Author Interviews, COVID -19 Coronavirus, JAMA, OBGYNE, Pediatrics / 23.04.2021

MedicalResearch.com Interview with: Aris Papageorghiou MBChB, MRCOG Professor of Fetal Medicine and the Clinical Research Director Oxford Maternal and Perinatal Health Institute University of Oxford MedicalResearch.com: What is the background for this study? Response: Our study was really guided by a key question: does Covid-19 in pregnancy increase the risk of adverse maternal and neonatal outcomes as compared with pregnant women who do not have the infection? The question is highly relevant because of the known deleterious effects of other coronavirus infections in pregnancy, e.g. SARS (severe acute respiratory syndrome) and MERS-CoV (Middle East respiratory syndrome coronavirus). In order to answer this question we undertook this multinational cohort study. (more…)
Author Interviews, CMAJ, COVID -19 Coronavirus, OBGYNE / 19.03.2021

MedicalResearch.com Interview with: Nathalie Auger Professeure agrégée de clinique École de santé publique - Département de médecine sociale et preventive University of Montreal MedicalResearch.com: What is the background for this study? Response: COVID-19, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been a major public health concern. The number of infected pregnant women continues to increase. Pregnant women and infants are particularly susceptible to COVID-19 because the physiologic changes of pregnancy involve cardiovascular, respiratory, and immune changes that may alter the response to SARS-CoV-2 infection. Fetuses may be exposed to SARS-CoV-2 during critical periods of development. The nature of the association between COVID-19 and pregnancy outcomes remains unclear and meta-analyses of pregnant women with COVID-19 are lacking. (more…)
Author Interviews, Cannabis, JAMA, OBGYNE, Pediatrics / 08.03.2021

MedicalResearch.com Interview with: Erica M. Wymore, MD MPH Assistant Professor, Neonatal- Perinatal Medicine Department of Pediatrics, Section of Neonatology University of Colorado School of Medicine Children's Hospital Colorado Maya Bunik, MD, MPH  |  Professor, Pediatrics Medical Director, Child Health Clinic, Primary Care  |  Breastfeeding Management Clinic Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) School of Medicine| University of Colorado Anschutz Medical Campus Children's Hospital Colorado MedicalResearch.com: What is the background for this study? Response: Marijuana legalization has been increasing in the United States, with increasing consumption of marijuana products. Currently, the American Academy of Pediatrics (AAP), American College of Obstetricians and Gynecologists (ACOG) and Academy of Breastfeeding Medicine (ABM) do not recommend marijuana use during pregnancy or lactation due to concerning though limited data on the effects of perinatal marijuana exposure. As there has been increasing prevalence of women using marijuana during pregnancy due to legalization and perceptions of safety, we sought to determine the duration of THC excretion in breast milk among women who had evidence of marijuana use at delivery and abstained post-partum.  (more…)
Fertility, OBGYNE / 17.02.2021

Not being able to have biological children is a fear most people hope they never to have to face. fertility-pregnancy-IVFAlthough we might not all have grown up knowing for sure if children were in our future, or already have our baby names picked out - James if it’s a boy Violet if it’s a girl - having the decision whether or not to have children taken away from us, due to biological issues inside our bodies, can be devastating. When trying to have children, it can of course, become very frustrating when you aren’t getting pregnant. If you find this is the case, it is recommended that you go to the doctor after one year of failing to conceive. It’s always a good idea to get tested to really understand what is happening in your body. The main signs a woman may be infertile is if her menstrual cycles are too long (35 days or more) or are too short (21 days or less). When going for fertility tests, it is good to have an idea of what to expect. For women, samples of blood will most likely be tested to check for the presence of the hormone Progesterone. For men, a semen sample is obtained for analysis, checking its quality and quantity. Sitting in a waiting room waiting for the results of yet more testing takes its toll, and it’s easy to feel helpless as the image of the life you had planned drifts further out of reach. Luckily nowadays, these results don’t have to be so final as we finally have other options. (more…)
Author Interviews, COVID -19 Coronavirus, OBGYNE / 13.12.2020

