenzie-Sampson, S., McCulloch, C. E., Oltman, S. P., Pantell, M. S., … Jelliffe-Pawlowski, L. L. (2021). The Lancet Regional Health - Americas, 2. 10.1016/j.lana.2021.100027AbstractIntroduction: Our understanding of the association between coronavirus disease 19 (COVID-19) and preterm or early term birth among racially and ethnically diverse populations and people with chronic medical conditions is limited. Methods: We determined the association between COVID-19 and preterm (PTB) birth among live births documented by California Vital Statistics birth certificates between July 2020 and January 2021 (n=240,147). We used best obstetric estimate of gestational age to classify births as very preterm (VPTB, <32 weeks), PTB (< 37 weeks), early term (37 and 38 weeks), and term (39-44 weeks), as each confer independent risks to infant health and development. Separately, we calculated the joint effects of COVID-19 diagnosis, hypertension, diabetes, and obesity on PTB and VPTB. Findings: COVID-19 diagnoses on birth certificates increased for all racial/ethnic groups between July 2020 and January 2021 and were highest for American Indian/Alaska Native (12.9%), Native Hawaiian/Pacific Islander (11.4%), and Latinx (10.3%) birthing people. COVID-19 diagnosis was associated with an increased risk of VPTB (aRR 1.6, 95% CI [1.4, 1.9]), PTB (aRR 1.4, 95% CI [1.3, 1.4]), and early term birth (aRR 1.1, 95% CI [1.1, 1.2]). There was no effect modification of the overall association by race/ethnicity or insurance status. COVID-19 diagnosis was associated with elevated risk of PTB in people with hypertension, diabetes, and/or obesity. Interpretation: In a large population-based study, COVID-19 diagnosis increased the risk of VPTB, PTB, and early term birth, particularly among people with medical comorbidities. Considering increased circulation of COVID-19 variants, preventative measures, including vaccination, should be prioritized for birthing persons. Funding: UCSF-Kaiser Department of Research Building Interdisciplinary Research Careers in Women's Health Program (BIRCWH) National Institute of Child Health and Human Development (NICHD) and the Office of Research on Women's Health (ORWH) [K12 HD052163] and the California Preterm Birth Initiative, funded by Marc and Lynn Benioff. -
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