CIHR Analysis of Human Development, Child and Youth Health Data Using Existing Canadian Databases and Cohorts
This opportunity funds research that uses data from existing Canadian cohorts, databases, cohort catalogues, and data platforms relevant to reproductive, maternal, child and/or youth health. The objective is to highlight and encourage use for research of previously funded cohorts, administrative and survey data to inform improved patient, population and system outcomes.
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A Partner Linkage Tool is available to facilitate new collaborations between organizations/individuals interested in providing access to cohort data, data platforms, administrative datasets, and other types of data for the purposes of research project proposals to be submitted to the Analysis of Human Development, Child and Youth Health Data Using Existing Canadian Databases and Cohorts funding opportunity.
Previous grantees
2023
Awardee profiles
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Adolescent health as a window into future risk of endometriosis
Endometriosis is a chronic inflammatory disease that affects 1 in 10 females in Canada. Endometriosis is often diagnosed between 20-40 years of age, but experts believe disease-related changes may begin as early as adolescence, with immune system dysfunction playing a key role. Females with endometriosis experience disabling pelvic pain and face delays in receiving a diagnosis because symptoms overlap with other chronic pain conditions. Endometriosis has no cure, so understanding risk factors is essential for early diagnosis and treatment to improve quality of life. Dr. Natalie Scime is a women’s health epidemiologist and former Banting Postdoctoral Fellow collaborating with Dr. Hilary Brown at the University of Toronto, Scarborough. They are leading a study to investigate whether adolescent onset of allergic (e.g., asthma) and psychiatric (e.g., depression) disorders, which share features of immune-related dysfunction and inflammation, foreshadow females’ risk of developing endometriosis over their lifespan. The researchers are analyzing three decades of province-wide health and demographic records to track females, from birth to adulthood, who were born in Ontario between 1988 and 1998. This is the first study of its kind in Canada. This study holds the potential to reveal whether health conditions during adolescence can help clinicians diagnose endometriosis earlier, limiting the extent of disease and its impacts on patients’ physical health and well-being. Further reading X |
Vasa Previa in Canada: Addressing Knowledge Gaps to Prevent Newborn Loss
Vasa previa (VP) is a rare but serious and often hidden pregnancy complication occurring when fetal blood vessels that are unprotected by the umbilical cord or placenta run through the amniotic membranes and cross the cervix. If VP is not diagnosed, the blood vessels may rupture during pregnancy, resulting in severe fetal blood loss, leading to complications or death of the baby during or shortly after birth. VP affects about 1 in 1,200 pregnancies; however, there is limited data available on VP, and it is often based on case reports. This highlights a critical gap in knowledge and underscores the urgent need for further research to better understand VP. Dr. Zuk will use an Ontario-wide cohort derived from anonymized health records at the Institute for Clinical Evaluative Sciences (ICES) to look at how often VP is diagnosed among birthing individuals in Canada; compare VP risk factors, clinical characteristics, indicators for delivery, and obstetric outcomes; and examine the rate of perinatal mortality, and neonatal complications among VP survivors. Dr. Zuk’s research will advance the understanding of neonatal and obstetric outcomes for individuals diagnosed with VP, while helping to improve patient outcomes. Additionally, the project will contribute to Canadian Clinical Practice Guidelines informed by data collected within Canada. This research will serve as a foundation for future studies, ultimately improving the quality of life for children across their lifespan. Further reading X |
Advancing Food Allergy Research for Safer and Healthier Lives
Food allergy is a growing public health concern worldwide; but currently there is no cure and treatment options are limited. This leaves millions of people at risk of life-threatening allergic reactions. Dr. Nazmul Islam and Dr. Derek Chu at McMaster University are working to better understand why food allergies develop, how they progress, and what factors can predict their outcomes. What makes their research new and exciting is its focus on identifying modifiable factors—things we can change—that may help prevent food allergies. They are using data from the CHILD cohort study, one of the largest and most comprehensive studies on child health in Canada, to study patterns from thousands of children to identify the early-life factors that influence food allergy development. Once these modifiable factors are identified, the researchers can design clinical trials to test new prevention and treatment methods. This research could lead to more personalized care, where treatments are tailored to each patient’s specific needs. Ultimately, this research will help improve the diagnosis, prevention, and treatment of food allergies, as well as support optimal child and youth health and development. Further reading X |
Can AI detect early signs of preeclampsia from prenatal ultrasound?Investigating the potential of AI in early obstetrical risk prediction 
