Anne R. Waldrop

All Publications

• Antenatal wildfire smoke exposure and preterm birth phenotypes: A retrospective cohort study ENVIRONMENTAL EPIDEMIOLOGY Waldrop, A. R., Blumenfeld, Y. J., Mayo, J. A., Panelli, D. M., Heft-Neal, S., Burke, M., Leonard, S. A., Shaw, G. M. 2025; 9 (6)

  View details for DOI 10.1097/EE9.0000000000000446

  View details for Web of Science ID 001630111400001

• Antenatal wildfire smoke exposure and preterm birth phenotypes: A retrospective cohort study. Environmental epidemiology (Philadelphia, Pa.) Waldrop, A. R., Blumenfeld, Y. J., Mayo, J. A., Panelli, D. M., Heft-Neal, S., Burke, M., Leonard, S. A., Shaw, G. M. 2025; 9 (6): e446

  Abstract

  Novel evidence suggests an association of wildfire smoke exposure with preterm birth (PTB). However, the mechanism and exposure timing of this association are poorly understood.We estimate the association of wildfire smoke on PTB phenotypes (spontaneous PTB [sPTB] and medically indicated PTB [mPTB]) as well as hypertensive disorders of pregnancy (HDP).Birth cohort data from singleton livebirths in California from 2007 to 2012 were combined with daily zip code-level estimates of wildfire smoke intensity. Satellite-based estimates of wildfire smoke plume boundaries and high-resolution gridded estimates of surface particulate matter 2.5 (PM2.5) concentrations were used to calculate smoke exposure from 4 weeks preconception through gestational week 20. The two primary exposures were (1) wildfire smoke exposure at distinct gestational ages and (2) concentration of wildfire smoke exposure. Logistic regression models assessed associations between the number of wildfire smoke-exposed days and PTB phenotypes. HDP were also assessed as an outcome, given their major contribution to mPTB. Four primary outcomes were used: (1) overall PTB (<37 weeks), (2) sPTB, (3) mPTB, and (4) HDP.Of 2,548,347 eligible pregnant individuals, 86% were exposed to at least 1 day of wildfire smoke of any PM2.5 intensity during the exposure period. Wildfire smoke of any intensity was significantly associated with sPTB during the exposure period (odds ratios [OR] [95% confidence intervals (CI)]: 1.003 [1.0021, 1.0039]). Each additional day of smoke exposure conferred 0.3% increased odds of sPTB. We did not observe an association of wildfire smoke with HDP. Only smoke exposure of any intensity between 14 and 20 weeks was associated with increased odds of mPTB OR CI (95%) (1.0038 [1.0008, 1.0069]). Wildfire smoke exposure of any intensity in the gestational period of smoke exposure was associated in increased odds of all PTB, except for the preconception period.Our study found an association of wildfire smoke exposure with PTB, which was largely driven by sPTB.

  View details for DOI 10.1097/EE9.0000000000000446

  View details for PubMedID 41357551

  View details for PubMedCentralID PMC12677857

• The new age of periviability. Current opinion in obstetrics & gynecology Soltani, A., Waldrop, A. R., Henkel, A. 2025

  Abstract

  PURPOSE OF REVIEW: This review focuses on the clinical and ethical complexities of managing pregnancies between 20 and 25 weeks and 6 days of gestation, known as periviability, where fetal survival is uncertain and viability cannot be uniformly defined.RECENT FINDINGS: Recent literature highlights that outcomes during periviability depend on a constellation of factors, including gestational age, fetal weight, institutional resources, and access to neonatal intensive care. Advances in neonatal and obstetric care have pushed the threshold of viability earlier, but survival and morbidity remain highly variable. The diagnosis of life-limiting fetal anomalies or severe maternal complications during this time frequently necessitates urgent decision-making around abortion. Legal changes post-Dobbs have further complicated access to abortion care. Additionally, new recommendations surrounding feticidal injection are highlighted. Studies also emphasize that parental decisions are guided more by intuitive beliefs than by statistics alone, underscoring the importance of values-based counseling.SUMMARY: Periviability challenges clinicians to balance medical, legal, and ethical considerations while supporting patients through highly individualized, time-sensitive decisions. A shared decision-making model grounded in ethical principles is essential. Ongoing dialogue and refined, patient-centered guidelines are needed to ensure compassionate, equitable, and evidence-based care at the threshold of viability.

