Laura Jelliffe-Pawlowski

Faculty

Jelliffe-Pawlowski Headsot

Laura Jelliffe-Pawlowski

MS PhD

1 212 998 9020

433 First Ave
New York, NY 10010
United States

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.

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

Preterm Birth

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 Intervention
Awardee, Bill and Melinda Bates Foundation, Gates Grand Challenges Phase I and II

Risk of Early Birth among Women with a Urinary Tract Infection: A Retrospective Cohort Study

Baer, R. J., Nidey, N., Bandoli, G., Chambers, B. D., Chambers, C. D., Feuer, S., Karasek, D., Oltman, S. P., Rand, L., Ryckman, K. K., & Jelliffe-Pawlowski, L. L. (2021). AJP Reports, 11(1), E5-E14. 10.1055/s-0040-1721668
Abstract
Abstract
Objective The aim of the study is to evaluate the risk of preterm birth (PTB, <37 weeks) and early term (37 and 38 weeks) birth among women with an emergency department (ED) visit or hospitalization with a urinary tract infection (UTI) by trimester of pregnancy. Methods The primary sample was selected from births in California between 2011 and 2017. UTIs were identified from the ED or hospital discharge records. Risk of PTB, by subtype, and early term birth were evaluated by trimester of pregnancy and by type of visit using log-linear regression. Risk ratios were adjusted for maternal factors. Antibiotic usage was examined in a population of privately insured women from Iowa. Results Women with a UTI during pregnancy were at elevated risk of a birth <32 weeks, 32 to 36 weeks, and 37 to 38 weeks (adjusted risk ratios [aRRs] 1.1-1.4). Of the women with a diagnostic code for multiple bacterial species, 28.8% had a PTB. A UTI diagnosis elevated risk of PTB regardless of antibiotic treatment (aRR 1.4 for treated, aRR 1.5 for untreated). Conclusion UTIs are associated with early birth. This association is present regardless of the trimester of pregnancy, type of PTB, and antibiotic treatment.

Risk and Protective Factors for Preterm Birth Among Black Women in Oakland, California

McLemore, M. R., Berkowitz, R. L., Oltman, S. P., Baer, R. J., Franck, L., Fuchs, J., Karasek, D. A., Kuppermann, M., McKenzie-Sampson, S., Melbourne, D., Taylor, B., Williams, S., Rand, L., Chambers, B. D., Scott, K., & Jelliffe-Pawlowski, L. L. (2021). Journal of Racial and Ethnic Health Disparities, 8(5), 1273-1280. 10.1007/s40615-020-00889-2
Abstract
Abstract
This project examines risk and protective factors for preterm birth (PTB) among Black women in Oakland, California. Women with singleton births in 2011–2017 (n = 6199) were included. Risk and protective factors for PTB and independent risk groups were identified using logistic regression and recursive partitioning. Having less than 3 prenatal care visits was associated with highest PTB risk. Hypertension (preexisting, gestational), previous PTB, and unknown Women, Infant, Children (WIC) program participation were associated with a two-fold increased risk for PTB. Maternal birth outside of the USA and participation in WIC were protective. Broad differences in rates, risks, and protective factors for PTB were observed.

Socioeconomic status, diabetes, and gestation length in Native American and White women