MedicalResearch.com Interview with: Sheela Maru, MD, MPH Department of Health System Design and Global Health and Arnhold Institute for Global Health and Department of Obstetrics, Gynecology and Reproductive Science Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Universal screening for SARS-CoV-2 infection on Labor and Delivery (L&D) units is a critical strategy to manage patient and health worker safety, especially in a vulnerable high-prevalence community. We describe the results of a SARS-CoV-2 universal screening program at the L&D Unit at Elmhurst Hospital in Queens, NY, a 545-bed public hospital serving a diverse, largely immigrant and low-income patient population and an epicenter of the global pandemic. (more…)
Author Interviews, Columbia, JAMA, OBGYNE, Weight Research / 05.11.2020

MedicalResearch.com Interview with: Marisa N. Spann, PhD, MPH Columbia University Irving Medical Center New York, New York MedicalResearch.com: What is the background for this study? Response: Prior research has demonstrated that higher maternal pre-pregnancy body mass index is associated with adverse long-term outcomes for offspring including obesity, poorer cognitive and social abilities, and increased risk of psychiatric disorders.  MedicalResearch.com: What are the main findings? Response: In this study, we investigated the association of maternal pre-pregnancy body mass index with fetal growth and neonatal functional connectivity and found that maternal pre-pregnancy BMI has a significant positive correlation with fetal weight and with greater thalamic connectivity of the brain.  (more…)
Author Interviews, Fertility, OBGYNE / 30.09.2020

MedicalResearch.com Interview with: Dr. Liron Rozenkrantz Postdoctoral Fellow Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology Program in Placebo Studies, Harvard Medical School Former PhD student at Human Olfaction Research group, Department of Neurobiology Weizmann Institute of Science Reut Weissgross Research student Human Olfaction Research group, Department of Neurobiology Weizmann Institute of Science MedicalResearch.com: What is the background for this study? Response: A pregnancy loss is not such a rare event as you would think: it is estimated that about 50% of all conceptions (or 15% of the documented pregnancies) end in spontaneous miscarriage. About 1-2% of all couples trying to conceive will experience recurrent pregnancy loss (RPL), meaning 2-3 consecutive miscarriages, and despite going through numerous clinical investigations (hormonal tests, genetics and so) - about half of these cases will remain unexplained. This devastating phenomenon leaves couples with no explanation as to why they cannot bear a child. While most research in this field is focused on the reproductive organs (mainly the uterus), hormones and genes, we set out to look for new possible routes. The literature regarding the tight connection between olfaction and reproduction, mainly by social body-odors (or pheromones), is heavily documented, especially in rodents. Body-odors emitted from males affect pubertal development of juvenile female rodents and estrus cycle, and females body odors affect other females’ fertility state. The most robust phenomenon in this relation is the Bruce effect, in which pregnant female mice who are exposed to body-odors from a non-stud male - will experience impanation failure in 80% of exposures! Since there is growing evidence for the involvement of the olfactory system in human reproduction, we asked whether the olfactory system is also involved in human reproductive disorders such as unexplained recurrent pregnancy loss (uRPL). To answer this question, we recruited 40 women experiencing uRPL and 57 matched controls (who never experienced a miscarriage, and are at similar age to the uRPL women), and compared their olfactory profile, mainly in response to men’s body-odors. (more…)
Author Interviews, Cannabis, JAMA, OBGYNE, Pediatrics / 25.09.2020

MedicalResearch.com Interview with: Sarah E. Paul, BA , Graduate Student and Ryan Bogdan, PhD, Associate Professor BRAIN Lab Washington University in St. Louis St. Louis, MO 63130 MedicalResearch.com: What is the background for this study? Sarah Paul: This study was motivated by several trends in cannabis use, its legal landscape, and people's perception of risk. As more states legalize recreational cannabis use, cannabis has become more accessible as well as more potent. Over the past couple of decades, the percentage of adolescents and adults who think that cannabis use is risky or harmful has fallen substantially. Cannabis dispensaries have been reported to actually recommend cannabis to pregnant women for the treatment of pregnancy-related nausea. And finally, between 2002/2003 and 2016/2017, the percentage of women reporting cannabis use during their pregnancies rose 106%. Given these trends and the mixed literature regarding the potential consequences associated with prenatal cannabis exposure, we aimed to comprehensively examine a range of outcomes in a large, representative sample while accounting for a host of important potentially confounding covariates. (more…)
Author Interviews, Brigham & Women's - Harvard, Fertility, Technology / 16.09.2020

