Dr. Giulia Muraca awarded the Society for Pediatric and Perinatal Epidemiologic Research Rising Star Award!
Health Research Methods PhD Candidate, Vanessa Hébert, found that rates of second stage cesarean births are rising in Ontario. See the findings of her latest publication in O&G Open.
Temporal trends in second-stage cesarean birth in Ontario, Canada, 2012–2021
Vanessa Hébert, Sheryll Dimanlig-Cruz, Giulia M. Muraca
O&G Open, vol. 2(3), 2025, pp. e084.
PUBLICATION ALERT! We're pleased to share our recent publication, led by Maya Rajasingham, highlighting racial and ethnic disparities in obstetric trauma in the United States that persist regardless of parity, obstetric history and mode of delivery. This work demonstrates important variations in the obstetric trauma rate within Asian racial subgroups and by immigration status.
Racial and ethnic disparities in obstetric anal sphincter injury: cross-sectional study in the USA
Maya Rajasingham, Parnian Hossein-Pour, Rohan D'Souza, Roxana Geoffrion, Cande V. Ananth, Giulia M Muraca
Ultrasound in Obstetrics and Gynecology, 2025
Congratulations to all the PERL presenters at the Canadian National Perinatal Research Meeting in Montreal, May 12-15, 2025.
Members of the PERL presented at the Department of Obstetrics and Gynecology Annual RT Weaver Research Day in Hamilton, ON, on May 7, 2025. A special congratulation to Maya for her Best Oral Presentation award for her work on severe maternal morbidity and mental health.
We are delighted to announce that Dr. Giulia Muraca was awarded $150,000 from the Canadian Institutes of Health Research Institute for Human Development, Child and Youth Health Early Career Researcher Award.
The PERL was well-represented at McMaster's Department of Health Research Methods, Evidence, and Impact Annual Research Day on April 29th, 2025. Congratulation to all the presenters!
And special congratulation to Maya for her Michael Gent Poster Presentation Award!
We held an Annual Update and Forum for our SERENE Project including presentations for SERENE Investigators and Lived Experience Advisory Network Members. We engaged in a World Cafe to map out the next year of work, priority set, and develop methods for future studies. Many thanks to all who participated and continue to support SERENE.
Congratulations to PERL member, Samantha Krueger, for winning the Midwifery Mentored Research Grant from the Association of Ontario Midwives.
A huge congratulations to Ebonee for securing 1st place for her oral presentation at the Interdisciplinary Social Accountability Conference in Healthcare!
Drs. Muraca and Kirubarajan awarded ~$350K from the Canadian Institutes of Health Research Project Grant competition for their project looking at Mode of operative delivery in the second stage of labour and risk of subsequent spontaneous preterm birth. This was in collaboration with several coinvestigators: Anderson L, Boutin, A, D’Souza R, Darling EK, Joseph KS, Lisonkova S, McDonald SD, Malhamé I, Mehrabadi A, Metcalfe A, Shah P.
The PERL Lab came together to celebrate the season at our annual holiday party!
The SERENE team was awarded a $50,000 Planning and Dissemination Grant from the Canadian Institutes of Health Research entitled LEANing into SERENE: Engaging people with lived and living experience in research on severe maternal morbidity NPI: Muraca G PIs: D’Souza R, Jack S, Frey B, Green S; Co-I: Atkinson D.
The PERL Lab got into the Halloween spirit with a fun-filled pumpkin carving contest!
Dr. Muraca presents work at the European Pediatric and Perinatal Epidemiology Conference in Copenhagen on Sep 17, 2024. on "Severe maternal morbidity by mode of delivery in the second stage of labour: a retrospective population-based cohort study of nulliparous people in Canada, 2004-2018.
Dr. Muraca speaks at the Society for Pediatric and Perinatal Epidemiologic Research Annual Meeting in Austin, Texas on "Severe maternal morbidity surveillance: temporal trends and regional variations in Sweden, 1999-2019" on Jun 18, 2024.
Publication alerts: PERL members Parnian Hossein-Pour and Maya Rajasingham publish two papers synthesizing the literature on cervical lacerations in forceps and vacuum delivery and highlighting racial inequities in maternal transfusion in the US.
Hossein Pour P, Rajasingham M, Muraca GM. Risk of cervical laceration in forceps versus vacuum delivery: a systematic review and meta-analysis. Acta Obstet Gynecol Scan 2004; 00: 1-10. doi:10.1111/aogs.14969.
Hossein Pour P, Rajasingham M, Zeller M, Muraca GM. Racial disparities in maternal blood transfusion in the United States by mode of delivery: a retrospective cohort study. PLOS One 19(10): e0312110.
Congrats to the PERL lab's MPH superstars, Maya Rajasingham and Parnian Hossein Pour for their publication on "Temporal trends in peripartum hysterectomy among individuals with a previous cesarean delivery." First of many!
Latest from PERL PI Giulia Muraca and colleages in The BMJ Assessing the evidence on sterile water injections for back pain in labour.
Fantastic presentations by our PERL team, and a big congratulations to Ebonee Lennord for winning the Undergraduate Oral Presentation Prize at McMaster's Dept of Ob/Gyn's RT Weaver Research Day.
