The WSMC was a first of its kind focused on women and sports medicine and was co-founded in 1997 by primary sports medicine physician Lisa R. Callahan, MD, and sports medicine surgeon Jo A. Hannafin, MD, PhD, who served as co-directors ever since. The multidisciplinary center now consists of a team of sports medicine-trained clinicians including physicians, nutritionists, exercise physiologists, physical therapists and sports psychologists.

 The change in leadership comes as Dr. Hannafin has recently retired her clinical practice while continuing to be active in the WSMC and as vice chair of the Institutional Review Board at HSS, which is responsible for the evaluation of current and newly submitted research projects. As a practicing physician, Dr. Callahan will also continue to be actively involved in the WSMC while serving in her role as chief medical officer of Madison Square Garden Sports.

 “The WSMC is a key reason why I feel excited to go to work each day. I am constantly inspired by my colleagues and the patient care that they provide, which motivates me to take the very best care of my own patients,” said Dr. Goolsby.

 Approximately 80,000 recreational and elite athletic patients a year receive collaborative care through the WSMC. Every clinician aims to empower each patient to achieve success based on his or her individual goals.

 “Being part of the WSMC has helped me in all facets of life. It’s been invaluable for my career, provided spectacular comradery, and guided me to find a work/life balance,” said Dr. Shubin Stein, who noted how Drs. Callahan’s and Hannafin’s successes have opened so many doors for all women. “They have helped us all to dream big.” 

 Drs. Callahan and Hannafin have led distinguished careers and have served as team physicians for numerous professional and Olympic teams. Notably, Dr. Callahan was the first female head team physician in the National Basketball Association and president of the NBA Physicians Association. Dr. Hannafin was the first female president of the American Orthopaedic Society for Sports Medicine (AOSSM).

“We want to ensure we carry on the legacy and support all of the work that Drs. Callahan and Hannafin have done as true pioneers in our field,” added Dr. Goolsby, who explained that she and Dr. Shubin Stein have spent time individually with all members to determine new, impactful goals for the group.

 WSMC clinicians have provided care for numerous Olympic and professional teams and organizations including the New York Knicks, Westchester Knicks, New York Liberty, TCS New York City Marathon, Champions Series Tennis, USA Basketball, USA Gymnastics, UFC, US Biathlon, US Rowing and US Lacrosse.

 “First and foremost, our priority is patient care. We strive to take care of the whole person, not just their knee or stress fracture. Our biggest advantage is that we have experts across many disciplines who can help keep our patients active through all phases of life,” said Dr. Shubin Stein.

 “I am incredibly proud of the fantastic physicians and surgeons we have recruited over the years as well as the outstanding specialists in physical therapy and sports performance, sports psychology and sports nutrition,” said Dr. Hannafin. “We place a large emphasis on developing and training the next generation of female leaders in sports medicine, so it is truly humbling to see so many of them as team physicians for professional, national and Olympic sports teams.”

 Mentorship formally occurs by training residents and fellows within the HSS Sports Medicine Institute as well as the WSMC summer internship and research assistant programs. Launched in 2000, the summer internship program is highly competitive, with more than 150 applicants each year for three spots.

 Of the more than 200 women mentored by members of the WSMC, 80 percent have pursued a career in medicine, physical therapy, psychology or nutrition. Five women have started sports medicine programs while others have joined the faculty at existing women’s sports medicine programs, fulfilling the critical need to expand expert care to active girls and women everywhere.

“I’m proud of the integrated legacy of care, education and research that has formed a strong foundation for the future of the WSMC,” said Dr. Callahan, who oversees the care of the New York Knicks, New York Rangers, Westchester Knicks and Hartford Wolf Pack. “Drs. Goolsby and Shubin Stein have the experience, knowledge and compassion to lead the next phase of growth and advancement. I look forward to their future accomplishments.”

Current research within the WSMC focuses on a variety of issues that impact women athletes, such as the female athlete triad, anterior cruciate ligament (ACL) injuries, vitamin D and bone health, patellofemoral disorders, frozen shoulder, postpartum care and more.

