Reproductive issues in women with systemic lupus erythematosus: should we be afraid of the Big Bad Wolf?
Bibliographic record
Abstract
Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder, which can affect almost any organ system and may even be life-threatening. SLE predominantly affects women during their reproductive years, with a prevalence of approximately 1.5/1000 in women of 18-44 years, and is associated with significant morbidity during pregnancy. Many women with SLE ask if the disease will impair their capacity to have children and affect the long-term health of their offspring. Studies assessing these issues are scant and limited by methodological considerations. The first two manuscripts in this thesis present relevant literature reviews.The objectives of this doctoral research were to fill this knowledge deficit by first assessing live births in women with SLE. We conducted two studies estimating live birth rates in women with SLE using standardized incidence ratios (SIR) with general population rates as a reference. Both studies had very different study populations: one relied on an international inception cohort of women with SLE (manuscript #3), the other on an SLE cohort derived from Quebec's administrative databases (manuscript #4). This allowed us to investigate different aspects and predictors of live birth rates in women with SLE. Then, to answer the second research question, we determined if maternal SLE influences the long-term health of the offspring. To do so, we performed two studies within a large population-based cohort of children born to SLE women, the "Offspring of SLE mothers Registry (OSLER)", which we specifically created for this thesis research. These studies respectively evaluated the risk of congenital heart defects (manuscript #5) and autism spectrum disorders (manuscripts #6) in SLE offspring compared to children from the general population.This doctoral research provides novel and much-needed information, which will help physicians provide adequate counseling to women with SLE contemplating pregnancy. We conclude this thesis by discussing potential future directions of additional studies on reproduction in women with SLE and health outcomes in their offspring.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.033 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.005 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".