Ross, K. M., Oltman, S., Baer, R., Altman, M., Flowers, E., Feuer, S., Gomez, A. M., & Jelliffe-Pawlowski, L. (2021). Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association, 40(6), 380-387. 10.1037/hea0001072
Abstract
Abstract
OBJECTIVE: "Diminishing returns" of socioeconomic status (SES) suggests that higher SES may not confer equivalent health benefits for ethnic minority individuals as compared to White individuals. Little research has tested whether diminishing returns also affects Native Americans. The objective of this study was to determine whether higher SES is associated with lower diabetes risk and longer gestational length in both Native American and White women, and whether SES predicts gestational length indirectly via diabetes risk. METHOD: A sample of 674,014 Native American and White women was drawn from a population-based California cohort of singleton births (2007-2012). Education, public health insurance status, gestational length, and diabetes diagnosis were extracted from a state-maintained birth cohort database. Covariates were age, health behaviors, pregnancy variables, residence rurality, and prepregnancy body mass index. RESULTS: In logistic regression models, the race by SES interaction (both education and insurance status) was associated with diabetes risk. Compared to high-SES White women, high- and low-SES Native American women had highest and equivalent diabetes risk. In path analyses, the race by SES interaction indirectly predicted gestational length through diabetes, ps < .001. For White women, an indirect effect of diabetes was detected, ps < .001, such that higher SES was associated with reduced risk for diabetes and thus longer gestational length. For Native American women, no indirect effect was detected, ps > .067. CONCLUSIONS: Among Native American women, higher SES did not confer protection against diabetes or shorter gestational length. These findings are consistent with the diminishing returns of SES phenomenon. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Twin chorionicity and zygosity both vary with maternal age

Yeaton-Massey, A., Sparks, T. N., Norton, M. E., Jelliffe-Pawlowski, L., & Currier, R. J. (2021). Prenatal Diagnosis, 41(9), 1074-1079. 10.1002/pd.5997
Abstract
Abstract
Objective: To determine the ratio of dichorionic (DC) to monochorionic (MC) twins by maternal age. Methods: We reviewed all twin pregnancies undergoing first trimester screening (FTS) with nuchal translucency from April 2009 to December 2012 with sonographic determination of chorionicity. Cases were linked to newborn screening (NBS) results and zygosity estimated based on rates of fetal sex discordance. The ratio of DC to MC placentation by maternal age was calculated. Results: We identified 11,351 twin pregnancies with FTS and documented chorionicity. Among these, 7861 (64.2%) had linked data on FTS and NBS to allow estimation of zygosity based on neonatal sex. Of these, 1464 (18.6%) were MC and 6406 (81.4%) DC. The MC twin rate remained constant while the DC twin rate increased with maternal age until 40 years. At <20 years, 55% of twin pregnancies were monozygotic (MZ), as compared to 29% at > 40 years. Of MZ twins, 38% were DC at < 20years, while 53% were DC at >40 years. Conclusions: Our data suggest a relationship of both zygosity and chorionicity with maternal age. DZ twinning increased with maternal age, while among MZ twins, the proportion that were DC also increased with maternal age.

Adverse Pregnancy Outcomes by Degree of Maternal Serum Analyte Elevation: A Retrospective Cohort Study

Yeaton-Massey, A., Baer, R. J., Rand, L., Jelliffe-Pawlowski, L. L., & Lyell, D. J. (2020). AJP Reports, 10(4), E369-E379. 10.1055/s-0040-1716741
Abstract
Abstract
Objective  The aim of this study was to evaluate rates of preterm birth (PTB) and obstetric complication with maternal serum analytes > 2.5 multiples of the median (MoM) by degree of elevation. Study Design  Retrospective cohort study of singleton live-births participating in the California Prenatal Screening Program (2005-2011) examining PTB and obstetric complication for α-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin A (INH) by analyte subgroup (2.5 to < 6.0, 6.0 to < 10.0, and ≥ 10.0 MoM vs. < 2.5 MoM). Results  The risk of obstetric complication increased with increasing hCG, AFP, and INH MoM, and were greatest for AFP and INH of 6.0 to <10.0 MoM. The greatest risk of any adverse outcome was seen for hCG MoM ≥ 10.0, with relative risk (RR) of PTB < 34 weeks of 40.8 (95% confidence interval [CI]: 21.7-77.0) and 13.8 (95% CI: 8.2-23.1) for obstetric complication. Conclusions  In euploid, structurally normal fetuses, all analyte elevations > 2.5 MoM confer an increased risk of PTB and, except for uE3, obstetric complication, and risks for each are not uniformly linear. These data can help guide patient counseling and antenatal management.