 According to Dr. Hannafin, there is a need for continued research into gender- and sex-specific issues in injury prevention, sports-specific injuries and response to treatment. Through this research, the WSMC can continue to optimize patient care with specialized treatment for each individual patient.

 “The center’s impact on the national landscape of women’s sports medicine is immeasurable. Their selective and immersive summer internships alone work to shape the future for women in the field,” said Andrew D. Pearle, MD, chief of the HSS Sports Medicine Institute. “We are proud to have them as part of our team.”

“The results may provide some reassurance to physicians who are taking care of women with rheumatic diseases who become pregnant or who are contemplating pregnancy during the pandemic, because there does not seem to be an increased risk of COVID-19, but the findings need to be interpreted with caution given that in other national datasets including the Centers for Disease Control and Prevention data, pregnant patients who get COVID-19 have been shown to have potentially more severe outcomes,” said lead study author Medha Barbhaiya, MD, MPH, rheumatologist at HSS and assistant professor of medicine and healthcare policy & research, Weill Cornell Medicine.

For their study, Dr. Barbhaiya and her colleagues emailed an online COVID-19 survey to 26,045 patients in the Division of Rheumatology at HSS. 7,094 responded with 1,547 in the targeted population of women age 18 to 50. 4% reported pregnancy.

The prevalence of self-reported COVID-19 was similar in pregnant and non-pregnant women (8% vs. 9% respectively; P=0.76). Among women with COVID-19, pregnant women had a shorter duration of symptoms (P<0.01) and were more likely to experience loss of smell or taste (P=0.02) than non-pregnant women. A systemic rheumatic disease was present in approximately three-fourths of women, with no differences when stratified by pregnancy or COVID-19 status. While 67% of pregnant women reported changes to prenatal care during the pandemic, 23% of postpartum women stated the pandemic affected delivery.

“These findings are novel and should be investigated in other cohorts. Future studies will hopefully assess the long-term outcomes of rheumatology patients and their offspring who were exposed to COVID-19 during pregnancy, which our cross-sectional study could not address,” said Dr. Barbhaiya.

“Why pregnant patients are more likely to present with these symptoms warrants further study. This unique finding may help us better understand the immunology of both conditions,” said senior study author Lisa A. Mandl, MD, MPH, rheumatologist at HSS and assistant professor of medicine and healthcare policy & research, Weill Cornell Medicine. “These data also suggest that testing for COVID-19 in otherwise well pregnant women who lose their sense of taste or smell may help in the timely identification of COVID-19 in these vulnerable patients.”

“The biggest take-home message from this study is that more lupus patients are attempting pregnancy, most of the physicians are not recommending against it, and women are having successful deliveries,” said lead study author Bella Mehta, MBBS, MS, an assistant attending physician at Hospital for Special Surgery and an instructor in clinical medicine at Weill Cornell Medicine, in New York City.

SLE is a systemic autoimmune disease, which affects 241 per 100,000 people in North America; it is predominantly diagnosed in women of childbearing age. Years ago, women with SLE were advised to avoid having children due to high rates of complications, including pre-eclampsia and eclampsia. In more recent years, studies have shown that pregnancy in women with SLE carries a higher maternal and fetal risk than does pregnancy in healthy women, but this is improving. Between 1960 and 2003, rates of miscarriages and other pregnancy loss decreased from 40 percent to 17 percent in women with lupus. In the last two decades, a new understanding of the pathophysiology of SLE, new medications, and guidelines for risk assessment and management of patients with lupus have improved outcomes in patients, but just how this has impacted pregnancy in these women was unclear.