MedicalResearch.com Interview with: Hadi Shafiee, PhD Assistant Professor, Harvard Medical School Brigham and Women's Hospital Department of Medicine MedicalResearch.com: What is the background for this study? What are some of the characteristics that AI uses to identify blastocysts witha better chance of successful implantation?  Response: In-vitro fertilization (IVF), while a solution to many infertile couples is still extremely inefficient with a success rate of nearly 30% and is both mentally, physically, and economically taxing to patients. The IVF process involves the insemination of eggs and the culture of embryos externally in a fertility lab before transferring the developed embryo to the mother. A major challenge in the field is deciding on the embryos that need to be transferred during IVF, such that chances of a healthy birth are maximal and any complications for both mother and child are minimal. Currently, the tools available to embryologists when making such are extremely limited and expensive, and thus, most embryologists are required to make these life-altering decisions using only their observational skills and expertise. In such scenarios, their decision-making process is extremely subjective and tends to be variable. (more…)
Author Interviews, Coffee, OBGYNE / 25.08.2020

MedicalResearch.com Interview with: Professor Jack E. James, PhD Reykjavík University Reykjavík Iceland  MedicalResearch.com: What prompted this study?  Response: Chronic exposure to any chemical during pregnancy is cause for concern. There should be no exception simply because that chemical, caffeine, happens to be widely consumed. Caffeine is a habit-forming substance of no nutritional value. If anything, its widespread consumption suggests that it should be given special attention. Concern is heightened by what is known about the effects of caffeine on the human body, where it affects neural processes in the brain, including networks that control respiration and heart function. When consumed during pregnancy, caffeine readily crosses the placenta, exposing the fetus to the drug. Notably, the fetus is largely physically incapable of metabolising caffeine – that ability develops during the first year of life. Pregnancy studies have shown that caffeine can interfere with fetal heart function and oxygenation.  (more…)
Author Interviews, OBGYNE / 30.06.2020

MedicalResearch.com Interview with: Prof Roger Gadsby MBE Honorary Associate Clinical Professor Warwick Medical School University of Warwick MedicalResearch.com: What is the background for this study? Response: The term "morning sickness" is widely used to describe the nausea and vomiting symptoms that occur in pregnancy. Previous research has reported that symptoms can occur both before and after midday but little has been published describing the daily and weekly pattern of symptoms. MedicalResearch.com: What are the main findings? Response: Using a database of 256 women who kept daily symptom diaries from the onset of symptoms till around 7 weeks of pregnancy, the study modeled the daily symptom patterns and changes in daily patterns by week of pregnancy. Nausea occurred throughout the day. Vomiting had a defined peak in the morning, but can occur throughout the day (more…)
Allergies, Author Interviews, JAMA, OBGYNE / 05.06.2020

MedicalResearch.com Interview with: Niklas Andersson MS Department of Epidemiology Research Statens Serum Institut Copenhagen S, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Second-generation antihistamines are among the most commonly prescribed drug classes during pregnancy. Fexofenadine is a widely used antihistamine but given the limited fetal safety on the use of antihistamines during pregnancy in general, current clinical guidelines only recommend the use cetirizine and loratadine during pregnancy when needed due to a larger body of fetal safety data for these antihistamines. (more…)
Author Interviews, CMAJ, Endocrinology, OBGYNE / 02.06.2020

MedicalResearch.com Interview with: Lois Donovan MD FRCPC Clinical Professor Cumming School of Medicine Division on Endocrinology and Metabolism and Department of Obstetrics and Gynecology University of Calgary MedicalResearch.com: What is the background for this study? 1) We observed in our clinical practices that minor TSH elevations in early pregnancy frequently normalized without intervention. 2) Recent randomized control trials have failed to show benefit of treating women with levothyroxine with minor TSH elevations in pregnancy  (more…)
Author Interviews, OBGYNE, Pediatrics / 21.05.2020

