Research
My research includes primary data collection studies in clinical and community settings, as well as secondary analysis of population-based surveys, health and demographic administrative data, community-based cohort studies, and other existing datasets.
Immune-related Disorders in Adolescence and Future Risk of Endometriosis
2024—Ongoing
Endometriosis is a chronic inflammatory disease affecting up to 1 in 10 females, characterized by debilitating pelvic pain. It is frequently diagnosed between 20 and 40 years of age, but onset may occur as early as adolescence with immune system dysfunction playing a key role. Given the absence of a definitive cure, understanding risk factors is essential for facilitating early diagnosis and treatment that can slow endometriosis progression and enhance patients’ quality of life. This study investigates whether adolescent onset of allergic (e.g., asthma) and psychiatric (e.g., depression) disorders, which share features of immune-related dysfunction and inflammation, may foreshadow females’ risk of experiencing endometriosis over the lifespan. Our team is using over three decades of population-based data from ICES to create a cohort of all females born in Ontario between 1988-1998 that spans health and demographic records from birth through adulthood – the first of its kind in Canada.​
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This study is funded by a Canadian Institutes of Health Research Operating Grant.
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Reproductive Factors and Characteristics of Menopause
2022—Ongoing
The menopausal transition signals the end of reproduction function for females. Menopause can occur any time during the midlife period of 40-60 years and due to natural or medical causes. The timing and type of menopause that women experience is closely tied with subsequent health and disease risk as women age. Given the significance of menopause for women's health, there is a need to generate knowledge on what factors across the life course influence menopause onset. This study investigates how female reproductive factors, such as infertility, parity, and lactation, are associated with characteristics of menopause using data from ~19,000 women followed through the Alberta's Tomorrow Project.
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This study is funded by a Canadian Institutes of Health Research Project Grant.
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Pregnancy Complications and Maternal Risk of Autoimmune Disease
2022—Ongoing
Autoimmune diseases are chronic immune-mediated conditions that are up to 9 times more common in females compared to males, and are a leading source of disability and premature death in women. Knowledge of risk factors specific to women is essential for informing early diagnosis and treatment that can mitigate disease progression. This study investigates the association between pregnancy complications and autoimmune disease risk in women during the reproductive and middle-age years using nearly two decades of health records data from ICES for the entire province of Ontario.
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This study is funded by a Banting Canada Postdoctoral Fellowship.
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Hysterectomy Versus Uterine Preservation for Pelvic Organ Prolapse Surgery (HUPPS) Study
2019—2024 (Completed)
Pelvic organ prolapse (POP) will affect half of Canadian women in their lifetime. Surgery to correct POP is common, and approaches can be divided into those that keep the uterus intact and those that remove the uterus from the patient’s body. There is limited high quality comparative evidence on which approach can best fix POP and restore quality of life. The HUPPS Study generated real-world evidence comparing 1-year outcomes following POP surgery in women selecting minimally invasive hysterectomy-based versus uterine-preserving native tissue surgery.​​
Key findings from the HUPPS Study published in the American Journal of Obstetrics & Gynecology and Conversation Canada and include:
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Anatomic recurrence of apical POP (descent past the mid-vagina) was 17.2% following hysterectomy and 7.5% following uterine preservation, resulting in a relative risk of 0.35 (95% confidence interval 0.15, 0.83) after controlling for confounders.
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Uterine preservation was associated with shorter surgery and hospitalization, less perioperative morbidity, and less composite prolapse recurrence than hysterectomy, with comparable functional and healthcare outcomes.​​
This study was funded by a Canadian Institutes of Health Research Clinical Mentorship Grant and Early Career Investigator Award and The MSI Foundation.​​
The Motherhood and Chronic Illness (MaCI) Study
2017—2023 (Completed)
Maternal chronic illness is increasingly common, and is prevalent in roughly 1 in 7 new or expecting mothers. The MaCI Study was aimed at exploring how chronic condition-related factors impact women's perinatal outcomes, with a focus on breastfeeding patterns. We recruited 405 pregnant women in Alberta living with pre-existing physical health conditions (e.g., diabetes, arthritis) to fill out a series of online questionnaires during pregnancy and up to 6 months after their baby was born.
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Key findings from the MaCI Study were published in the Journal of Psychosomatic Research, International Breastfeeding Journal, and Acta Obstetricia et Gynecologica Scandinavica and include:
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​Women who perceive their illness experience to worsen during pregnancy were less likely to plan to exclusively breastfeed to 6 months in accordance with public health recommendations
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Half of women with chronic conditions experienced clusters of breastfeeding difficulties corresponding either to low milk production or to ineffective latch in the first 6 weeks postpartum. Associations with chronic condition types suggest that connections between lactation physiology and disease pathophysiology should be considered when providing breastfeeding support.
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Women with chronic conditions who discontinued preexisting medications while breastfeeding had significantly shorter breastfeeding duration and were less likely to meet their breastfeeding goals in the first 6 months postpartum com- pared to women who continued preexisting medications.​
This study was funded by a University of Calgary Department of Pediatrics Innovation Award and the Alva Foundation.
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