Preeclampsia is a common, life-threatening complication of pregnancy and a leading cause of maternal death. It is a progressive, multi-system disorder involving high blood pressure and signs of liver or kidney damage after the 20th week of pregnancy. There is still no cure for preeclampsia, but taking low-dose aspirin daily before 16 weeks of pregnancy can reduce its severity. Unfortunately, current screening methods can only identify a fraction of high-risk mothers, making it difficult to target preventative therapy effectively. Dr. Steven Hawken is leading a multidisciplinary team that is testing a novel approach to preeclampsia prediction. The team is using specialized artificial intelligence (AI) models, called deep learning neural networks, which have already been applied successfully to identify birth defects from prenatal ultrasound images. Building on this previous work, the current study will evaluate if AI can identify abnormalities in the placenta and uterus from first trimester ultrasound images. If this approach is successful, individuals at high risk of developing preeclampsia could be identified and treated earlier, leading to fewer negative outcomes. Further reading X |
Non-invasive assessment of pregnancy and placental health
The placenta is an organ that provides oxygen and nutrients to a growing fetus during pregnancy. When the placenta doesn’t work properly—a condition called placental insufficiency—it can cause serious complications, such as preeclampsia (high blood pressure in pregnancy) and poor fetal growth. These problems can harm both the baby and the mother, sometimes with lasting effects. Our research focuses on understanding why the placenta doesn’t function properly in some pregnancies. We study the variation in genetic sequence (molecular "instructions" that control how the placenta works). We also assess changes to chemical marks on DNA that can modify how genes are expressed (called epigenetics) that might be linked to pregnancy complications. During pregnancy, DNA is shed from the placenta into the mother’s bloodstream. We look at genetic and epigenetic profiles in placental DNA and the DNA shed from the placenta using cutting-edge biological methods to generate genomic and epigenomic data. Using this data along with computational biology and machine learning (artificial intelligence) approaches, we find patterns in the data that can help us understand the causes of placental insufficiency. These patterns could help us develop non-invasive ways to monitor the placenta and predict which pregnancies might become high risk. By identifying early warning signs of complications and understanding the molecular mechanisms involved, our research could help doctors act sooner and develop new preventative treatments, improving outcomes for both mothers and babies. Further reading |
Maternal depression: Long-Term Effects on Children’s Success
Depression is a leading cause of disability worldwide and a significant contributor to the overall global health burden. It doesn’t just affect the person who is depressed, like mothers, but also impacts the people around them, including their children. Research has shown that the effects of maternal depression can harm children’s well-being throughout their lives, starting as early as in the womb and continuing through infancy, childhood, adolescence, and beyond. Maternal depression can also have long-term consequences for children’s future, including their ability to develop professional skills and secure good jobs. While many studies have explored how a mother’s mental health affects the emotional well-being of their adult children, there has been less focus on how it impacts the children’s future economic success, such as their ability to pursue higher education, find meaningful work, and earn a decent income. This project aims to fill that gap by using data from the National Longitudinal Survey of Children and Youth and the T1 Family File tax data to explore whether maternal depression affects adult children’s socioeconomic outcomes in Canada. The findings from this research will help create strategies to improve maternal mental health, which can then lead to better outcomes for children’s health and their future financial well-being. It will also provide valuable information for public health policies and decisions. Further reading |
Understanding Water Birth in OntarioUncovering who chooses water birth, where, and the main outcomes could help inform choices made by midwifery clients, professionals and policy- and decision-makers about this effective therapy. 
Researchers at Ontario Tech University, McMaster University and Sick Kids Hospital are working together to understand more about water birth in Ontario. Midwives who are looking to promote healthy births for people at low risk of complications, offer to deliver a baby in a pool of water as one option for care. Childbearing people highly value water birth and a significant amount of international research supports its safety, effectiveness and appropriateness. However, in Ontario there are many unanswered questions about water birth. For example, we don’t know who chooses water birth, where it takes place, and what the outcomes are for mothers and newborns in the Ontario health care context. To answer these questions, we are working with a variety of knowledge users, including members of the public, healthcare professionals, policymakers and researchers, and analyzing birth data from provincial datasets in a historical cohort observational study. Our findings will help childbearing people, as well as healthcare practitioners and policy-makers in the province, make informed decisions about water birth - whether to consider it as a birthing option and whether to offer and support it in Ontario. Further reading |
What mental health challenges do sexually and gender diverse youth in Quebec face today?