MedicalResearch.com Interview with: Yanmin Zhu, M.S., Ph.D. Postdoctoral Research Fellow Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women's Hospital and Harvard Medical School  MedicalResearch.com: What is the background for this study? Response: Animal studies and case reports suggest a potential teratogenic effect associated with the use of high doses of fluconazole during pregnancy. The malformations reported in case reports have a distinct phenotype, including femoral bowing, thin ribs, cleft palate, and abnormal craniofacial ossification. A few controlled studies have examined the risk of congenital malformations associated with the use of fluconazole during the first trimester, but findings are inconsistent. (more…)
Anesthesiology, Author Interviews, COVID -19 Coronavirus, OBGYNE / 13.04.2020

MedicalResearch.com Interview with: Dr. Alicia Warlick, MD Anesthesiologist at UNC/Rex, American Anesthesiology Raleigh, North Carolina MedicalResearch.com: As a physician working on the frontlines of the COVID-19 battle, how are you addressing expecting mothers’ concerns about the disease and how it might impact their pregnancy? Response: While COVID-19 has disrupted nearly every aspect of healthcare, whether its virtual appointments or delayed surgeries; there are certain things that are inevitable – like childbirth. As this virus continues to take over the country and we learn more about it each day, pregnant women are facing new challenges and fears. For women approaching their due dates, questions about staying healthy, keeping their baby safe and limiting their risk of exposure while in the hospital are all leading to anxiety and stress. And while policies and guidelines are constantly changing, as physicians we need to remind our patients that we are there to alleviate their concerns, address their questions and remind them to not lose sight of the joy the comes with bringing a child into the world. It’s a scary time for everyone, but by working together and supporting one another, we will get through this. (more…)
Author Interviews, Diabetes, Kidney Disease, OBGYNE, Race/Ethnic Diversity / 30.03.2020

MedicalResearch.com Interview with: Silvi Shah, MD, MS, FACP, FNKF, FASN Assistant Professor Division of Nephrology University of Cincinnati Cincinnati, OH-45267 MedicalResearch.com: What is the background for this study? Response: The study identified 42,190,790 pregnancy related hospitalizations between Jan. 1, 2006 and Dec. 31, 2015, using data from the from the Nationwide Inpatient Sample. (more…)
Asthma, Author Interviews, Brigham & Women's - Harvard, NEJM, Pediatrics, Vitamin D / 10.02.2020

MedicalResearch.com Interview with: Augusto A. Litonjua, M.D., M.P.H. Professor - Department of Pediatrics, Pulmonology Interim Chief - Department of Medicine , Pulmonary Diseases and Critical Care Professor - Department of Medicine , Pulmonary Diseases and Critical Care University of Rochester MedicalResearch.com: What is the background for this study? Response: Vitamin D deficiency and insufficiency is prevalent worldwide. Prior observational studies have shown that low vitamin D levels have been associated with the development of asthma. Animal studies have reported that antenatal vitamin D is important for lung development in utero. Thus, we conducted a randomized, double-blind, controlled trial of vitamin D supplementation in pregnant women to see if we could prevent the development of asthma and wheezing illnesses in young children. The initial report of the trial results showed that children born to mothers in the vitamin D supplementation arm had lower risks for developing either asthma or recurrent wheezing episodes over the first 3 years, but this was not statistically significant (p=0.051)(Litonjua et al. JAMA 2016). (more…)
Author Interviews, Dermatology, HPV, Infections, JAMA, OBGYNE / 08.01.2020

MedicalResearch.com Interview with: Niklas Worm Andersson, MD Department of Clinical Pharmacology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen NV, Denmark MedicalResearch.com: What is the background for this study? What is Podophyllotoxin used for? Response: Podophyllotoxin is an antimitotic agent primarily used in the local treatment of anogenital warts, which are among the most prevalent sexually transmitted diseases worldwide. Most women affected by anogenital warts are of childbearing age and during pregnancy, they may become symptomatic, enlarge, or multiply. While podophyllotoxin is part of first-line treatment of anogenital warts for the non-pregnant population, it is contraindicated during pregnancy. Fetal safety data are limited and to our knowledge, no previous human data exist to help inform on this issue. (more…)
Author Interviews, Infections, OBGYNE / 04.12.2019