Cohort study of respiratory hospital admissions, air quality and sociodemographic factors in preterm infants born in California

Steurer, M. A., Costello, J., Baer, R. J., Oltman, S. P., Feuer, S. K., Pacheco-Werner, T., Rogers, E., Jankowska, M. M., Block, J., McCarthy, M., Pantell, M. S., Chambers, C., Ryckman, K. K., & Jelliffe-Pawlowski, L. L. (2020). Paediatric and Perinatal Epidemiology, 34(2), 130-138. 10.1111/ppe.12652
Abstract
Abstract
Background: Preterm infants suffer from respiratory morbidity especially during the first year of life. Objective: To investigate the association of air quality and sociodemographic indicators on hospital admission rates for respiratory causes. Methods: This is a retrospective cohort study. We identified all live-born preterm infants in California from 2007 to 2012 in a population-based administrative data set and linked them to a data set measuring several air quality and sociodemographic indicators at the census tract level. All sociodemographic and air quality predictors were divided into quartiles (first quartile most favourable to the fourth quartile least favourable). Mixed effect logistic models to account for clustering at the census tract level were used to investigate associations between chronic air quality and sociodemographic indicators respiratory hospital admission during the first year of life. Results: Of 205 178 preterm infants, 5.9% (n = 12 033) were admitted to the hospital for respiratory causes during the first year. In the univariate analysis, comparing the first to the fourth quartile of chronic ozone (risk ratio [RR] 1.29, 95% confidence interval [CI] 1.21, 1.37), diesel (RR 1.10, 95% CI 1.02, 1.17) and particulate matter 2.5 (RR 1.07, 95% CI 1.01, 1.14) exposure were associated with hospital admission during the first year. Following adjustment for confounders, the risk ratios for hospital admission during the first year were 1.53 (95% CI 1.37, 1.72) in relation to educational attainment (per cent of the population over age 25 with less than a high school education) and 1.23 (95% CI 1.09, 1.38) for poverty (per cent of the population living below two times the federal poverty level). Conclusions: Among preterm infants, respiratory hospital admissions in the first year in California are associated with socioeconomic characteristics of the neighbourhood an individual is living in.

Early pregnancy prediction of gestational diabetes mellitus risk using prenatal screening biomarkers in nulliparous women

Snyder, B. M., Baer, R. J., Oltman, S. P., Robinson, J. G., Breheny, P. J., Saftlas, A. F., Bao, W., Greiner, A. L., Carter, K. D., Rand, L., Jelliffe-Pawlowski, L. L., & Ryckman, K. K. (2020). Diabetes Research and Clinical Practice, 163. 10.1016/j.diabres.2020.108139
Abstract
Abstract
Aims: To evaluate the clinical utility of first and second trimester prenatal screening biomarkers for early pregnancy prediction of gestational diabetes mellitus (GDM) risk in nulliparous women. Methods: We conducted a population-based cohort study of nulliparous women participating in the California Prenatal Screening Program from 2009 to 2011 (n = 105,379). GDM was ascertained from hospital discharge records or birth certificates. Models including maternal characteristics and prenatal screening biomarkers were developed and validated. Risk stratification and reclassification were performed to assess clinical utility of the biomarkers. Results: Decreased levels of first trimester pregnancy-associated plasma protein A (PAPP-A) and increased levels of second trimester unconjugated estriol (uE3) and dimeric inhibin A (INH) were associated with GDM. The addition of PAPP-A only and PAPP-A, uE3, and INH to maternal characteristics resulted in small, yet significant, increases in area under the receiver operating characteristic curve (AUC) (maternal characteristics only: AUC 0.714 (95% CI 0.703–0.724), maternal characteristics + PAPP-A: AUC 0.718 (95% CI 0.707–0.728), maternal characteristics + PAPP-A, uE3, and INH: AUC 0.722 (0.712–0.733)); however, no net improvement in classification was observed. Conclusions: PAPP-A, uE3, and INH have limited clinical utility for prediction of GDM risk in nulliparous women. Utility of other readily accessible clinical biomarkers in predicting GDM risk warrants further investigation.

