About

Ghada Bourjeily, MD, is a professor of medicine at Brown University and serves as the director of women's research at Lifespan, the women's medicine collaborative. Her clinical expertise is in pulmonary disease and pregnancy, with a research focus on understanding sleep disordered breathing in pregnant women, its impact on cardiovascular and metabolic outcomes of pregnancy, and its fetal and neonatal implications. Dr. Bourjeily's work has advanced the field of pulmonary disease and sleep in pregnancy, and she has held leadership roles in numerous national and international societies, receiving multiple research and leadership awards. Her research areas include end-stage renal disease, fetal and obstetric outcomes, sleep apnea, and women's health, contributing significantly to the understanding of sleep-related disorders and pulmonary conditions in pregnant women.

Research topics

• Medicine
• Internal medicine
• Pediatrics
• Obstetrics
• Environmental health
• Endocrinology
• Psychiatry
• Intensive care medicine

Selected publications

• The Persona Paradox: Medical Personas as Behavioral Priors in Clinical Language Models

  ArXiv.org · 2026-01-08

  articleOpen access

  Persona conditioning can be viewed as a behavioral prior for large language models (LLMs) and is often assumed to confer expertise and improve safety in a monotonic manner. However, its effects on high-stakes clinical decision-making remain poorly characterized. We systematically evaluate persona-based control in clinical LLMs, examining how professional roles (e.g., Emergency Department physician, nurse) and interaction styles (bold vs.\ cautious) influence behavior across models and medical tasks. We assess performance on clinical triage and patient-safety tasks using multidimensional evaluations that capture task accuracy, calibration, and safety-relevant risk behavior. We find systematic, context-dependent, and non-monotonic effects: Medical personas improve performance in critical care tasks, yielding gains of up to $\sim+20\%$ in accuracy and calibration, but degrade performance in primary-care settings by comparable margins. Interaction style modulates risk propensity and sensitivity, but it's highly model-dependent. While aggregated LLM-judge rankings favor medical over non-medical personas in safety-critical cases, we found that human clinicians show moderate agreement on safety compliance (average Cohen's $κ= 0.43$) but indicate a low confidence in 95.9\% of their responses on reasoning quality. Our work shows that personas function as behavioral priors that introduce context-dependent trade-offs rather than guarantees of safety or expertise. The code is available at https://github.com/rsinghlab/Persona\_Paradox.

  PublisherOA PDF

• The Persona Paradox: Medical Personas as Behavioral Priors in Clinical Language Models

  arXiv (Cornell University) · 2026-01-08

  preprintOpen access

  Persona conditioning can be viewed as a behavioral prior for large language models (LLMs) and is often assumed to confer expertise and improve safety in a monotonic manner. However, its effects on high-stakes clinical decision-making remain poorly characterized. We systematically evaluate persona-based control in clinical LLMs, examining how professional roles (e.g., Emergency Department physician, nurse) and interaction styles (bold vs.\ cautious) influence behavior across models and medical tasks. We assess performance on clinical triage and patient-safety tasks using multidimensional evaluations that capture task accuracy, calibration, and safety-relevant risk behavior. We find systematic, context-dependent, and non-monotonic effects: Medical personas improve performance in critical care tasks, yielding gains of up to $\sim+20\%$ in accuracy and calibration, but degrade performance in primary-care settings by comparable margins. Interaction style modulates risk propensity and sensitivity, but it's highly model-dependent. While aggregated LLM-judge rankings favor medical over non-medical personas in safety-critical cases, we found that human clinicians show moderate agreement on safety compliance (average Cohen's $κ= 0.43$) but indicate a low confidence in 95.9\% of their responses on reasoning quality. Our work shows that personas function as behavioral priors that introduce context-dependent trade-offs rather than guarantees of safety or expertise. The code is available at https://github.com/rsinghlab/Persona\_Paradox.