MedicalResearch.com Interview with: Giovanni Piedimonte, MD, FAAP, FCCP Vice President for Research Institutional Official Professor of Pediatrics Tulane University MedicalResearch.com: What is the background for this study? Response: We have been testing the hypothesis that, when a pregnant woman catches a common cold with a virus called respiratory syncytial virus (RSV), viral particles can spread from the mother’s respiratory tract to the unborn child via the placenta. Preliminary data in animal models suggest that this is possible, and might cause changes in lung growth predisposing the offspring to develop asthma after birth. Recently, also human data have supported this theory. However, an essential step to conclusively demonstrate vertical transmission of respiratory viruses was the confirmation that human placentas can be infected and allow the transmission of such germs, which is the main finding of this study. (more…)
Alcohol, Author Interviews, Heart Disease, Pediatrics / 06.10.2019

MedicalResearch.com Interview with: Dr Jiabi Qin, MD, PhD Xiangya School of Public Health Central South University Changsha, China  MedicalResearch.com: What is the background for this study? Response: Congenital heart defects (CHDs), defined as a gross structural abnormality of the heart or intrathoracic great vessels occurring in embryonic period and affected nearly 1% of lives births, is the most common of all congenital defects and remains a major cause of mortality and morbidity in fancy and childhood. With a worldwide prevalence of CHDs now estimated to be 1.35 million newborns with CHDs every year, the number of CHDs is steadily increasing, representing a major global health burden. The association between maternal alcohol exposure and the risk of congenital heart defects (CHDs) has been explored, but little is known about the association between paternal alcohol exposure and the risk of CHDs. Furthermore, subsequent studies regarding the association between alcohol exposure and the risk of congenital heart defects have not yield consistent results. Therefore, given the inconsistency of existing literatures and insufficient evidence of primary studies, further an update meta-analysis based on the new and previously is evidently required. Especially, to our knowledge, any meta-analysis between paternal alcohol exposure and the risk of CHDs have not been conducted.  (more…)
Author Interviews, Kidney Disease, OBGYNE / 02.10.2019

MedicalResearch.com Interview with: Silvi Shah, MD, MS, FACP, FASN| Assistant Professor Division of Nephrology, University of Cincinnati Cincinnati, OH-45267 MedicalResearch.com: What is the background for this study? Response: Our study uses data from the largest retrospective cohort of dialysis patients in the United States from the United States Renal Data System to determine pregnancy rates and factors associated with pregnancy in 47,555 women aged 15-44 years on dialysis. We identified 2,352 pregnancies with a rate of 17.8 pregnancies per 1000 person-years (PTPY) with the highest rate in women aged 20-24 years (40.9 PTPY). (more…)
Author Interviews, Infections, JAMA, OBGYNE, USPSTF / 01.10.2019

MedicalResearch.com Interview with: Melissa A. Simon, M.D., M.P.H. Member, U.S. Preventive Services Task Force George H. Gardner professor of clinical gynecology, Vice chair of clinical research Department of Obstetrics and Gynecology Professor of preventive medicine and medical social sciences Northwestern University Feinberg School of Medicine  MedicalResearch.com: What is the background for this study? Response: Asymptomatic bacteriuria, or ASB, is when someone has bacteria in their urine but does not have any signs or symptoms of a urinary tract infection. For pregnant people, this can be a major health concern resulting in severe, even life-threatening, infections that can lead to serious harms for both the mother and the baby. The Task Force’s primary finding in updating its recommendation on this topic was that screening for ASB continues to be beneficial in preventing complications and preserving the health of mothers and their babies during pregnancy.  (more…)
Author Interviews, Cannabis, Depression, OBGYNE / 08.08.2019