Effects of Selective Exclusion of Patients on Preterm Birth Test Performance

Jelliffe-Pawlowski, L. L., Rand, L., & Ryckman, K. K. (2020, April 1). In Obstetrics and Gynecology (Vols. 135, Issues 4, pp. 971-972). 10.1097/AOG.0000000000003783

Environmental and socioeconomic factors influence the live-born incidence of congenital heart disease: A population-based study in california

Peyvandi, S., Baer, R. J., Chambers, C. D., Norton, M. E., Rajagopal, S., Ryckman, K. K., Moon-Grady, A., Jelliffe-Pawlowski, L. L., & Steurer, M. A. (2020). Journal of the American Heart Association, 9(8). 10.1161/JAHA.119.015255
Abstract
Abstract
BACKGROUND: The development of congenital heart disease (CHD) is multifactorial with genetic and environmental influences. We sought to determine the relationship between socioeconomic and environmental factors with the incidence of CHD among live-born infants in California and to determine whether maternal comorbidities are in the causal pathway. METHODS AND RESULTS: This was a population-based cohort study in California (2007–2012). The primary outcome was having significant CHD. Predictors included socioeconomic status and environmental exposure to pollutants determined by U.S. Census data. A social deprivation index and environmental exposure index was assigned based on neighborhood socioeconomic variables, categorized into 4 quartiles. Quartile 1 was the best with the least exposure to pollutants and social deprivation, and quartile 4 was the worst. Multivariate logistic regression and mediation analyses were performed. Among 2 419 651 live-born infants, the incidence of CHD was 3.2 per 1000 live births. The incidence of CHD was significantly higher among those in quartile 4 compared with quartile 1 (social deprivation index: 0.35% versus 0.29%; odds ratio [OR], 1.31; 95% CI, 1.21–1.41; environmental exposure index: 0.35% versus 0.29%; OR, 1.23; 95% CI, 1.15–1.31) after adjusting for maternal race/ ethnicity and age and accounting for the relationship between the 2 primary predictors. Maternal comorbidities explained 13% (95% CI, 10%–20%) of the relationship between social deprivation index and environmental exposure index with the incidence of CHD. CONCLUSIONS: Increased social deprivation and exposure to environmental pollutants are associated with the incidence of live-born CHD in California. Maternal comorbidities explain some, but not all, of this relationship. These findings identify targets for social policy initiatives to minimize health disparities.

Exposures to structural racism and racial discrimination among pregnant and early post-partum Black women living in Oakland, California

Chambers, B. D., Arabia, S. E., Arega, H. A., Altman, M. R., Berkowitz, R., Feuer, S. K., Franck, L. S., Gomez, A. M., Kober, K., Pacheco-Werner, T., Paynter, R. A., Prather, A. A., Spellen, S. A., Stanley, D., Jelliffe-Pawlowski, L. L., & McLemore, M. R. (2020). Stress and Health, 36(2), 213-219. 10.1002/smi.2922
Abstract
Abstract
Research supports that exposure to stressors (e.g., perceived stress and racism) during pregnancy can negatively impact the immune system, which may lead to infection and ultimately increases the risk for having a preterm or low-birthweight infant. It is well known that Black women report higher levels of stressors at multiple timepoints across pregnancy compared with women of all other racial and ethnic groups. This study addresses gaps in the literature by describing pregnant and early post-partum Black women's exposures to structural racism and self-reported experiences of racial discrimination, and the extent to which these factors are related. We used a cross-sectional study design to collect data related to exposures to racism from pregnant and early post-partum Black women residing in Oakland, California, from January 2016 to December 2017. Comparative analysis revealed that living in highly deprived race + income neighborhoods was associated with experiencing racial discrimination in three or more situational domains (p =.01). Findings show that Black women are exposed to high levels of racism that may have negative impacts on maternal health outcomes.