Sexually and gender diverse youth, including those identifying as lesbian, gay, bisexual, and transgender, are growing in number in Canada. Despite Canada’s reputation for inclusivity, LGBT youth face significantly higher risks of mental health challenges. Unfortunately, there is a lack of understanding about how mental health problems, such as depression, anxiety, suicidality and substance use, develop over time, and if and how mental health services are used by young people. Using data from the Quebec Longitudinal Study of Child Development (QLSCD), which follows youth from birth in 1997 to age 25 in 2023, this project will provide a clearer picture of LGBT youth mental health in Quebec. The study takes a lifespan approach to look at how mental health changes over time, by studying both self-reported data and medical records to track healthcare use. In collaboration with youth who have lived experiences, the project aims to identify mental health differences between LGBT and heterosexual/cisgender youth, with the goal of improving how resources are allocated. This research also supports the training of Dr. Sasha MacNeil, a postdoctoral researcher, and two graduate students, Alicia Martineau and Lauren Anzarouth, contributing to the development of the next generation of mental health scientists. Further reading X |
The Reading Connection: How the Brain’s Wiring Supports the Development of Reading SkillsBrain imaging research provides insight to the neurobiological bases of reading (dis)ability 
An alarming 9% of children in Canada persistently struggle with reading, a condition known as reading disability (RD). RD can affect a child’s ability to read and write, often resulting in poor academic achievement. Children with RD are more likely to have poor mental health, including anxiety, depression and low self-esteem. Early intervention improves outcomes in children with RD, but current screening practices remain imprecise, and many children do not receive adequate support in school. Understanding which parts of the brain support reading activities can facilitate the development of novel neurobiological identification and intervention methods. Our team applies advanced brain imaging techniques to link reading ability to specific brain features that may serve as early indicators of risk for RD, and/or potential targets of noninvasive brain stimulation treatments for RD. We recently linked reading ability to the tissue density of a key neural pathway of the brain’s reading and language systems. Children’s reading outcomes were consistently associated with the tissue structure of this pathway measured from early childhood through early adolescence, suggesting that densely organized fibers provide a foundation for reading development by enabling efficient communication among distant brain regions. Together with ongoing research, these findings will help researchers and educators understand the brain differences underlying reading difficulties and develop targeted intervention practices to improve outcomes for children with RD. Further reading X Bluesky |
2022
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The missing mourners in Canadian societyUnderstanding prevalence, demographics, and disparities in children’s grief in Canada 
Experiencing the death of a parent or sibling during childhood can have a life-long impact on a child's health and wellbeing. While there are agencies available to support grieving children across the country, it is not clear how many children might be grieving at any given time. Through this research we will identify the number of Canadian children less than 19 years of age who are grieving the death of a parent or sibling as well as their demographics and distribution provincially and nationally. We will adapt the Child Bereavement Estimation Model, which has been used in the US, to the Canadian context using the Canadian Vital Statistics Database and the Census of the population. The Canadian model will allow us to look at ethnicity, immigration, and Indigenous status to address the need for diversity data in Canada. We will also examine neighbourhood income, to enable targeting of services to geographic areas with greater needs; and cause of death, to enable distinction between sudden vs. expected death. This project provides a critical foundation for the development and delivery of grief supports to address the complex and varied needs of Canadian children and their families. Further reading |
Understanding what happens to children who grow up in households with intimate partner violence
A child in Manitoba witnesses intimate partner violence (IPV) every two hours. Some of the short-term consequences of growing up in households with IPV include behavioural problems, high stress levels, and trouble with school. Less is known about what happens in the long-term to children who grow up in households with IPV. Our goal is to describe the relationship between growing up in households with IPV and mental health, educational performance, and social outcomes. We will also identify factors that protect children from worse outcomes despite growing up in households with IPV. The Manitoba Center for Health Policy houses excellent provincial administrative data, including health, education, justice, and social data. We will compare children whose mothers pressed charges for IPV to children whose mothers did not press charges for IPV. We will follow children for up to 20 years and determine if they are ever subsequently diagnosed with a mental health disorder, how they perform in school, if they are involved in the judicial system as young adults, or if they require social assistance as young adults. We hope our results will help us advocate for more social programming to support children who grow up in households with IPV. Further reading |
Emergency general surgical conditions in pregnancy and the post-partum period
