The Canadian Mother-Child Cohort Active Surveillance Initiative (CAMCCO): Comparisons between Quebec, Manitoba, Saskatchewan, and Alberta.

<h4>Background</h4>Given that pregnant women taking medications are excluded from clinical trials, real-world evidence is essential. We aimed to build a Canadian Mother-Child Cohort Active Surveillance Initiative (CAMCCO) and compare frequency of prematurity, low-birth-weight (LBW), majo...

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Main Authors: Anick Bérard, Padma Kaul, Sherif Eltonsy, Brandace Winquist, Dan Chateau, Steven Hawken, Ann Sprague, Mark Walker, Sasha Bernatsky, Michal Abrahamowicz, Cristiano Soares de Moura, Évelyne Vinet, Bruce Carleton, Gillian Hanley, Tim Oberlander, Odile Sheehy, Yessica Haydee Gomez, Jessica Gorgui, Anamaria Savu
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0274355
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author Anick Bérard
Padma Kaul
Sherif Eltonsy
Brandace Winquist
Dan Chateau
Steven Hawken
Ann Sprague
Mark Walker
Sasha Bernatsky
Michal Abrahamowicz
Cristiano Soares de Moura
Évelyne Vinet
Bruce Carleton
Gillian Hanley
Tim Oberlander
Odile Sheehy
Yessica Haydee Gomez
Jessica Gorgui
Anamaria Savu
author_facet Anick Bérard
Padma Kaul
Sherif Eltonsy
Brandace Winquist
Dan Chateau
Steven Hawken
Ann Sprague
Mark Walker
Sasha Bernatsky
Michal Abrahamowicz
Cristiano Soares de Moura
Évelyne Vinet
Bruce Carleton
Gillian Hanley
Tim Oberlander
Odile Sheehy
Yessica Haydee Gomez
Jessica Gorgui
Anamaria Savu
author_sort Anick Bérard
collection DOAJ
description <h4>Background</h4>Given that pregnant women taking medications are excluded from clinical trials, real-world evidence is essential. We aimed to build a Canadian Mother-Child Cohort Active Surveillance Initiative (CAMCCO) and compare frequency of prematurity, low-birth-weight (LBW), major malformations, multiplicity, and gestational medication use across four provinces.<h4>Methods</h4>CAMCCO is a collaborative research infrastructure that uses real-world data from large provincial health care databases in Canada; developed with standardized methods to similarly construct population-based pregnancy/child cohorts with longitudinal follow-up by linking administrative/hospital/birth databases. CAMCCO also includes a common repository to i) share algorithms and case definitions based on diagnostic and procedural codes for research/training purpose, and ii) download aggregate data relevant to primary care providers, researchers, and decision makers. For this study, data from Quebec (1998-2015), Manitoba (1995-2019), Saskatchewan (1996-2020), and Alberta (2005-2018) are compared (Chi-square tests, p-values), and trends are calculated using Cochran-Armitage trend tests.<h4>Results</h4>Almost two-thirds (61%) of women took medications during pregnancy, mostly antibiotics (26%), asthma drugs (8%), and antidepressants (4%). Differences in the prevalence of prematurity (5.9-6.8%), LBW (4.0-5.2%), and multiplicity (1.0-2.5%) were statistically significant between provinces (p<0.001). Frequency of major malformations increased over time in Quebec (7-11%; p<0.001), Saskatchewan (5-11%; p<0.001), and Alberta (from 7-8%; p<0.001), and decreased in Manitoba (5-3%; p<0.001). Cardiovascular and musculoskeletal malformations were the most prevalent.<h4>Interpretation</h4>Medications are often used among Canadian pregnancies but adverse pregnancy outcomes vary across provinces. Digitized health data may help researchers and care providers understand the risk-benefit ratios related to gestational medication use, as well as province-specific trends.
