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Publications (290)
Objectives
The medications used for autoimmune diseases have significantly evolved in recent years, but there is limited knowledge about how treatment practices changed during pregnancy. This study aimed to describe the temporal trends of immunosuppressants, immunomodulators and biologics use during pregnancy among women with autoimmune diseases, c...
Background
Epilepsy management during pregnancy is crucial for both the mother and fetus. The use of antiseizure medications (ASMs) during pregnancy requires careful consideration due to their potential effects on maternal and fetal health.
Methods
This study analyzed trends in ASMs use among pregnant people in four Canadian provinces over 20 year...
Background:
Prepartum and postpartum maternal symptoms of stress, anxiety and depression are likely to influence the child's sensory processing through hormonal alterations and an influence on mother-child interactions.
Objective:
We investigated the associations between maternal prepartum and postpartum symptoms of depression, anxiety and stres...
Background: The COVID-19 pandemic has significantly affected the mental health of pregnant persons. Objective: We aimed to evaluate the impact of maternal mental health and antidepressant use on children’s cognitive development. Methods: We followed a cohort of children born during the COVID-19 pandemic. Maternal mental health was self-reported dur...
Objective:
Assess the association between prenatal mental health during the COVID-19 pandemic and preterm birth (PTB; delivery < 37 weeks gestation) and low birth weight (LBW; < 2500 g).
Methods:
Pregnant individuals, > 18 years, were recruited in Canada and provided data through a web-based questionnaire. We analyzed data on persons recruited b...
Background
Children conceived through assisted reproduction are at an increased risk for growth and genomic imprinting disorders, often linked to DNA methylation defects. It has been suggested that assisted reproductive technology (ART) and underlying parental infertility can induce epigenetic instability, specifically interfering with DNA methylat...
Background:
Several vaccines against SARS-CoV-2 have been developed and approved at an unparalleled speed. Given that SARS-CoV-2 vaccines are recommended to pregnant people, our aim was to quantify vaccination uptake, and describe vaccination hesitancy and behavioural attitudes surrounding SARS-CoV-2 vaccination in pregnancy in Canada.
Methods:...
The effect of the COVID-19 pandemic on maternal mental health has been described in Canada and China but no study has compared the two countries using the same standardized and validated instruments. In this study, we aimed to evaluate and compare the impact of COVID-19 public health policies on maternal mental health between Canada and China, as w...
Over the last decade, the use of medically assisted reproduction (MAR) has steadily increased but controversy remains with regards to its risks. We aimed to quantify the risk of being born small for gestational age (SGA) and very SGA (VSGA) associated with MARs overall and by type, namely ovarian stimulators (OS) and assisted reproductive technolog...
Background
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 f...
Background:
Drug-related problems (DRPs) are one of the leading causes of hospital readmissions. Children with chronic diseases are more likely to experience DRPs than adults. The burden and characteristics of drug-related readmissions at and after hospital discharge in children remain unclear.
Objective:
We aimed to summarize the impact of DRPs...
Importance and objective
Prenatal cannabis effect on attention deficit with or without hyperactivity disorder (ADHD) remains to be determined. Our aim is to quantify the impact of in-utero exposure to cannabis on the risk of ADHD.
Design
Cohort study.
Setting
Questionnaires were mailed to women sampled from the Quebec Pregnancy Cohort (QPC). Data...
Background and Hypothesis
Maternal schizophrenia heightens the risk for certain perinatal complications, yet it is not known to what degree future childhood chronic health conditions (Childhood-CC) might arise.
Study Design
This population-based cohort study using health administrative data from Ontario, Canada (1995–2018) compared 5066 children o...
Introduction:
We aimed to measure the impact of the COVID-19 pandemic on maternal mental health, stratifying on pregnancy status, trimester of gestation, and pandemic period/wave.
Methods:
Pregnant persons and persons who delivered in Canada during the pandemic, >18 years, were recruited, and data were collected using a web-based strategy. The c...
Introduction: We aimed to measure the impact of the COVID-19 pandemic on maternal mental health, stratifying on pregnancy status, trimester of gestation, and pandemic period/wave.
Methods: Pregnant persons and persons who delivered in Canada during the pandemic, >18 years, were recruited, and data were collected using a web-based strategy. The curr...
Abstract Background Recent studies show a rapid growth among pregnant women using high potency opioids for common pain management during their pregnancy. No study has examined the duration of treatment among strong opioid users and weak opioid users during pregnancy. We aimed to investigate the prevalence of prescribed opioid use during pregnancy,...