To shed light on this issue, researchers from HSS, the Icahn School of Medicine at Mount Sinai, Weill Cornell Medicine and New York-Presbyterian/Weill Cornell Medical Center, all in New York City, turned to the National Inpatient Sample (NIS) database. The NIS contains discharge data from approximately 20 percent of all community hospitals in the United States. It is the largest all-payer inpatient database in the United States focusing on adult pregnant hospitalized women with and without SLE. Using this database, the investigators examined data for all pregnant women from 1998 through 2015, focusing on in-hospital maternal mortality, fetal mortality, preeclampsia/eclampsia, c-section, non-delivery related admission, and length of stay.

Among the findings, the researchers identified a dramatic decline in in-hospital mortality in SLE patients, 442 per 100,000 admissions for the years between 1998 and 2000 compared with <50 per 100,000 admissions for the years between 2013 and 2015. In-hospital mortality also declined for patients without lupus during the same time period, but not as dramatically, from 13 to 10 per 100,000 admissions. In other words, the increased risk for in-hospital mortality for patients with lupus fell from 34 times higher for the period between 1998 and 2000 to only 2.5-5 times higher for the period between 2013 and 2015. A decline in fetal mortality was also noted in patients with lupus and was larger than in patients without lupus, but the difference was not statistically significant.

“For lupus patients who are young and who are thinking of pregnancies, they should know that many other patients with lupus over the past two decades have successfully become pregnant and delivered, and mortality is minimal,” said Dr. Mehta. “This is encouraging for young women with lupus. If they decide to have children, they can. In the 1980s, there were clinicians who advised young women with lupus not to get pregnant because they were so worried about mortality. What this study proves is this is no longer applicable.”

Other findings from the study showed that preeclampsia/eclampsia rates decreased in patients with lupus during the two periods studied, from 9.5 percent to 9.1 percent, and increased in patients without lupus, from 3.3 percent to 4.1 percent. Hospital length of stay declined in lupus pregnancies, from a mean of 4.3 days to 3.8 days, but increased in non-lupus-pregnancies, from a mean of 2.5 to 2.7 days.

The percentage of lupus patients increased significantly from 0.9 percent to 0.16 percent in all pregnancy-related admissions and from 0.08 percent to 0.14 percent in delivery-related admissions. The researchers believe that as care for lupus has improved, more patients with the disease have attempted and succeeded in having healthy pregnancies.

Improved outcomes have likely been the product of better diagnosis and referral of patients with mild disease to rheumatologists, counseling of patients to attempt pregnancy when disease is quiescent, and improved therapies for lupus and lupus-associated pregnancy complications. Other factors improving outcomes include continuation of hydroxychloroquine throughout pregnancy and use of low dose aspirin and heparin for patients with antiphospholipid syndrome (APS), a condition that is common in lupus patients and associated with miscarriages and fetal loss.

“Lupus is a disease that largely affects women and most particularly women of color,” said senior author Dr. Said Ibrahim, chief of the Division of Healthcare Delivery Service and Innovation, senior associate dean for diversity and inclusion and professor of healthcare policy and research at Weill Cornell Medicine. “While our study couldn’t thoroughly examine race and income disparities in lupus pregnancy outcomes, the findings support the concept that improving quality of care for all patients is one way to address inequities in healthcare. It is a hopeful message.”

“Besides mortality, complications that clinicians worry about in women with lupus, such as preeclampsia, have also decreased in the past two decades. The times are changing,” said Dr. Mehta. “I think physicians should be aware of this, so they can advise patients and give them the right sort of guidance. It is okay for women with lupus to get pregnant, as long as they are under the care of a rheumatologist and high risk obstetrics.”

Within HSS, the Lupus and Antiphospholipid Center of Excellence provides individualized, state of the art care, support and education to patients with lupus and APS, including pregnant women with the disease. The Center centralizes patient care and research with the goal of improving the quality of life for all lupus and APS patients.

At the core of the initiative, Karen M. Sutton, MD, sports medicine surgeon at HSS, credits her passion and dedication to helping others reach their fullest potential, as part of her daily motivation to keeping the female athletes, colleagues, and role models she works with on a regular basis empowered.  

Read the full article at InsideLacrosse.com.