MedicalResearch.com Interview with: Jamie A. Seabrook, Ph.D. Associate Professor, School of Food and Nutritional Sciences Brescia University College at Western University Adjunct Research Professor, Dept of Paediatrics, Western University Adjunct Associate Professor, Dept of Epidemiology & Biostatistics, Western University Scientist, Children's Health Research Institute Scientist, Lawson Health Research Institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: Alcohol, tobacco, and cannabis are the most commonly used substances during pregnancy. High alcohol consumption has been linked with preterm birth, and tobacco and/or cannabis use is associated with low birth weight. Much of what we know about predictors of drug use during pregnancy comes from the United States and Australia, with limited studies in Canada. The objective of our study was therefore to assess the relative effects of socioeconomic, demographic, and mental health risk factors associated with drug use during pregnancy. Our retrospective cohort study consisted of 25,734 pregnant women from Southwestern Ontario. We found that maternal depression was the top risk factor associated with all three substances. Compared to women who were not depressed during their pregnancy, women who were depressed were 2.2 times more likely to use alcohol (95% CI: 1.6, 2.9), 1.7 times more likely to smoke tobacco (95% CI: 1.5, 2.0), and 2.6 times more likely to use cannabis (95% CI: 2.0, 3.4). (more…)
Author Interviews, Education, Gender Differences, JAMA, Surgical Research / 07.08.2019

MedicalResearch.com Interview with: Maria S. Altieri, MD, MS Invasive Surgery Stony Brook, NY MedicalResearch.com: What is the background for this study? What are the main findings? Response: For majority of residents, training years coincide with prime child bearing years.  Historically, surgical residency has not been conducive for having children, as it is one of the most demanding experiences, requiring long hours, high stress levels, and the acquisition of clinical and technical skills over a short period of time. However, with recent trends towards a more favorable work-life balance and the 80-hour work week, more male and female residents are having children or considering having children during training.  Thus, the topic of parental leave during residency is becoming more fundamental.  However, there is little research on the attitudes of residents towards their pregnant peers and parental leave. We wanted to examine the perceptions of surgical trainees towards parental leave and pregnancy during residency.  Through understanding the perceptions of current residents, obstacles could be identified which could lead to potential changes in policies that could help to normalize parenthood and parental leave during surgical training.    (more…)
Author Interviews, Hepatitis - Liver Disease, JAMA, OBGYNE, USPSTF / 24.07.2019

MedicalResearch.com Interview with: Melissa Simon, M.D., M.P.H.  George H. Gardner Professor of Clinical Gynecology Vice Chair of Clinical Research, Department of Obstetrics and Gynecology Professor of Preventive Medicine and Medical Social Sciences Northwestern University Feinberg School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: Hepatitis B is a viral infection of the liver caused by the hepatitis B virus, or HBV. HBV causes liver disease, which can be either a mild, short-term illness, or a serious, lifelong issue. The U.S. Preventive Services Task Force has reaffirmed its 2009 recommendation that clinicians screen all pregnant people for HBV at their first prenatal visit. This is an A recommendation. (more…)
Author Interviews, JAMA, Johns Hopkins, OBGYNE, Race/Ethnic Diversity / 20.07.2019

MedicalResearch.com Interview with: Alison Gemmill, PhD Assistant Professor Johns Hopkins Bloomberg School of Public Health  MedicalResearch.com: What is the background for this study? What are the main findings? Response: A growing body of evidence suggests that the circumstances surrounding the 2016 presidential election may have had a uniquely negative impact on the health of U.S. Latino population. Few studies, however, have evaluated the population health implications of the election for Latina mothers and their children. We used national data and methods that control for temporal patterning to test the hypothesis that preterm birth rose above otherwise expected levels among Latina women in the U.S. following the election of Donald Trump. We find that the number of preterm births among Latina women increased above expected levels following the election. Specifically, we find 3.5 percent more preterm births among Latinas than projected for nine months following election. (more…)
Annals Internal Medicine, Author Interviews, OBGYNE, Rheumatology / 17.07.2019

MedicalResearch.com Interview with: Bella Mehta, MBBS, MS Assistant Attending Physician, Hospital for Special Surgery Instructor, Weill Cornell Medical College MedicalResearch.com: What is the background for this study? What are the main findings? Response: For women with lupus, pregnancy has long been considered high-risk and associated with both medical and obstetric complications. In the 1960s and 1970s, pregnancy was thought to be contraindicated in lupus patients. Beginning in the 1980s, and especially in the 1990s, many studies identified specific risk factors for pregnancy complications and proposed best-practice management guidelines. We wished to see whether these advances improved pregnancy outcomes for lupus patients. Our study showed a decline in maternal mortality and other outcomes in lupus patients. The improvement in pregnancy outcomes was observed more so in lupus patients than those without lupus.  (more…)