To assess the association between time of birth and mortality among preterm infants.
Population-based study of infants born 22–36 weeks gestation (GA) in Canada from 2010 to 2015 (n = 173 789). Multivariable logistic regression models assessed associations between timing of birth and mortality.
Among infants 22–27 weeks GA, evening birth was associ...
Migraine is prevalent during pregnancy. Antimigraine medications such as dihydroergotamine (DHE) and triptans have been associated with adverse pregnancy outcomes in individual studies but lack of consensus remains. We compared the risk of prematurity, low birth weight (LBW), major congenital malformations (MCM), and spontaneous abortions (SA) asso...
Introduction: Chloroquine (CQ) and hydroxychloroquine (HCQ) are currently used for the prevention/treatment of malaria, and treatment of systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA). Although present data do not show their efficacy to treat COVID-19, they have been used as potential treatments for COVID-19. Given that pregnant...
Background
Medications already available to treat other conditions are presently being studied in clinical trials as potential treatments for COVID-19. Given that pregnant women are excluded from these trials, we aimed to investigate their safety when used during pregnancy within a unique population source.
Methods
Using the population-based Quebe...
Aims:
The use of attention deficit/hyperactivity disorder (ADHD) medications has grown over the past decade among pregnant women, but these treatments are not without risk. Updated prevalence of ADHD medication use and whether prescribed dosages follow guidelines are needed. The aim of this study is to describe the prevalence of ADHD medication us...
Introduction
The ‘Developmental Origins of Health and Disease’ hypothesis suggests that a healthy trajectory of growth and development in pregnancy and early childhood is necessary for optimal health, development and lifetime well-being. The purpose of this paper is to present the protocol for a randomised controlled trial evaluating a preconceptio...
Attention deficit with hyperactivity disorder (ADHD) medications in pregnancy would be associated with ADHD in children, however, estimates can be confounded by genetic predispositions and environmental factors related to the mother-child pair. We aim to quantify the risk of ADHD in children associated with ADHD medication exposures during pregnanc...
An increase in cannabis use is inevitable, and the spread of its legalization will probably result in increasing use during pregnancy. A study from Canada uses real-world data to quantify the cognitive effects on offspring of in utero cannabis exposure.
Ondansetron is increasingly used off label to treat nausea and vomiting during pregnancy. The main objective of this study was to evaluate the risk of major congenital malformations (MCM), cardiac defects and orofacial clefts associated with first trimester exposure to ondansetron using a meta‐analytic approach. MEDLINE, ClinicalTrials.gov and Scop...
Background
The CYP2D6 gene locus has been extensively studied over decades, yet a portion of variability in CYP2D6 activity cannot be explained by known sequence variations within the gene, copy number variation, or structural rearrangements. It was proposed that rs5758550, located 116 kb downstream of the CYP2D6 gene locus, increases gene expressi...
WE READ WITH GREAT INTEREST COMMENTS FROM CAO ET AL ON OUR ARTICLE. WE AGREE WITH THEM THAT MULTIPLE TESTING COULD POTENTIALLY EXPLAIN SOME OF OUR FINDINGS AND SOME OF OUR RESULTS SHOULD BE INTERPRETED WITH CAUTION SINCE SOME ANALYSES WERE UNDERPOWERED AND RESIDUAL CONFOUNDING COULD NOT BE RULED OUT FOR MANY REASONS. FOR EXAMPLE, WHEN THE NUMBER OF...
Background:
The use of fertility treatments has been growing over the past decade, but these treatments are not without risk. We aimed to quantify the risk of preterm birth associated with the use of ovarian stimulators (OS) and assisted reproductive technologies (ART) overall and by type of fertility treatment.
Methods:
We conducted a case-cont...
In Reply Although we agree with Wisner and Yonkers that our findings¹ can potentially be explained by residual confounding by indication, we have performed several additional sensitivity analyses to validate our results. First, the impact of the diseases for which benzodiazepines are prescribed was addressed in the main analysis where statistical a...
Objectives
The aim of this study was to determine the association between antidepressant (AD) classes, types and duration of use during pregnancy and the risk of gestational diabetes mellitus (GDM).
Design and setting
A nested case–control study was conducted within the Quebec Pregnancy Cohort (QPC), a Canadian provincial database which includes d...
Purpose
We described the medication use during pregnancy in the French population using the French Pregnancy Cohort (FPC).