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spelling doaj.art-af651dcc4556471e87dd7d157ad383262022-12-22T04:27:13ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01179e027435510.1371/journal.pone.0274355The Canadian Mother-Child Cohort Active Surveillance Initiative (CAMCCO): Comparisons between Quebec, Manitoba, Saskatchewan, and Alberta.Anick BérardPadma KaulSherif EltonsyBrandace WinquistDan ChateauSteven HawkenAnn SpragueMark WalkerSasha BernatskyMichal AbrahamowiczCristiano Soares de MouraÉvelyne VinetBruce CarletonGillian HanleyTim OberlanderOdile SheehyYessica Haydee GomezJessica GorguiAnamaria Savu<h4>Background</h4>Given that pregnant women taking medications are excluded from clinical trials, real-world evidence is essential. We aimed to build a Canadian Mother-Child Cohort Active Surveillance Initiative (CAMCCO) and compare frequency of prematurity, low-birth-weight (LBW), major malformations, multiplicity, and gestational medication use across four provinces.<h4>Methods</h4>CAMCCO is a collaborative research infrastructure that uses real-world data from large provincial health care databases in Canada; developed with standardized methods to similarly construct population-based pregnancy/child cohorts with longitudinal follow-up by linking administrative/hospital/birth databases. CAMCCO also includes a common repository to i) share algorithms and case definitions based on diagnostic and procedural codes for research/training purpose, and ii) download aggregate data relevant to primary care providers, researchers, and decision makers. For this study, data from Quebec (1998-2015), Manitoba (1995-2019), Saskatchewan (1996-2020), and Alberta (2005-2018) are compared (Chi-square tests, p-values), and trends are calculated using Cochran-Armitage trend tests.<h4>Results</h4>Almost two-thirds (61%) of women took medications during pregnancy, mostly antibiotics (26%), asthma drugs (8%), and antidepressants (4%). Differences in the prevalence of prematurity (5.9-6.8%), LBW (4.0-5.2%), and multiplicity (1.0-2.5%) were statistically significant between provinces (p<0.001). Frequency of major malformations increased over time in Quebec (7-11%; p<0.001), Saskatchewan (5-11%; p<0.001), and Alberta (from 7-8%; p<0.001), and decreased in Manitoba (5-3%; p<0.001). Cardiovascular and musculoskeletal malformations were the most prevalent.<h4>Interpretation</h4>Medications are often used among Canadian pregnancies but adverse pregnancy outcomes vary across provinces. Digitized health data may help researchers and care providers understand the risk-benefit ratios related to gestational medication use, as well as province-specific trends.https://doi.org/10.1371/journal.pone.0274355
spellingShingle Anick Bérard
Padma Kaul
Sherif Eltonsy
Brandace Winquist
Dan Chateau
Steven Hawken
Ann Sprague
Mark Walker
Sasha Bernatsky
Michal Abrahamowicz
Cristiano Soares de Moura
Évelyne Vinet
Bruce Carleton
Gillian Hanley
Tim Oberlander
Odile Sheehy
Yessica Haydee Gomez
Jessica Gorgui
Anamaria Savu
The Canadian Mother-Child Cohort Active Surveillance Initiative (CAMCCO): Comparisons between Quebec, Manitoba, Saskatchewan, and Alberta.
PLoS ONE
title The Canadian Mother-Child Cohort Active Surveillance Initiative (CAMCCO): Comparisons between Quebec, Manitoba, Saskatchewan, and Alberta.
title_full The Canadian Mother-Child Cohort Active Surveillance Initiative (CAMCCO): Comparisons between Quebec, Manitoba, Saskatchewan, and Alberta.
title_fullStr The Canadian Mother-Child Cohort Active Surveillance Initiative (CAMCCO): Comparisons between Quebec, Manitoba, Saskatchewan, and Alberta.
title_full_unstemmed The Canadian Mother-Child Cohort Active Surveillance Initiative (CAMCCO): Comparisons between Quebec, Manitoba, Saskatchewan, and Alberta.
title_short The Canadian Mother-Child Cohort Active Surveillance Initiative (CAMCCO): Comparisons between Quebec, Manitoba, Saskatchewan, and Alberta.
title_sort canadian mother child cohort active surveillance initiative camcco comparisons between quebec manitoba saskatchewan and alberta
url https://doi.org/10.1371/journal.pone.0274355
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