  PublisherDOI

• Effectiveness of nonpharmacological sleep interventions in pregnancy: a systematic review and meta-analysis

  Journal of Clinical Sleep Medicine · 2025-04-01 · 1 citations

  review
  PublisherDOI

• Obstructive sleep apnea in pregnancy: emerging insights into maternal and fetal outcomes

  Current Opinion in Pulmonary Medicine · 2025-09-03 · 1 citations

  articleSenior authorCorresponding

  PURPOSE OF REVIEW: Sleep disordered breathing (SDB) encompasses a spectrum of disorders ranging from snoring to complete upper airway collapse and cessation of respiration leading to oxygen desaturation and sleep fragmentation. SDB is highly prevalent in the pregnant population, particularly predisposed to SDB because of physiological changes such as hormonal changes, changes to body habitus, and respiratory mechanics due to the gravid uterus. RECENT FINDINGS: The disorder has been associated with adverse maternal outcomes in pregnancy such as gestational hypertension, preeclampsia, impaired glucose metabolism, severe maternal cardiovascular morbidity, and long-term morbidity, as well as maternal mental health conditions with potential societal consequences. There is also mounting evidence on the impact of SDB with regards to the fetal and neonatal outcomes, including preterm birth, altered growth trajectories, and congenital anomalies, as well as evidence of epigenetic changes in the offspring exposed to disordered breathing during sleep. SUMMARY: This review focuses on SDB in pregnancy and recent data demonstrating its impact on maternal morbidity and fetal and neonatal outcomes, and recent guidelines and data on treatment modalities and their impact on pregnancy health.

  PublisherDOI

• Interoception and eating behavior in participants at risk for hypertensive disorders of pregnancy

  Journal of Complementary and Integrative Medicine · 2025-12-17

  articleOpen access

  OBJECTIVES: Disordered eating during pregnancy can impact maternal and fetal health. Disordered eating has been linked to higher cardiovascular risks including hypertensive disorders of pregnancy (HDP). Interoceptive awareness, the ability to perceive and respond to bodily sensations, is reduced among people with disordered eating and may be associated with blood pressure (BP). This study tested these associations in pregnant women at risk for HDP. METHODS: Ninety-five pregnant women at risk for HDP participated in the study. At ∼18 weeks' gestation we measured 24-hour BP, interoceptive awareness, and disordered eating. Linear regression analyses were used to test associations, adjusting for covariates (BMI, education, income, race). RESULTS: Greater interoceptive awareness-specifically lower anxiety about bodily sensations ("Not Worrying")-was significantly associated with lower daytime diastolic BP (B=-0.21, p=0.05), lower uncontrolled eating (B=-0.52, p<0.001), and lower emotional eating (B=-0.51, p<0.001). Higher scores on the "Not Worrying" subscale were associated with less uncontrolled eating (B=-0.52, p<0.001) and less Emotional Eating (B=-0.51, p<0.001). Higher scores on the "Attention Regulation" subscale were associated with less uncontrolled eating (B=-0.24, p=0.02) and less emotional eating (B=-0.25, p=0.02). Cognitive Restraint was associated with higher nighttime diastolic BP (B=0.27, p=0.04) but not interoceptive awareness. CONCLUSIONS: Increased interoceptive awareness was associated with both healthier eating behaviors and lower BP in pregnant women at risk for HDP. Interventions that enhance interoceptive awareness may offer a promising strategy for reducing risk for cardiovascular complications in pregnancy.

  PublisherDOI

• Relational Concerns and Continuous Positive Airway Pressure (CPAP) Adherence in Pregnant and Not-Pregnant Reproductive Age Females