Methods
The FPC was built with the sampling of all pregnant women included in the French Echantillon généraliste des bénéficiaires (EGB), which is a 1/97th representative sample of the population covered by the French health i...
Objectives:
The aim of the study was to quantify the risk of major congenital malformations (MCM) associated with first-trimester exposure to antiemetics.
Study design and setting:
Using the Quebec Pregnancy Cohort (1998-2015), first-trimester doxylamine-pyridoxine, metoclopramide, and ondansetron exposures were assessed for their association wi...
Women tend to discontinue their antidepressants during pregnancy. This study compared the risk of depressive symptoms in the second-half of pregnancy in women who discontinue or continue with or without dosage modification their antidepressant during gestation. Women were eligible if they called MothertoBaby during 2006-2010 and within 14 completed...
Importance
Benzodiazepine use in early pregnancy is associated with spontaneous abortion (SA). However, to date, the association between specific benzodiazepine agent exposure and the risk of SA has not been examined.
Objective
To quantify the risk of SA associated with gestational benzodiazepine incident use by drug class, duration of action, and...
Bioelectric signaling is transduced by neurotransmitter pathways in many cell types. One of the key mediators of bioelectric control mechanisms is serotonin, and its transporter SERT, which is targeted by a broad class of blocker drugs (selective serotonin reuptake inhibitors [SSRIs]). Studies showing an increased risk of multiple malformations ass...
Background:
While topical azoles are the first-line treatment for fungal infections, oral fluconazole is frequently used during pregnancy. We aimed to assess the effect of exposure to low and high doses of fluconazole during pregnancy on the occurrence of spontaneous abortions, major congenital malformations and stillbirths.
Methods:
Within the...
At least one in ten women is exposed to a psychotropic medication in the perinatal period, and the rate has increased tremendously over the past two decades. Pregnancy is a period of extreme vulnerability to the onset of depression and other mental illnesses, and the use of pharmacological treatment has become highly concerning to patients and thei...
BACKGROUND: The use of medications to treat attention deficit hyperactivity disorder (ADHD) has increased, but the prevalence of ADHD medication use across different world regions is not known. Our objective was to determine regional and national prevalences of ADHD medication use in children and adults, with a specific focus on time trends in ADHD...
Children conceived using Assisted Reproductive Technologies (ART) have a higher incidence of growth and birth defects, attributable in part to epigenetic perturbations. Both ART and germline defects associated with parental infertility could interfere with epigenetic reprogramming events in germ cells or early embryos. Mouse models indicate that th...
Background: The use of medications to treat attention deficit hyperactivity disorder (ADHD) has increased, but the prevalence of ADHD medication use across different world regions is not known. Our objective was to determine regional and national prevalences of ADHD medication use in children and adults, with a specific focus on time trends in ADHD...
Aims:
Data available on the fetal safety of trimethoprim-sulfamethoxazole exposure during pregnancy remains scarce and inconclusive. A previous study assessing the link between use TMP-SMX exposure during pregnancy and the risk of spontaneous abortion (SA) did not control for protopathic bias and indication bias.
Methods:
We conducted a nested c...
[This corrects the article DOI: 10.1007/s40471-017-0104-1.].
Pregnant women may take non-steroidal anti-inflammatory drugs (NSAIDs), selective cyclooxygenase (COX)-2 inhibitors or biologic agents to relieve symptoms or manage disease flares in late pregnancy. We aimed to quantify the risk of prematurity associated with late pregnancy exposure to non-selective NSAIDs, selective COX-2 inhibitors and biologic a...
Objectives
Leflunomide is known to be embryotoxic and teratogenic in rodents. However, there is less evidence in humans. We quantified the risk of major congenital malformation (MCM), prematurity, low birth weight (LBW) and spontaneous abortion associated with leflunomide exposure during pregnancy in humans.
Methods
From a cohort of 289 688 pregna...
Objective:
To quantify the risk of major congenital malformations associated with gestational combination antiretroviral use.
Design:
Population-based prospective cohort study.
Methods:
Using the Quebec Pregnancy Cohort from 1998-2015, we included women who covered by Quebec Drug Plan and have a singleton livebirth. All antiretroviral use alon...
Introduction:
Few studies have investigated the link between individual antibiotics and major congenital malformations (MCMs) including specific malformations owing to small sample size. We aimed to quantify the association between exposure to gestational antibiotic and the risk of MCMs.
