Women’s Health and Obstetrics  

One area of focus is on maternal cardiometabolic health and how it shapes fetal outcomes during the first 1,000 days of life. By identifying risks early and implementing targeted interventions, health-care providers can improve long-term health for both mothers and their children. 

Our research investigates the critical link between maternal pre-pregnancy health and pregnancy outcomes. Conditions such as obesity, diabetes, and chronic hypertension can lead to serious complications, including hypertensive disorders of pregnancy (including preeclampsia). These health issues not only impact the mother’s wellbeing but also significantly affect fetal development, highlighting the importance of addressing maternal health before and during pregnancy. 

Pregnancy can exacerbate existing cardiometabolic conditions, putting women with hypertension, heart disease, metabolic syndrome or obesity at a greater risk for severe complications. Additionally, hypertensive disorders such as preeclampsia can lead to increased cardiovascular risks for mothers later in life.  We are working to find better tools to identify pregnant people at greatest risk of pregnancy and postpartum complications before they become symptomatic. In addition, we are investigating the structural and functional differences in the placenta that are related to maternal obesity, metabolic, and cardiovascular disorders.  

We also focus on the implications of fetal and neonatal outcomes related to maternal health. Infants born too small due to placental insufficiency and/or preterm birth, or too large due to maternal diabetes or obesity, are at a heightened risk for developing obesity, diabetes and hypertension later in life. Adverse intrauterine environments can negatively impact brain development, leading to cognitive and behavioral issues in children. Our research emphasizes the importance of early intervention strategies for monitoring maternal health, employing innovative tools for risk assessment, and ensuring ongoing follow-up for mothers with a history of hypertensive disorders to support healthier outcomes for both mothers and their children. 

This research focuses on the intergenerational effects of conditions experienced during pregnancy and their impact on both infant health and long-term health outcomes into adulthood. It examines how factors such as overnutrition, undernutrition, and environmental exposures influence a child’s development and future health, including their own pregnancy outcomes. By exploring these connections, the research aims to identify strategies to improve maternal and infant health across generations. 

One key area of investigation is the relationship between maternal obesity and fetal development. This research utilizes advanced imaging techniques, including magnetic resonance imaging (MRI), to study fetal fat and metabolic development, as well as brain development during pregnancy. The goal is to enhance clinical care and increase the likelihood of positive pregnancy outcomes by understanding the implications of maternal obesity and related health conditions for fetal development and childhood health.

In the fast-paced, high-stakes world of obstetrics, split-second decisions and seamless teamwork are essential to positive outcomes for both the mother and the infant. Yet, understanding and improving the intricate dynamics of health-care teams under pressure remains a critical challenge. This program of research focuses on advancing health-care team performance and patient outcomes in obstetrics through innovative applications of simulation-based education and qualitative research. This work leverages simulation in novel ways to investigate complex questions about team dynamics, communication and clinical decision-making that are otherwise challenging to study in real-world settings. 

By using simulation as both a training platform and a research tool, the program examines how health-care teams interact under pressure and identifies opportunities for improving collaboration and performance. These insights are being translated into practices that enhance teamwork and care delivery in obstetrics. 

An additional research focus is on optimizing pregnancy care in marginalized populations, including those experiencing homelessness, those with substance use disorders, and amongst refugee populations. One key area is the identification and treatment of infectious diseases which are more prevalent in these populations. We are currently participating in a multicentre phase IV study of hepatitis C treatment during pregnancy, with the aim of improving pregnancy outcomes and preventing mother-to-child transmission. 

Over 90 per cent of pregnant individuals take at least one medication during pregnancy, but the exclusion of pregnant individuals from clinical drug trials often means that the risk to both the pregnant parent and baby is unknown. As a result, pregnant individuals often take medications with limited data to inform safety, dosing, and efficacy. To address these issues, our research uses an ex vivo placental dual perfusion model and physiology-based pharmacokinetics to study the placental transfer of drugs. The data generated from this research enables physicians to better assess the risk-benefit ratio and provide counseling to patients regarding drug use during pregnancy. This information allows us to counsel pregnant patients who may require medications in pregnancy. Our research is translated into expert opinions of medications in pregnancy in peer reviewed publications and guidelines. We also offer related clinical services informed through this evidence in the Fetal Risk Assessment after Fetal Exposure (FRAME) clinic. 

Our cancer researchers at LHSCRI conduct a number of laboratory-based and clinical studies focused on better understanding breast and ovarian cancer, with the goal of improving patient outcomes. Learn more about breast and ovarian cancer research at LHSCRI.