Emergency general surgical (EGS) conditions are very common. EGS patients present with a variety of infectious and obstructive conditions of the gastrointestinal tract. These often require urgent infection control, and/or treatment through surgical, image-guided, and/or endoscopic interventions. Non-obstetric abdominopelvic surgery for EGS conditions such as appendicitis and gallstone disease occur in 0.2-0.5% of pregnancies. With over 358,000 deliveries in Canada per year this is equivalent to over 1,800 emergency procedures during pregnancy every year for appendicitis and gallstone disease alone. Despite how common these conditions are, significant diagnostic and management challenges during pregnancy remain. Risks of ionizing radiation from CT scans and lower diagnostic yield of abdominal sonography, as well as the presence of physiologic leukocytosis and nausea during pregnancy, can lead to delayed diagnosis. Despite the fact that emergency surgery is often necessary and supported by guidelines, patients and surgeons may be reluctant to proceed out of concern for fetal wellbeing during an operation, and fetal loss or preterm birth after an operation. Our objective is to improve the care of EGS conditions during pregnancy and postpartum by filling these knowledge gaps through a population-based analysis of a broad group of EGS conditions in pregnancy and the post-partum period with a focus on maternal and peri-natal outcomes. Further reading |
Estimating the number of children who experience parental incarceration in CanadaThe CHIRP (CHildren with IncarceRated Parents) Study 
Parental incarceration is recognized as an adverse childhood event, and poses serious risks to healthy child development. While numbers are estimated to be in the thousands, there is a lack of systematic data on the true number of children who experience parental incarceration, making this population largely invisible from a policy perspective. In partnership with community stakeholders, our interdisciplinary team is leading research to address this important knowledge gap. Using Statistics Canada's Social Data Linkage Environment, we will access comprehensive data for people incarcerated in 5 provinces between 2015 and 2020, and identify their children by linking with vital statistics, hospitalization, and child tax benefits data. We will examine the number of children exposed to parental incarceration and the timing and nature of their exposure. Additionally, we will examine key health status indicators for these children such as mortality and injury. We will use study findings to inform the design and delivery of initiatives to support children who experience parental incarceration and their families. We will also advance further research on the health status of these children and the impacts of the criminal justice system on child and family health. Further reading |
'Big Data for Little People': Understanding the Relationship Between Home Ventilator Adherence to Therapy and Healthcare Utilization in ChildrenThe number of children who use a mechanical ventilator (a machine that supports breathing) at home (HMV) is increasing worldwide – helping more children who use HMV to live at home instead of the hospital 
At present, we lack data from large pediatric cohorts regarding ventilator usage at home and the factors preventing their use. The pandemic led to increased use of remote monitoring in healthcare. Many programs caring for kids using HMV can now link via Bluetooth to the ventilators to learn how these machines are used. We now have an opportunity to study pediatric ventilator use, in general, and factors predicting ventilator use, as well as health service utilization to see if using a ventilator regularly helps children stay out of the hospital. The results of this study will also be used to help develop a system for the government to collect data on ventilator use to help individuals with poor usage. For this project, we will link data on ventilator use from the Ontario Ventilator Equipment Pool (a part of the provincial government that provides ventilators) to health administrative databases (data on health care use). This will be the first study in Canada to study home ventilator use and associated health care service use in children. This study will help build the foundation for policy makers to have up to date information for healthcare planning to improve patient and family centered care. Further reading |
Navigating pregnancy with multiple chronic conditionsRoughly 16% of women entering pregnancy are affected; how is their care being managed? 
Chronic conditions like diabetes and depression affect 50% of the population. The co-occurrence of multiple chronic conditions (MCC) in an individual is a growing public health concern. Approximately 16% of women enter pregnancy with MCC. However, few studies have examined their pregnancy outcomes. Using an Ontario-wide cohort derived from anonymized health records at ICES, Dr. Brown is examining the association between MCC and risks of adverse pregnancy-related outcomes like severe maternal and newborn morbidity and mortality. She is looking at how risks of these outcomes change with the number of chronic conditions, the complexity of MCC, and clusters of specific chronic conditions. She is also looking at how other social and health care access inequities affect the relationship between MCC and adverse pregnancy-related outcomes. Health care is challenged by a health system that is organized around the management of single and acute conditions. Dr. Brown’s data will show how obstetric care should be escalated according to the degree and characteristics of MCC, as well as other social and health care access inequities. The findings will facilitate development of multidisciplinary care models that address the full spectrum of needs of women with MCC from preconception to postpartum and newborn care. Further reading |
Multimorbidity…not just a concern for the agedUnderstanding the intersection of physical and mental illness early in life can help support children and families across the life-course 