Methods:
Using the Quebec pregnancy cohort (1998 -2008), w...
Importance: Polymorphic expression of drug metabolizing enzymes affects the metabolism of antidepressants, and thus can contribute to drug response and/or adverse events. Pregnancy itself can affect CYP2D6 activity with profound variations determined by CYP2D6 genotype.
Objective: To investigate the association between CYP2D6 genotype and the risk...
Background:
The association between antidepressant (AD) use during pregnancy and the risk of attention deficit with or without hyperactivity disorder (ADHD) in children is debated. We investigated the risk of ADHD associated with overall and class-specific antidepressant exposure in utero.
Methods:
We designed a register-based cohort study using...
Background:
Although antibiotics are widely used during pregnancy, evidence regarding their fetal safety remains limited. Our aim was to quantify the association between antibiotic exposure during pregnancy and risk of spontaneous abortion.
Methods:
We conducted a nested case-control study within the Quebec Pregnancy Cohort (1998-2009). We exclu...
Objective.:
The aim was to evaluate the prevalence of postpartum complications, including depression, in new mothers who had juvenile idiopathic arthritis (JIA) and to assess whether these differ from mothers who never had JIA.
Methods.:
Our cohort study used data from physician billing and hospitalizations covering Quebec, Canada. We identified...
Purpose of Review
Administrative claims databases, which collect reimbursement-related information generated from healthcare encounters, are increasingly used to evaluate medication safety in pregnancy. We reviewed the strengths and limitations of claims-only databases and how other data sources may be used to improve the accuracy and completeness...
Objective
To quantify the association between first-trimester antidepressant exposure and the risk of major congenital malformations (MCM) in a cohort of depressed women.
Method
Data were obtained from the Quebec pregnancy cohort. All pregnancies with a diagnosis of depression or anxiety, or exposed to antidepressants in the 12 months before pregn...
Background
Administrative databases are increasingly used to measure drug exposure in perinatal pharmacoepidemiology. We aimed to estimate the concordance between records of prescriptions filled in pharmacies and self‐reported drug use during pregnancy.
Methods
Data on self‐reported medication use were collected at each trimester of pregnancy amon...
Objective:
Recent evidence suggests in utero exposure to maternal antibodies and cytokines as important risk factors for autism spectrum disorders (ASD). We aimed to systematically review the risk of ASD in children born to mothers with rheumatoid arthritis (RA) compared to children born to mothers without RA.
Methods:
We conducted a systematic...
Objective:
To compare children's cognitive, motor, and language development at 2 years of age after assisted reproductive technologies (ARTs) relative to natural conception.
Methods:
The 3D-Study (2010-2012) is a prospective cohort study, which sought to improve the understanding among perinatal events, obstetric outcomes, and child development....
This conference report describes six presentations that were given during a Canadian Institutes for Health Research-funded workshop. The goal of the workshop was to discuss key knowledge gaps in the study of outcomes in mothers with rheumatic diseases and their offspring. Presentations focused on epidemiological and methodological issues associated...
Objective
Antidepressant use during gestation has been associated with risk of major congenital malformations but estimates can lack statistical power or be confounded by maternal depression. We aimed to determine the association between first-trimester exposure to antidepressants and the risk of major congenital malformations in a cohort of depres...
Aim:
Use of selective serotonin reuptake inhibitors (SSRIs) in late pregnancy may be associated with an increased risk of persistent pulmonary hypertension of the newborn (PPHN). Limited data are available on the risk of PPHN associated with serotonin norepinephrine reuptake inhibitors (SNRIs). We aimed to quantify both associations.
Methods:
Us...
Appendix S2. Template for maternal and infant medication and nutritional supplement logs.
Appendix S3. Information collected on child health problems.
Figure S1. Map of 3D Cohort Study sites.
Figure S2. 3D Cohort Study recruitment, follow‐up, and data collection.
Table S1. Demographic, environmental, and health measurements assessed on maternal partners in the 3D Cohort Study.
Table S2. Self‐reported psychosocial measurements assessed on maternal partners in the 3D Cohort Study.
Appendix S1. Measures collected on individual and family medical history.
Background:
The 3D Cohort Study (Design, Develop, Discover) was established to help bridge knowledge gaps about the links between various adverse exposures during pregnancy with birth outcomes and later health outcomes in children.
Methods:
Pregnant women and their partners were recruited during the first trimester from nine sites in Quebec and...