  View details for DOI 10.1097/GCO.0000000000001061

  View details for PubMedID 40815136

• Impact of air pollution exposure on cytokines and histone modification profiles at single-cell levels during pregnancy. Science advances Jung, Y. S., Aguilera, J., Kaushik, A., Ha, J. W., Cansdale, S., Yang, E., Ahmed, R., Lurmann, F., Lutzker, L., Hammond, S. K., Balmes, J., Noth, E., Burt, T. D., Aghaeepour, N., Waldrop, A. R., Khatri, P., Utz, P. J., Rosenburg-Hasson, Y., DeKruyff, R., Maecker, H. T., Johnson, M. M., Nadeau, K. C. 2024; 10 (48): eadp5227

  Abstract

  Fine particulate matter (PM2.5) exposure can induce immune system pathology via epigenetic modification, affecting pregnancy outcomes. Our study investigated the association between PM2.5 exposure and immune response, as well as epigenetic changes using high-dimensional epigenetic landscape profiling using cytometry by time-of-flight (EpiTOF) at the single cell. We found statistically significant associations between PM2.5 exposure and levels of certain cytokines [interleukin-1RA (IL-1RA), IL-8/CXCL8, IL-18, and IL-27)] and histone posttranslational modifications (HPTMs) in immune cells (HPTMs: H3K9ac, H3K23ac, H3K27ac, H2BK120ub, H4K20me1/3, and H3K9me1/2) among pregnant and nonpregnant women. The cord blood of neonates with high maternal PM2.5 exposure showed lower IL-27 than those with low exposure. Furthermore, PM2.5 exposure affects the co-modification profiles of cytokines between pregnant women and their neonates, along with HPTMs in each immune cell type between pregnant and nonpregnant women. These modifications in specific histones and cytokines could indicate the toxicological mechanism of PM2.5 exposure in inflammation, inflammasome pathway, and pregnancy complications.

  View details for DOI 10.1126/sciadv.adp5227

  View details for PubMedID 39612334

• Air Pollution and Pregnancy: Insights into Immune Response, Histone Modifications, and Cytokine Signatures Jung, Y., Ha, J., Aguilera, J., Kaushik, A., Cansdale, S., Yang, E., Dermadi, D., Lurmann, F., Lutzker, L., Hammond, K., Balmes, J., Noth, E., Eisen, E., Aghaeepour, N., Shaw, G., Waldrop, A., Khatri, P., Utz, P., Rosenburg-Hasson, Y., Maecker, H., Burt, T., Johnson, M., Nadeau, K. MOSBY-ELSEVIER. 2024: AB370

  View details for Web of Science ID 001267526000850

• RETRACTED: 60 Predicting chorioamnionitis using AI-based methods: a retrospective cohort study. American journal of obstetrics and gynecology Waldrop, A. R., James, T. K., Suharwardy, S., Studer, M., Chang, A., Bernal, C. E., Xie, F., Shome, S., Hazra, D., Kim, Y., Clarke, G., Chakraborty, D., Mataraso, S., Berson, E., Xue, L., Payrovnaziri, S., Mohammadi, N., Haberkorn, W., Maric, I., El-Sayed, Y. Y., Carvalho, B., Aghaeepour, N. 2024; 230 (1S): S46

  Abstract

  This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/policies/article-withdrawal). This meeting abstract has been retracted at the request of the authors. The team determined further analysis is warranted before the formal presentation of the results.

