Biography

PhD (Epidemiology and Biostatistics) – University of British Columbia

MSc (Epidemiology) – State University of New York, NY, USA

MD – Palacky University, Olomouc, Czech Republic

Publications

Lisonkova S, Sabr Y, Mayer C, Young C, Skoll A, Joseph KS. Maternal morbidity associated with early-onset and late-onset preeclampsia. Obstettrics and Gynecology.  Obstetrics and Gynecology 2014; DOI: 10.1097/AOG.0000000000000472.

 

Lisonkova S, Joseph KS. Incidence of pre-eclampsia: risk factors and outcomes associated with early- versus late-onset disease. American Journal of Obstetrics and Gynaecology 2013; 209(6):544.e1-544.e12.

Lisonkova S, Sabr Y, Butler B, Joseph KS. International comparisons of preterm birth rates: higher rates of late preterm birth are associated with lower rates of stillbirth and neonatal death. British Journal of Obstetrics and Gynaecology 2012; 119(13): 1630-9.

Lisonkova S, Sabr Y, Joseph KS. Diagnosis of subclinical amniotic fluid infection prior to rescue cerclage using Gram stain and glucose tests: an individual patient meta-analysis. Journal of the Obstetrics and Gynaecology Canada 2014;36(2):116-122.

Lisonkova S, Joseph KS, Bell R, Glinianaia S. Older maternal age and improved perinatal outcomes among twins: does chorionicity explain the paradox? Annals of Epidemiology 2013; 23(7):428-34.

Lisonkova S, Paré E, Joseph KS. Does advanced maternal age confer a survival advantage to infants born at early gestation? BMC Pregnancy and Childbirth 2013, doi:10.1186/1471-2393-13-87.

Grants

Co-investigator: Etiology of dyspareunia in endometriosis. CIHR Operating Grant – Reproductive and Child Heath (start-up grants). 

Projects

Studies on preeclampsia

Two of my recent studies have documented the incidence of preeclampsia across pregnancy and highlighted differences between early- and late-onset preeclampsia in terms of risk factors and fetal/infant and maternal adverse outcomes. I also proposed a plausible explanation for the intriguing inverse association between smoking and preeclampsia. I plan to further examine the methodological issue of competing risks in observational studies of pregnancy outcomes.

International comparisons of preterm birth rates and effects on perinatal mortality

Although preterm birth is the most important perinatal challenge facing industrialized countries, recent increases in iatrogenic preterm birth have made this a complex index, affected not only by overall perinatal health but also by the level of obstetric care/intervention. I and my colleagues showed that preterm births rates >= 32 weeks in industrialized countries are inversely associated with stillbirth rates and neonatal death rates >=32 weeks. I have proposed further research on determinants of different types of preterm birth, and the effect of iatrogenic delivery on maternal, fetal and infant health.

Population-based study of fertility drug use

Fertility drug treatments are more prevalent than other assisted reproductive techniques (e.g., in vitro fertilization) in many jurisdictions, and may have a larger effect on the rate of multiple pregnancies than other ART. Nevertheless, population-level information on fertility drug use is virtually non-existent in North America. My study showed that approximately 3 per 1000 women in British Columbia use the fertility drug clomiphene citrate, and that new treatment initiation increased between 2000 and 2008 among older women. In my next study on this issue I propose to examine the effect of fertility drug use on population rates of multiple pregnancy, preterm birth and adverse perinatal outcomes, and long-term effects of clomiphene citrate on women’s health.

Maternal mortality surveillance

Until recently, rates of maternal mortality in Canada were estimated annually based on Vital Statistics data. However, these estimates represented serious underestimates of true maternal mortality. I collaborated on this issue with the Public Health Agency of Canada and proposed an original and innovative method for ascertaining maternal death rates using hospitalization data from the Canadian Institute for Health Information. This method is more timely and more accurate than the previous Vital Statistics based estimation for determining rates and trends in maternal mortality. This research changed the Public Health Agency of Canada’s strategy for maternal mortality surveillance (see http://www.phac-aspc.gc.ca/rhs-ssg/maternal-maternelle/mortality-mortalite/index-eng.php#Ref). Although issues related to maternal mortality are critical, there are sound epidemiologic arguments for focusing population health research in Canada on severe maternal morbidity. These arguments include the paucity of maternal deaths and the heterogeneity in the causes of death. My future research will therefore focus on studying severe maternal morbidity and life-threatening pregnancy complications.