// file intentionally left blank ?>
Even prior to legalization, cannabis use has been increasing in Canada, including among pregnant Canadian women. Although we anticipate further increases because of greater availability of cannabis and low perceptions of harm, there is a lack of conclusive evidence on the short-term outcomes and long-term sequelae of exposed children.
We are conducting population-based cohort studies to examine pregnancy, neonatal and childhood health outcomes following exposure to cannabis. We have already leveraged provincial health administrative data to demonstrate increases in cannabis use in pregnant women in Ontario and have shown that self-reported cannabis use in pregnancy is associated with preterm birth, lower birthweight and admission to neonatal intensive care units. Our ongoing work includes examining the longer-term health outcomes of children exposed to cannabis in pregnancy and through breastfeeding and exploring the knowledge, attitudes and practices regarding cannabis use in pregnancy among Canadians.
Select publications related to this program:
Rates of hospitalization and death due to opioid overdose in Canada have increased significantly over the last decade. Opioid use and misuse in pregnancy has also increased, creating the potential for profoundly damaging long-term health and social effects on mothers and their children. Clinical studies have been unable to conclusively determine the risks of prenatal exposure to opioids. Robust, population-based data on perinatal and neurodevelopmental outcomes of in utero opioid exposure is necessary to understand this emerging health crisis.
We are leveraging robust population-based provincial datasets to evaluate trends in substance abuse in pregnancy and associated adverse perinatal, neonatal and childhood health outcomes. We are simultaneously assessing health service utilization in children born to mothers with and without opioid use in pregnancy. This work will yield important results to assist in shaping comprehensive policy and public health messaging for Canadian women.
Gestational diabetes mellitus (GDM) is a form of glucose intolerance characterized by onset or detection during pregnancy. The incidence of GDM is increasing across all Canadian provinces and territories. Both pre-existing diabetes and GDM are associated with an increased risk of obstetrical complications and adverse fetal outcomes. In addition, a history of GDM is associated with increased risk of GDM in future pregnancies and development of type-2 diabetes and cardiovascular disease in later life.
We are characterizing this unique population of women, the patterns of care that they receive during pregnancy, as well as their pregnancy, neonatal and breastfeeding outcomes. We are also examining how the persistence or development of postpartum risk factors are associated with adverse outcomes in later life and in subsequent pregnancies. With this data, we will develop predictive models capable of identifying populations at highest risk of GDM and other outcomes associated with hyperglycemia in pregnancy.
We are committed to improving the quality of care and health outcomes of mothers and their newborns globally. In the past, we have we have led projects evaluating barriers to accessing maternal care in Sub Saharan Africa, and the implementation of innovative solutions to decrease maternal mortality. More recently, collaboration with the Bill & Melinda Gates Foundation has resulted in exciting studies that 1) leverage big data to develop predictive models for pregnancy and neonatal outcomes and validating the utility of those models for use in low resource settings, and 2) involve metabolomic analysis of bio-specimens collected from OMIN cohort studies to build translational research capacity in the maternal child space to benefit local and international research efforts.
Other ongoing efforts leverage publicly available data from the Demographic and Health Surveys (DHS) Program to evaluate population trends and maternal and neonatal health outcomes across communities and countries. The DHS has collected, analyzed, and disseminated accurate and representative data on population, health, HIV, and nutrition through more than 400 surveys in over 90 countries, and is thereby an invaluable resource.
This research program is designed to explore sexual and gender-based violence across the lifespan with a focus on sexual and reproductive health including perinatal outcomes. The research has strong roots in patient care, policy, practice, through both academic and community networks. Projects include:
The goal of this research program is to foster interdisciplinary research collaborations to improve the patient continuum of care for survivors of violence, support social change and ultimately lead to a safer society free from violence.