  View details for DOI 10.1016/j.ajog.2023.11.081

  View details for PubMedID 38355237

• Intrahepatic Cholestasis of Pregnancy and Transaminitis in Women with COVID-19: A Case Series. AJP reports Waldrop, A. R., Henkel, A., Lee, K. B., Druzin, M. L., Aziz, N., El-Sayed, Y., Lyell, D. J. 2024; 14 (1): e16-e18

  Abstract

  Objective  The four initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pregnant women presenting at term gestation to our institution presented with transaminitis. Three of the four were diagnosed with intrahepatic cholestasis of pregnancy (IHCP). Growing evidence exists of an associated transaminitis in nonpregnant SARS-CoV-2 patients. However, there are limited data of hepatic involvement of SARS-CoV-2 in pregnancy, and no previous studies have assessed the association with IHCP in patients with coronavirus disease 2019 (COVID-19). Study Design  This was a retrospective, single-center case series of four consecutive pregnant women with a positive result for SARS-CoV-2 presenting with transaminitis in third trimester. Results  The clinical courses of four pregnant women with COVID-19 and transaminitis, three of four of whom were diagnosed with IHCP, are described. Testing for SARS-CoV-2 was done through a reverse transcription polymerase chain reaction test of a nasopharyngeal swab. Conclusion  As we await larger studies ascertaining the incidence of IHCP in SARS-CoV-2, this prevalence highlights the importance of diagnosing IHCP among women with COVID-19 as a potential etiology of transaminitis, as IHCP risks may be ameliorated with earlier delivery. Moreover, delineating a hepatobiliary association in pregnancy may provide further information about the mechanism of liver impairment in SARS-CoV-2 in all patients.

  View details for DOI 10.1055/s-0043-1777999

  View details for PubMedID 38269122

  View details for PubMedCentralID PMC10805562

• A Case of an Obstructed Delivery by a Large, Lower Uterine Segment Fibroid Interlocked with a Fetal Mentum. AJP reports Miller, S. E., Miller, H. E., Waldrop, A. R., Karakash, S. D., Shaw, K. A. 2024; 14 (1): e85-e87

  Abstract

  Uterine leiomyomata are associated with many pregnancy complications and will likely become increasingly common as the average age of childbearing increases. We describe a case of an obstructed delivery by a large fibroid. A 37-year-old G2P1001 with a 10-cm anterior, lower uterine segment fibroid presented for labor induction. Labor was complicated by arrest of descent due to suspected obstruction of the fetal body by the fibroid after descent of the fetal head, and delivery during cesarean section was complicated by apparent interlocking of the fetal mentum with the fibroid. Large, anterior lower uterine segment fibroids have the potential to obstruct delivery of the fetal head or of the fetal body, and these patients should be counseled regarding the potential for complications via both vaginal and cesarean deliveries.

  View details for DOI 10.1055/s-0043-1778002

  View details for PubMedID 38370329

  View details for PubMedCentralID PMC10874688

• The impacts of ambient air pollution exposure during pregnancy on maternal and neonatal inflammatory biomarkers Ha, J., Aguilera, J., Jung, Y., Cansdale, S., Lurmann, F., Lutzker, L., Hammond, K., Balmes, J., Noth, E., Eisen, E., Aghaeepour, N., Shaw, G., Waldrop, A., Khatri, P., Utz, P. J., Rosenburg-Hasson, Y., Maecker, H., Burt, T., Nadeau, K., Prunicki, M. MOSBY-ELSEVIER. 2023: AB119

  View details for Web of Science ID 000991651900367

• Antenatal wildfire smoke exposure and hypertensive disorders of pregnancy Waldrop, A. R., Blumenfeld, Y. J., Mayo, J. A., Panelli, D. M., Heft-Neal, S., Burke, M., Leonard, S. A., Shaw, G. M. MOSBY-ELSEVIER. 2023: S59-S60

  View details for Web of Science ID 000909337400072

• Factors contributing to delay in family building among sexual/gender minority people in the COVID19 pandemic Waldrop, A. R., Zhang, J., Flentje, A., Lunn, M. R., Lubensky, M. E., Leonard, S. A., Dastur, Z., Obedin-Maliver, J. MOSBY-ELSEVIER. 2023: S434