Congratulations to PERL PI, Dr. Giulia Muraca, for winning the 11th Annual Mohide Lectureship and presenting her work: "Maternal and neonatal trauma: Quantitative data, patient perspectives and considering the path forward".
Giulia Muraca and PERLer, Maya Rajasingham, presenting their work at the Canadian Society for Pelvic Medicine 2024 Annual Meeting in Montreal
Drs Giulia Muraca, Rohan D'Souza, Susan Jack, Benicio Frey, and Sheryl Green awarded $1.9 million from JRI to study severe maternal morbidity.
The project, titled SERENE: Supportive, Evidence-informed, Responsive, and Equity-oriented prevention-and-care model to reduce the incidence and NEgative impacts of severe maternal morbidity, has been made possible through a generous donation by the late Charles and Margaret Juravinski.
Dr Giulia Muraca
Dr Rohan D'Souza
Dr Susan Jack
Dr Benicio Frey
Dr Sheryl Green
Dr Giulia Muraca
Dr Rohan D'Souza
Dr Susan Jack
Dr Benicio Frey
Dr Sheryl Green
Congratulations to all the PERLers presenting oral and poster presentations at HEI Research Day 2024.
Maya Rajasingham wins Health Equity Award for her paper "Contextualizing racial/ethnic disparities in obstetric anal sphincter injury in the United States".
Check out latest publication by PERL members in the American Journal of Obstetrics and Gynecology Maternal Fetal Medicine: The association between unintended hysterotomy extensions with cesarean delivery and subsequent preterm birth.
A. Why was this study conducted?
• Evidence suggests an increased risk of preterm birth (PTB) among individuals with a previous second stage cesarean delivery (CD) compared with previous vaginal delivery.
• A proposed mechanism is via hysterotomy extensions near or within the internal cervical os leading to cervical insufficiency; however, evidence to support this relationship is lacking.
B. What are the key findings?
• Hysterotomy extension following a primary CD at full term is not associated with PTB <37 weeks in a subsequent delivery.
• The rate of subsequent PTB <34 weeks is 2.5 times higher among patients with a hysterotomy extension.
C. What does this study add to what is already known?
• The association between hysterotomy extension and PTB may support the hypothesized biological mechanism underlying the relationship between second stage CD and subsequent PTB.
New PERL publication co-authored by Drs. Muraca and Rottenstreich titled: Impacted fetal head extraction methods at second stage cesarean and subsequent preterm delivery: A multicenter study
Congratulations to PERL trainee, Meejin Park, on the successful defence of her Master’s of Science in Global Health at McMaster University. Meejin’s thesis is titled “Elucidating the Intersectional Effects of Race and Migration on Obstetric Anal Sphincter Injury. ” Many thanks to Meejin’s stellar committee, Drs. Rohan D’Souza, Roxana Geoffrion, and Susitha Wanigaratne and to all the collaborators who have helped guide Meejin’s important work. Dr. Muraca and your committee are so proud of what you have accomplished, Meejin. Best of luck in all your future endeavours!
Happy Holidays! from the Perinatal Epidemiology Research Lab.
Listen to PERL Principal Investigator Dr. Giulia Muraca on CBC's The current discuss severe childbirth injuries from forceps, vacuum 'unacceptably high' in Canada, research shows
Watch CBC's segment on Severe childbirth injuries from forceps and vacuum delivery featuring Dr. Giulia Muraca
PERL research featured on CTV: Forceps severely injure 1 in 4 Canadian mothers when used in childbirth: study
McMaster's Faculty of Health Sciences website discusses PERL research findings. Persistently high rates of severe maternal trauma during forceps and vacuum births warrant national response, analysis shows.
Research led by PERL investigators showcased on Yahoo News: Maternal trauma: What to know about risks of forceps and vacuum deliveries in Canada
Watch Global news segment on Maternal injuries happening at ‘absurdly high’ rate in Canada during labour. Why?
Watch CHCH news segment on High rates of trauma in births using forceps, vacuums: McMaster study featuring PERL PI, Dr. Muraca
PERL's recent publication in the BMJ titled: Maternal and neonatal trauma during forceps and vacuum delivery must not be overlooked.
PERL investigators published in the Canadian Medical Association Journal Hospital factors associated with maternal and neonatal outcomes of deliveries to patients with a previous cesarean delivery: an ecological study
Congratulations to Dr. Abi Kirubarajan on the successful publication of her work regarding Operative delivery in the second stage of labour and preterm birth in a subsequent pregnancy: a systematic review and meta-analysis.
This systematic review, published in the American Journal of Obstetrics & Gynecology, summarizes 18 studies encompassing 605,138 individuals. Spontaneous preterm birth in people with prior second-stage cesarean delivery was twice as likely when compared with operative vaginal delivery but the majority of studies didn't address important confounding factors and had a high risk of misclassification bias.
Congratulations to Meejin for her publication addressing Asian-white disparities in obstetric anal sphincter injury: Protocol for a systematic review and meta-analysis.