As many as 30% of children under 18 years of age have co-occurring physical and mental/neurodevelopmental illnesses (e.g., diabetes and depression; asthma and ADHD). This level of burden has tremendous public health implications given that these children report compromised quality of life that extends throughout life, have parents who experience elevated stress, and use considerably more health services, resulting in increased health system costs for society. Unfortunately, very little research has comprehensively examined co-occurring physical and mental illness in children. Using data from the Canadian Health Survey on Children and Youth, Dr. Ferro and his team will estimate the proportion of children with physical-mental multimorbidity; identify predictors and outcomes of child physical-mental multimorbidity; and investigate how child physical-mental multimorbidity impacts the use of mental health services. Findings will help Dr. Ferro and his team inform the development of programs and services to promote the mental health and well-being of children with physical illness and aim to improve integrated care for physical-mental multimorbidity in childhood. Because data were collected immediately prior to the COVID-19 pandemic, they provide an important baseline for future studies to examine how the mental health of children with and without physical illnesses may change post-pandemic. Further reading
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Are there long-term consequences of cannabis use in youth?Cannabis use in very common in youth, but certain patterns of use may increase the risk of negative long-term consequence 
Cannabis use in young people is a significant public health issue, especially when it starts in early adolescence. While ongoing research debates the link between cannabis use and negative mental health outcomes, studies indicate that a significant number of users report mental health issues. Concerns about cannabis-related harms are heightened for adolescents and young adults due to ongoing brain development. To guide healthcare and public health policies, it's crucial to understand which patterns of cannabis use lead to long-term problems. Our research, using data from the Québec Longitudinal Study of Kindergarten Children, Montréal Longitudinal Experimental Study, and Québec Longitudinal Study of Child Development, explores the link between youth cannabis use and later physical, mental, and psychosocial health over four decades. We analyze clinically relevant usage patterns, considering when and how often cannabis is used, and use objective administrative data for our study. The results will aid clinicians, researchers, and policymakers in developing effective prevention and treatment programs, raising awareness among youth as well as the general population about the potential long-term consequences of cannabis use. Further reading |
Early-life RSV infection: More than just a coldUnderstanding long-term sequalae and sociodemographic inequities to inform prevention strategies 
Respiratory syncytial virus (RSV) is the most common cause of respiratory tract infection and hospitalization in infants worldwide. RSV also causes considerable disease in older and immunocompromised adults. Despite its ubiquity, there is still much we do not understand about RSV, including long-term sequalae, drivers of transmission, and burden. The RSV prevention landscape is currently undergoing a radical shift, with the recent approval of multiple new vaccines and a long-acting monoclonal antibody. These new products offer promise for the widespread prevention of RSV disease; however, the optimal and equitable implementation of these population-based programs will benefit from a comprehensive understanding of their myriad direct and indirect impacts, as well as public acceptance and accessibility. Dr. Fitzpatrick’ research program is tackling a range of these gaps in our understanding of RSV, including changes in post-pandemic seasonality, social inequities in disease burden, and parental attitudes and beliefs regarding new immunization products, as well as the development of new modelling tools. With the support of the operating grant, Data Analysis Using Existing Databases and Cohorts, Dr. Fitzpatrick is examining the causal relationship between early-life RSV infection and the development of asthma, offering important insights towards understanding the long-term benefits of RSV prevention. Further reading |
Are children born with heart defects at increased risk of cancer if they have genetic syndromes?
Benefitting from cardiac diagnostic and interventional imaging, patients born with heart defects now survive into adulthood. However, they are at increased risk for cancer due to repeated radiation exposure from diagnostic and therapeutic cardiac imaging procedures. The cancer risk might be even higher in children born with heart defects because the younger age of exposure makes them more sensitive to the harmful effect of radiation. In this patient population, those with genetic syndromes might be at increased risk of radiation-induced cancer due to their genetic predisposition. However, this has never been assessed. This project aims to assess if children with genetic syndromes are more susceptible to the carcinogenic effect of radiation from cardiac imaging procedures. The study findings will provide scientific evidence for identifying high risk patients for cancer and suggest effective cancer surveillance. Further reading |
“I want to see myself in these trails.”Urban trails, Indigenous equity and mental health outcomes for youth 
Cities across Canada are investing billions of dollars annually to support cycling and active transportation. Many of these new urban structures are not accessible to racially oppressed youth and their families, particularly Indigenous youth. Our team is addressing two questions:
Studies from our team and others suggest these trails could have significant health benefits for youth. We are working closely with local organizations to study the impact of urban trails on the mental health of youth and uncover other aspects of the city that youth feel benefit their mental well-being. Further reading
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2021
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Overcoming adversityUniversity of Manitoba researcher aims to identify protective factors to reduce substance use, build resilience and improve health outcomes among adolescents who have experienced adversity in childhood 