  American Journal of Respiratory and Critical Care Medicine · 2025-05-01

  articleSenior author

  Abstract Rationale Obstructive sleep apnea (OSA) is associated with many adverse health outcomes in the general population. In the pregnant population, untreated OSA is associated with increased maternal (hypertensive disorders of pregnancy, gestational diabetes, cardiovascular) and fetal (preterm birth) morbidity. Treatment of OSA with continuous positive airway pressure (CPAP) addresses OSA symptoms and may mitigate negative health outcomes secondary to OSA. However, treatment may impose additional relational concerns. As adherence to CPAP is critical to mitigating outcomes of the disorder, it is crucial to understand and provide solutions to barriers to care. We aimed to explore how CPAP serves as a facilitator or barrier to care with regards to relational concerns in pregnant and non-pregnant reproductive age women diagnosed with OSA. Methods Pregnant and non-pregnant women of reproductive age newly diagnosed with OSA were interviewed using a semi-structured qualitative interview guide. Interviews were conducted 4-8 weeks following CPAP initiation to allow for acclimation to therapy. Recordings of 60-90-minute interviews were transcribed, deidentified, and double coded using a combined deductive and inductive structure. Codes include participant perceptions of OSA, participant experiences of treatment process and healthcare, experiences interacting with CPAP equipment, and barriers and facilitators to adherence to therapy. Data were summarized using a framework matrix to explicate barriers and facilitators to CPAP use. Results Twenty-one women (n=21) with OSA participated in the study; 11 were pregnant; 8 were Black or Latina. Analysis revealed several themes regarding CPAP as a barrier to relational concerns: (1) self-perception of one's appearance or their partner's opinion of their appearance, (2) equipment logistics, and (3) partner's discomfort with CPAP, as well as CPAP as a facilitator: (1) partners’ support of patient's health, and (2) patients’ motivation to treat OSA to benefit their partners. Pregnant individuals faced additional barriers due to the discomfort of pregnancy. Pregnant individuals’ motivation to use CPAP included assuring their baby's wellbeing. Untreated OSA also negatively impacts relationships through exhaustion and snoring, forcing partners to leave the bed. Conclusions Relational concerns can be a barrier to CPAP adherence, increasing risk of an untreated or under-treated condition. Pregnancy can compound the toll, placing pregnant individuals at higher risk for nonadherence to CPAP. Behavioral interventions focused on reshaping perceptions, and potential positive impact of CPAP on relationships may be offered and would need to be tested in addressing such barriers to CPAP adherence.

  PublisherDOI

• Impact of Asthma and Obstructive Sleep Apnea on Central Airways Resistance During Pregnancy

  Lung · 2025-06-03 · 2 citations

  articleSenior author
  PublisherDOI

• Psychological mechanisms of prenatal mindfulness training on antenatal blood pressure reduction: A pilot study

  Journal of Psychosomatic Research · 2025-06-06

  article
  PublisherDOI

• Sleep is an opportunity to reduce pregnancy-related severe morbidity and mortality

  Obstetric Medicine · 2025-11-24 · 1 citations

  articleOpen access1st authorCorresponding

  Maternal mortality and severe maternal morbidity have been on an upward trend over the past couple of decades in the USA, contrasting other developed countries. Sleep disturbances are common during pregnancy and vary by group demographics, similarly to severe maternal morbidity. This narrative review focuses on highlighting the association between sleep and sleep impairment with severe maternal morbidity and mortality, as well as with adverse perinatal outcomes, making sleep disturbances a potentially modifiable risk factor for maternal morbidity and mortality. The review will also discuss some sleep interventions that are non-pharmacological and that may hold the prospect for reducing the risk of perinatal outcomes associated with severe maternal morbidity and mortality, without increasing the risk of teratogenicity. We also discuss knowledge gaps and potential focus of future research from testing the impact of sleep modification on pregnancy outcomes to the identification of sleep disturbances and disorders in perinatal care.

  PublisherOA PDFDOI

• Diagnosing Pulmonary Embolism During Pregnancy

  CHEST Journal · 2025-05-20 · 3 citations

  reviewOpen access
  PublisherOA PDFDOI

Recent grants

• Predictors of de novo development of obstructive sleep apnea in pregnancy

  NIH · $2.6M · 2016–2022

• Placental role in mediating adverse outcomes in obstructive sleep apnea

  NIH · $2.7M · 2014–2020

Frequent coauthors

• Margaret H. Bublitz

  Providence College

  249 shared

• Laura Sanapo

  Brown University

  155 shared

• Geralyn Lambert‐Messerlian

  Brown University

  74 shared

• Richard P. Millman

  Providence College

  58 shared

• Christina Raker

  Rhode Island Hospital

  57 shared

• Margaret A. Miller

  53 shared

• Susan Martin

  Hospital de Poniente

  47 shared

• Elena Salmoirago‐Blotcher

  Providence College

  46 shared

Education

• M.D.

  Brown University