This protocol outlines a systematic review and meta-analysis that will synthesize the extant literature to better estimate the rates of OASI in Asian and white populations in non-Asian, high-income settings and the relative risk of OASI between these two groups. This systematic summary of the evidence will inform the discrepancy in health outcomes experienced by Asian and white birthing individuals.
Listen to PERL Principal Investigator Dr. Muraca discuss our work on forceps and vacuum delivery in Canada.
A warm welcome to PERL’s new Research Coordinator Jennifer Zering!
We are delighted to announce that Jennifer Zering has joined PERL as our new Research Coordinator. Welcome, Jeni!
PERL is DELIGHTED to share that McMaster Health Research Methods doctoral student Irina Oltean has been awarded a Doctoral Canada Graduate Scholarship from the Canadian Institutes of Health Research. This highly competitive award will support Irina in her research on comparative estimates of maternal and perinatal morbidity following operative delivery options among risk-stratified individuals. Well deserved, Irina, and we look forward to seeing your research career develop.
Read our recent response to the Commentary ‘Causes of ART-related outcomes in the COVID-19 era’ in Paediatric and Perinatal Epidemiology.
PERL PI, receives the 10th Annual Mohide Lectureship
Congratulations to Dr. Abi Kirubarajan for being accepted into the Health Research Methodology PhD program at McMaster University starting September 2023!
Abi’s doctoral research will focus on the effects of mode of delivery on subsequent pregnancy complications under the supervision of Dr. Muraca.
Best of luck on your doctoral work , Abi!!
Drs. Giulia Muraca, Jon Barrett and Rohan D'Souza receive funding from the Hamilton Academic Health Sciences Organization to study long term outcomes of operative delivery
Principal Investigators Drs. Giulia Muraca and Jon Barrett – with co-investigators Drs. Rohan D’Souza and Sarka Lisonkova (University of British Columbia) – received $200,000 from the Hamilton Academic Health Sciences Organization (HAHSO) to study the long-term outcomes of mothers and babies following forceps, vacuum and cesarean deliveries that occur late in labour.
The study will use information from population-based databases in Ontario and British Columbia to follow mothers and babies for up to 18 years to assess physical and mental health outcomes among mothers and neurodevelopmental outcomes among children.
Understanding the long-term benefits and risks associated with these different modes of delivery can assist in the prevention and early treatment of medical conditions and will support pregnant individuals in making informed decisions about mode-of-delivery interventions late in labour.
A warm welcome to PERL’s new Data Analyst Alexander Hemming!
We are delighted to announce that Alexander Hemming has joined PERL as our new Data Analyst. Welcome, Alexander! We’re all looking forward to working with you and indulging in nerdy coding jargon with a fellow data-phile.
Congratulations to PERL trainees Irina and Meejin for their excellent presentations at HEI Research Day!
PERL PhD student, Irina Oltean, and MSc student, Meejin Park, presented their work at the Annual Health Research Methods, Evidence and Impact Research Day on Thursday, Mar 23rd. Irina delivered an oral presentation of her work on severe maternal and perinatal morbidity and mortality associated with operative delivery and Meejin presented her poster on Asian-white disparities in obstetric anal sphincter injuries. We are so proud of these exceptional PERLers!!!
New Publication Alert! PERL investigators published in the Canadian Medical Association Journal
This study, entitled: “Hospital factors associated with maternal and neonatal outcomes of deliveries to patients with a previous cesarean delivery: an ecological study” found that rates of serious adverse maternal and neonatal outcomes did not decrease with increasing hospital tier of obstetric service and delivery volume.
Muraca Perinatal Epidemiology lab awarded $360,000 for project to advance equity in maternal perinatal health and well being in Canada
Dr. Giulia Muraca (NPI) and Dr. Rohan D’Souza (PI), along with Co-Investigators Dr. Jon Barrett and Dr. Liz Darling, were awarded $336,600 to launch their project: “Advancing equity in maternal and perinatal care in Canada: Population-based investigations of racial and ethnic disparities in severe maternal morbidity and severe perinatal morbidity and mortality”. This initiative will use an innovative linkage of high-quality, population-based datasets in Canada to study racial disparities in severe pregnancy complications across the country, to profile the patterns and drivers of these complications, and to evaluate intersectional and mediating factors, in an effort to inform evidence-based, clinical and health policy targets to promote health equity in maternal and neonatal health.
PERL is delighted to share that Meejin Park’s work on racial disparities in obstetric anal sphincter injury has been accepted for presentation at the Society of Obstetrician and Gynecologist 2023 Annual Clinical and Scientific Conference in Ottawa. Congratulations, Meejin!
Congratulations to Dr. Muraca for being honoured as one of eight recipients of the Hamilton Health Sciences Foundation Research and Innovation Project Awards.
The awards will be presented at the 2022 Hamilton Health Sciences Foundation Gala on Saturday, December 10th, 2022
Congratulations to PERL Master's student, Meejin Park, for her selection for an oral presentation at this year's Racialized Maternal Health Conference.
Watch PERL collaborator, Dr. Sarka Lisonkova, summarize recent results from a population-based cohort study of deliveries in the US that quantified racial and ethnic disparities in perinatal death, preterm birth, and serious neonatal morbidity.