When children and adolescents experience adverse childhood experiences, they are more likely to use substances and have poor mental and physical health across the lifespan. Dr. Tracie Afifi at the University of Manitoba studies child maltreatment and mental health with a focus on resilience, intervention, and prevention. Dr. Afifi and her team are conducting research and analyzing data to understand what factors might be protective and reduce the likelihood of substance use, including the use of alcohol, nicotine, and cannabis among adolescents who have experienced adversity. They also want to know how sexual or gender identity influences the relationship between substance use and mental health in these young people. The results of their first studies have shown that the likelihood of substance use becomes significantly greater if adolescents with a history of adverse childhood experiences also experiences peer victimization. This work will help develop strategies and interventions that build resilience in adolescents and young adults and decrease substance use, mental health problems, and physical health conditions. Further reading |
2020
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Is weight loss during pregnancy safe for women with obesity?Over 52,000 Ontario women with pre-pregnancy obesity will help to guide weight management during pregnancy   
Almost 20% of Canadian women enter pregnancy with an elevated body mass index (BMI). Appropriate gestational weight gain helps to improve maternal and fetal outcomes for individuals living with obesity. Due to limited and controversial findings of current studies, weight gain recommendations during pregnancy are not tailored for individuals with increasing BMI categories. The 2009 Institute of Medicine (IOM) guidelines for gestational weight gain recommend that individuals living with obesity should gain between 5 and 9 kg during pregnancy regardless of their obesity class. Although weight loss during pregnancy is not indicated, it has been shown that 5-8% of women with obesity, and up to 15% of women with extreme obesity, reported intentional weight loss during pregnancy. Given that a clinical trial of gestational weight loss is not feasible, a high-quality observational study was greatly needed to explore potential harms of intentional weight loss during pregnancy. Drs. Guo, Corsi and El-Chaâr and their team at the OMNI Research Group, based at the Ottawa Hospital Research Institute, are using data from BORN Ontario to study the impact of weight loss during pregnancy on a wide range of adverse maternal and infant outcomes for individuals with obesity. As the largest and most robust provincial perinatal dataset, BORN Ontario captures all hospital births in the province, accounting for 40% of births across Canada. Using data from more than 52,000 charts, the team has already identified that intentional weight loss during pregnancy is associated with small-for-gestational-age babies for all obesity classes. This study overcomes limitations of previous research and fills gaps by investigating dose-response effects of gestational weight loss on perinatal outcomes. Further reading |
How does income inequality affect adolescent health?It may be associated with deaths attributed to drug overdose among Canadian youth 
Dr. Roman Pabayo is an Associate Professor in the University of Alberta’s School of Public Health and a Canada Research Chair in Social and Health Inequities. Dr. Pabayo leads the Emerge Research Lab where he supervises a team of researchers and students who are investigating the adverse relationship between income inequality and population health outcomes, particularly among Canadian youth. In one population-based study, PhD candidate Claire Benny identified a harmful, significant association between income inequality within residential areas and an increased risk for all-cause mortality and deaths attributed to drug overdose among Canada's youth. These findings highlight the need to decrease inequities, which have a detrimental effect on the health of the youth population in Canada. They also present opportunities to target those at risk and to mitigate the harmful effects of income inequality, which include higher depressive and anxiety symptoms among adolescents as well as substance abuse. Further reading |
2019
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Risk of asthma in children diagnosed with bronchiolitis during infancy: A longitudinal study linking emergency department-based clinical data to provincial health administrative databasesNames: Institution: Bronchiolitis is a viral illness that affects infants during winter months causing fever, cough, wheezing and difficulty breathing. It is the most common disease of the lungs during the first year of life. Asthma is the most common pediatric lung disorder in North America with one in five children being diagnosed with asthma by age 10. Evidence has suggested that bronchiolitis during infancy is associated with development of asthma in later life. Better understanding of the relationship between bronchiolitis and future asthma is needed. We propose a study that will link clinical data from two emergency department-based (ED) bronchiolitis studies to provincial health administrative databases. Through linkage of ED-based clinical data to health administrative datasets, we will have a rich source of data from which to enhance our understanding of the long-term respiratory effects of interventions used to treat bronchiolitis and also identify risk factors (such as child’s clinical course, demographic and maternal factors and health service utilization related risk factors) associated with future development of asthma. Our goal is to generate evidence on the long-term respiratory outcome of children after bronchiolitis, specifically the development of asthma at a later stage of childhood. Identification of risk factors associated with development of asthma may prevent progression of disease, help maintain a good quality of life and reduce healthcare costs. |
Depression Trajectories in Pregnant and Postpartum Women: An Individual Participant Data Meta-AnalysisNames: Institution: |
 