  View details for Web of Science ID 000909337401223

• Practice patterns and telehealth usage of maternal fetal medicine providers by US region and urbanicity Waldrop, A. R., Cruz, G., Trepman, P., Suharwardy, S. MOSBY-ELSEVIER. 2022: S175-S176

  View details for Web of Science ID 000737459400241

• Telehealth barriers in maternal fetal medicine providers by patient insurance status Waldrop, A. R., Cruz, G., Trepman, P., Suharwardy, S. MOSBY-ELSEVIER. 2022: S735

  View details for Web of Science ID 000737459401514

• Barriers to telehealth usage by maternal fetal medicine providers by US region and urbanicity Waldrop, A. R., Cruz, G., Trepman, P., Suharwardy, S. MOSBY-ELSEVIER. 2022: S88-S89

  View details for Web of Science ID 000737459400099

• Postpartum depression in mothers with pregnancies complicated by fetal cardiac anomaly. Journal of perinatology : official journal of the California Perinatal Association Waldrop, A. R., Sherwin, E. B., Anderson, J. N., Boissiere, J. C., Hintz, S. R., Maskatia, S. A., Girsen, A. I., Blumenfeld, Y. J. 2021

  Abstract

  OBJECTIVE: To investigate factors associated with positive postpartum depression (PPD) screen in pregnancies complicated by fetal congenital cardiac anomaly.STUDY DESIGN: We reviewed all records of pregnancies complicated by fetal congenital cardiac anomaly receiving prenatal, intrapartum and postpartum care at our single center, October 2016-October 2019. Maternal, obstetric, and neonatal data were compared between women with and without a positive PPD screen at the 6-week postpartum visit.RESULTS: Out of 415 women referred for fetal congenital cardiac anomaly, 86 women had complete inclusion criteria. Twenty-four women (28%) had a positive PPD screen. The frequencies of planned future infant surgery (73.9 vs. 26.2%, p=0.01) and neonatal death prior to postpartum visit (12.5 vs. 0%, p=0.02) were significantly higher among women with a positive PPD screen.CONCLUSION: In pregnancies complicated by fetal congenital cardiac anomaly, mothers of infants with planned future surgery or neonatal death are at significant risk for postpartum depression.

  View details for DOI 10.1038/s41372-021-01017-6

  View details for PubMedID 33712713

• Prepregnancy body mass index and gestational diabetes mellitus across asian subpopulations Sperling, M., Leonard, S. A., Waldrop, A. R., Miller, S., Blumenfeld, Y. J., Carmichael, S., Chueh, J. MOSBY-ELSEVIER. 2021: S118–S119

  View details for Web of Science ID 000621547400177

• Management of brain tumors presenting in pregnancy: a case series and systematic review Management of brain tumors presenting in pregnancy: a case series and systematic review Rodrigues, A. 2021; 3 (1)

  View details for DOI 10.1016/j.ajogmf.2020.100256

• Management of brain tumors presenting in pregnancy: a case series and systematic review. American journal of obstetrics & gynecology MFM Rodrigues, A. J., Waldrop, A. R., Suharwardy, S., Druzin, M. L., Iv, M., Ansari, J. R., Stone, S. A., Jaffe, R. A., Jin, M. C., Li, G., Hayden-Gephart, M. 2021; 3 (1): 100256

