• Lisonkova, Sarka

    Titles

    Investigator, BC Children's Hospital
    Assistant Professor, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, University of British Columbia

    Degrees / Designations
    MD, PhD
    Primary Area of Research
    Healthy Starts
    Secondary Area(s) of Research
    Phone
    604-875-2000 ext. 4793
    Fax
    604-875-2725
    Lab Phone
    604-875-2000 ext. 4793
    Mailing Address
    BC Children's Hospital
    Room C403
    4480 Oak Street

    Vancouver, BC, V6H 3V4, Canada

    Affiliate Websites
    Research Areas
    Perinatal Epidemiology
    Summary
    My research interest is in perinatal epidemiology, including pregnancy complications, fetal and neonatal outcomes and maternal morbidity. My recent and current research projects have used epidemiological methods to examine the risk factors and consequences of early- and late-onset preeclampsia on fetal and infant outcomes, and trends in maternal mortality in Canada. Other areas of research interest include the effects of older maternal age on pregnancy outcomes, assisted reproduction, preterm birth, and neonatal mortality and morbidity. I am particularly interested in using perinatal databases to address problem of health status and health care. 

    My goal is to advance the scientific knowledge-base related to the etiology of pregnancy complications, preterm birth, and severe maternal morbidity, and to improve maternal and child health in British Columbia, Canada and elsewhere.
    Current Projects
    Severe maternal morbidity

    To view the analysis plan, click here.

    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.

    Selected 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.

    Lisonkova S, Hutcheon JA, Joseph KS. Sudden Infant Death Syndromme: a re-examination of temporal trends. BMC Pregnancy and Childbirth 2012;12:59.

    Lisonkova S, Joseph KS. Temporal trends in clomiphene citrate use: a population-based study. Fertility Sterility 2012; 97(3):639-44

    Lisonkova S, Bartholomew S, Rouleau J, Liu S, Liston RM, Joseph KS. Temporal trends in maternal mortality in Canada I: estimates based on Vital Statistics. Journal of Obstetrics and Gynaecology Canada 2011; 33(10): 1011-1019. 

    Lisonkova S, Liu S, Bartholomew S, Liston RM, Joseph KS. Temporal trends in maternal mortality in Canada II: estimates based on hospitalization data. Journal of Obstetrics and Gynaecology Canada 2011; 33(10):1020-1030.     

    Lisonkova S, Mehrabadi A, Allen VM, Bujold E, Crane JM, Gaudet L, Gratton RJ7, Ladhani NN, Olatunbosun OA, Joseph KS. Atonic Postpartum Hemorrhage: Blood Loss, Risk Factors, and Third Stage Management. J Obstet Bynaecol Can. 2016 Dec PMID: 27986181 

    Joseph KS, Lisonkova S, Muraca GM, Razaz N, Sabr Y, Mehrabadi A, Schisterman EF. Factors Underlying the Temporal Increase in Maternal Mortality in the United States. Obstet Gynecol. 2017 Jan PMID: 27926651

    Potts J, Lisonkova S, Murphy DT, Lim K. Gadolinium magnetic resonance imaging during pregnancy associated with adverse neonatal and post-neonatal outcomes. J Pediatr. 2017 Jan PMID:28010800 

    Robertson JE, Lisonkova S, Lee T, De Silva DA, von Dadelszen P, Synnes AR, Joseph KS, Liston RM, Magee LA. Fetal, Infant and Maternal Outcomes among Women with Prolapsed Membranes Admitted before 29 Weeks GestationPloS One.2016 Dec 21;11(12):e0168285. 

      

    Grants

    Co-investigator: Etiology of dyspareunia in endometriosis. CIHR Operating Grant - Reproductive and Child Heath (start-up grants). March/2014

    Honours & Awards
    Post-doctoral Fellow poster award, CIHR-IHDCYH Scientific Forum, Vancouver, British Columbia

    Post-doctoral Fellowship: Michael Smith Foundation for Health Research, Vancouver, BC, Canada


    Summer Institute in Perinatal Epidemiology, CIHR, Canada & National Institutes of Health, USA

    Graduate Scholarship: John E. Fogarty International Center for Advanced Study in the Health Sciences, National Institutes of Health, Bethesda, MD, USA

    Research Group Members
    • Dr. Yasser Sabr, PhD student, School of Population and Public Health, UBC
    • Dane DeSilva, MPH student, School of Population and Public Health, UBC