Missed opportunities for early intervention: Determinants of prevalence and characteristics of children with impairments unrecognized in health systems by kindergarten age among the 2009 birth cohort of Ontario childrenNames: Institution: Early identification and subsequent intervention can have a beneficial impact on the lives of young children with developmental delays. The percentage of children who enter kindergarten with an impairment or a special health need (ISHN) has been increasing in the last decade. In Ontario, education and health data are kept separate, which means we know very little about these children, and even less whether - and why - they have or have not been identified prior to school entry by any health professional. How many of these children have been identified early? Who are the children who have not? What predicts early identification? We bring the health and education population-level data together for children born in 2009 who attended kindergarten in publicly-funded schools in Ontario in 2014/2015. We matched kindergarten teachers’ reports of children’s development and their ISHN using the Early Development Instrument (EDI), collected in the second half of the 2014/2015 school year, with health data from ICES (formerly called the Institute for Clinical Evaluative Sciences). In this study we try to understand why some children with early health problems start school without being flagged in the healthcare system, thus missing an opportunity to benefit from early intervention. Twitter: Websites: |
Health and developmental trajectories of infants born with Neonatal Abstinence Syndrome: sex differences and implications for harm reductionName: Institution: Exposure to opioids during pregnancy can have negative effects on baby’s development, including preterm birth, slow fetal growth, and neonatal abstinence syndrome. Neonatal abstinence syndrome is a drug withdrawal syndrome occurring shortly after birth and affecting baby’s sleep, feeding and nervous system function. Our previous research shows that neonatal abstinence syndrome increased in Canada from 2.0 to 5.1 per 1000 live births between 2005 and 2015, and that the affected babies have high occurrence of severe neonatal morbidity. However, very little is known about long-term effects of neonatal abstinence syndrome on childhood health and development. Our first objective is to examine health trajectories among children born with neonatal abstinence syndrome in British Columbia between 2001/02 and 2017/18 in a follow-up period up to 18 years. Secondly, we will assess developmental vulnerability among these children and thirdly, we will look at potential differences in these outcomes and risk factors between boys and girls. In the light of the ongoing opioid crisis, our goal is to provide information on determinants of early childhood morbidity and adverse developmental outcomes among children born with neonatal abstinence syndrome. Our results will help to create optimal targets for harm reduction and prevention. Twitter: |
Asking the Right Questions: Understanding Social and Emotional Determinants of Child Health in Pediatric Primary CareNames: Institution: Children’s mental health difficulties are a pressing public health concern in Canada. Children who experience mental health difficulties such as anxiety, depression, aggression, and conduct problems in childhood, are at risk of poor health and mental health across the lifespan. Thus, identifying the origins of children’s mental health difficulties will provide opportunities to implement targeted prevention and intervention strategies to reduce the impact of mental health difficulties on Canadian society. Many of the risk factors that lead to mental health difficulties in childhood are present early in life. The objectives of this study are to: 1) identify the individual, family, and social-environmental risk factors that are most predictive of poor child mental health at 8 years of age, and 2) identify risk clusters that predict poor mental health symptoms and diagnoses at 8 years of age. We will answer these research questions by leveraging a longitudinal cohort of over 3,000 mother-child dyads from the All Our Families study which we will link to administrative health data to determine what risk factors are the most salient predictors of children’s mental health symptoms and diagnoses at 8 years of age. The AOF study collected data twice in pregnancy, and at 4, 12, 24, 36, and 60 months postpartum. Extensive demographic, mental health, and information on early risk factors were collected using standardized tools. Children’s mental health diagnoses will be obtained from their health record. The research team is composed of experts in children’s mental health, child development, data linkage, and longitudinal statistical analyses. The potential for impact at both a practice and policy level to improve the mental health of Canadian children is significant. Twitter: |
 
Quality population-based studies of outcomes of extremely preterm infants born by cesarean section compared to vaginal birthNames: Institution: Preterm birth is the main cause of infant death and longterm disability. For extremely preterm infants born before 28 weeks of pregnancy who were presenting bottom-first, not head-first, Caesarean section may be associated with 40% lower odds of death for the infant but not all predictors were accounted for (studies did not account for other factors, like growth restriction). For extremely preterm infants presenting head-first, Caesarean section appears to reduce death by approximately 40% with. Although we summarized all available published literature, there were key gaps in the data regarding extremely preterm infants delivered by Caesarean section compared with vaginal birth:
We have gathered a team of experts in obstetrics, neonatology, methodology and statistics, national organizations and parents to study short term infant outcomes using established databases. We will also study neurological development in infants at 18-21 months after their expected due date. We will use sophisticated analysis to understand the impact of Caesarean section alone compared to vaginal birth and convey our results using articles and social media. Twitter: |
Short interpregnancy interval and risk of subsequent adverse pregnancy outcomes: modifiers and mediatorsName: Institution: |
 