  Abstract

  Patients who present with brain tumors during pregnancy require unique imaging and neurosurgical, obstetrical, and anesthetic considerations. Here, we review the literature and discuss the management of patients who present with brain tumors during pregnancy. Between 2009 and 2019, 9 patients were diagnosed at our institution with brain tumors during pregnancy. Clinical information was extracted from the electronic medical records. The median age at presentation was 29 years (range, 25-38 years). The most common symptoms at presentation included headache (n=5), visual changes (n=4), hemiparesis (n=3), and seizures (n=3). The median gestational age at presentation was 20.5 weeks (range, 11-37 weeks). Of note, 8 patients (89%) delivered healthy newborns, and 1 patient terminated her pregnancy. In addition, 5 patients (56%) required neurosurgical procedures during pregnancy (gestational ages, 14-37 weeks) because of disease progression (n=2) or neurologic instability (n=3). There was 1 episode of postneurosurgery morbidity (pulmonary embolism [PE]) and no surgical maternal mortality. The median length of follow-up was 15 months (range, 6-45 months). In cases demonstrating unstable or progressive neurosurgical status past the point of fetal viability, neurosurgical intervention should be considered. The physiological and pharmacodynamic changes of pregnancy substantially affect anesthetic management. Pregnancy termination should be discussed and offered to the patient when aggressive disease necessitates immediate treatment and the fetal gestational age remains previable, although neurologically stable patients may be able to continue the pregnancy to term. Ultimately, pregnant patients with brain tumors require an individualized approach to their care under the guidance of a multidisciplinary team.

  View details for DOI 10.1016/j.ajogmf.2020.100256

  View details for PubMedID 33451609

• Postpartum depression in women with pregnancies complicated by a fetal congenital cardiac anomaly Waldrop, A. R., Sherwin, E. B., Anderson, J. N., Boissiere, J. C., Girsen, A., Blumenfeld, Y. J. MOSBY-ELSEVIER. 2020: S348

  View details for DOI 10.1016/j.ajog.2019.11.555

  View details for Web of Science ID 000504997300538

• Short interval between IUD removal and conception increases risks for hemorrhage and retained placenta Fox, K. A., Wall-Wieler, E., Waldrop, A. R., Lyell, D. J., Davis, B. R., Carusi, D. A. MOSBY-ELSEVIER. 2020: S347

  View details for DOI 10.1016/j.ajog.2019.11.554

  View details for Web of Science ID 000504997300537

• Ranking States on Coverage of Cancer-Preventing Vaccines Among Adolescents: The Influence of Imprecision. Public health reports (Washington, D.C. : 1974) Waldrop, A. R., Moss, J. L., Liu, B., Zhu, L. 2017; 132 (6): 627-636

  Abstract

  Identifying the best and worst states for coverage of cancer-preventing vaccines (hepatitis B [HepB] and human papillomavirus [HPV]) may guide public health officials in developing programs, such as promotion campaigns. However, acknowledging the imprecision of coverage and ranks is important for avoiding overinterpretation. The objective of this study was to examine states' vaccination coverage and ranks, as well as the imprecision of these estimates, to inform public health decision making.We used data on coverage of HepB and HPV vaccines among adolescents aged 13-17 from the 2011-2015 National Immunization Survey-Teen (n = 103 729 from 50 US states and Washington, DC). We calculated coverage, 95% confidence intervals (CIs), and ranks for vaccination coverage in each state, and we generated simultaneous 95% CIs for ranks using a Monte Carlo method with 100 000 simulations.Across years, HepB vaccination coverage was 92.2% (95% CI, 91.8%-92.5%; states' range, 84.3% in West Virginia to 97.0% in Connecticut). HPV vaccination coverage was 57.4% (95% CI, 56.6%-58.2%; range, 41.8% in Kansas to 78.0% in Rhode Island) for girls and 31.0% (95% CI, 30.3%-31.8%; range, 19.0% in Utah to 59.3% in Rhode Island) for boys. States with the highest and lowest ranks generally had narrow 95% CIs; for example, Rhode Island was ranked first (95% CI, 1-1) and Kansas was ranked 51st (95% CI, 49-51) for girls' HPV vaccination. However, states with intermediate ranks had wider and more imprecise 95% CIs; for example, New York was 26th for girls' HPV vaccination coverage, but its 95% CI included ranks 18-35.States' ranks of coverage of cancer-preventing vaccines were imprecise, especially for states in the middle of the range; thus, performance rankings presented without measures of imprecision could be overinterpreted. However, ranks can highlight high-performing and low-performing states to target for further research and vaccination promotion programming.

  View details for DOI 10.1177/0033354917727274

  View details for PubMedID 28854349

  View details for PubMedCentralID PMC5692154