Factors of Mothers and Infants in Longitudinal Years (FAMILY)Names: Teresa To Institution: The Hospital for Sick Children, Research Institute Funding partners: Today, questions on how biological, prenatal, maternal risk factors, early life social and environmental determinants interact and influence later childhood lung health and developmental outcomes remain largely unanswered. For this project, we will use health administrative data to link mothers and children from three existing Ontario pediatric cohorts (TCHEQ, CHILD, and TARGetKids!) to create a birth cohort of infants, their siblings, and mothers. Using this cohort, we will conduct two studies to: 1) determine whether the risk of common childhood respiratory diseases, atopic and allergic conditions (e.g. asthma, allergic rhinitis and eczema), and poor child development is increased with early life exposures; and 2) examine whether poor delivery, common childhood respiratory diseases, atopic allergic conditions, and poor child development are associated with mothers’ patterns of health care use and lifestyle during pregnancy. Considering the high health burden of asthma in children, the high incidence of asthma exacerbation during pregnancy, and the significant economic burden of poorly controlled asthma on the health care system, it is paramount to examine the short- and long-term impacts of this highly prevalent and dangerous health condition on children and mothers. Twitter: Websites: |
 
Neighbourhood environments and weight management outcomes in the Canadian Pediatric Weight Management Registry (CANPWR)Names: Institution: The ways in which neighbourhoods are designed influence children’s lifestyle behaviours such as physical activity and diet, which in turn influence body weight and chronic diseases. However, there is almost no research on whether neighbourhood characteristics can support the adoption of healthy lifestyle behaviours and improve health and body weight specifically among children who are seeking clinical care for obesity. With more than 1 in 4 children who have an excess in body weight, a growing number of children and families are being followed in pediatric weight management centres across Canada. This study builds on two existing research infrastructures: 1) CANPWR, a study of Canadian children with overweight or obesity who are followed in pediatric weight management programs across Canada, and 2) CANUE which facilitates the use of neighbourhood environment data in health research. We are doing analyses to understand which neighbourhood characteristics influence weight management outcomes, and which combinations of neighbourhood, program, family and child characteristics are linked to improved weight management outcomes. The results of this research will provide new information about the role of neighbourhoods on childhood obesity prevention and management, and on how to tailor weight management interventions to the places where children live. Twitter: Websites: |
 
Prenatal maternal physical activity and brain structure and function in young childrenNames: Academic institution: Funding partners: Exercise during pregnancy can be good for mothers and babies. Yet less than 2 in 10 pregnant women meet the Canadian guidelines of at least 150 minutes of moderate activity per week. Children of mothers who were more active during pregnancy appear to have better learning and memory, but we do not know why. Studies in mice show that prenatal exercise changes the brain, particularly in the hippocampus, an area involved in memory. This study will investigate how prenatal physical activity is related to young children’s brains. We will use data from an existing study that enrolled women during pregnancy and has followed their children since. Women reported physical activity in each trimester of pregnancy. Children received a magnetic resonance imaging (MRI) scan and memory test between the ages of 2-5 years. We will measure the structure and function of the hippocampus from the MRI scans and compare that to mothers’ activity during pregnancy. We will also look at whether our findings help explain memory function in the children. Evidence showing the impact of prenatal exercise on children’s brains is necessary for developing appropriate guidelines that will ultimately improve child health. Twitter: |
2017
Awardee profiles
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Adolescent injury, substance use, and mental health: An exploration of rates, determinants, and comorbidities in Canadian survey dataName: Mark Asbridge |
Artificial sweeteners during pregnancy: Do they alter the baby’s microbiome?
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Impact of asthma diagnosed during pregnancy on perinatal outcomesName: Lucie Blais Asthma firstly diagnosed during pregnancy may be of a different nature than asthma diagnosed during pregnancy, maybe more difficult to treat, and may have stronger consequences on the newborn. We compared the risk of prematurity and low birth weight between women who were diagnosed with asthma in the two years prior to pregnancy and those who developed asthma during pregnancy. We observed that women who developed asthma during pregnancy were at increased risks of having a premature delivery and a baby with a low birth weight. Further research is needed to know whether this increased risk is due to the nature of asthma itself being more severe when developed during pregnancy or it is due to the fact that physicians and women are more reluctant to start the required treatment when asthma is diagnosed during pregnancy. Twitter: |
Mining the gap: Establishment of pregnancy-specific laboratory reference intervals using provincial laboratory dataName: Vilte Barakauskas |
Perinatal exposure to perfluoroalkyl substances (PFASs) and polybrominated diphenyl ethers (PBDEs) and weight gain trajectory in children: Data from the maternal-infant research on environmental chemicals (MIREC) cohortName: Maryse Bouchard |
Depressive symptoms in adolescence: Do genetics and physical activity play a role?Name: Jennifer Brunet Although depression can occur at any age, the average age of onset of depression is decreasing and between 2-9% of adolescents are affected by major depressive disorder. These individuals have poorer educational, behavioural and health outcomes than do asymptomatic adolescents underscoring the critical need to identify and understand factors involved in the development and alleviation of depressive symptoms in this age demographic. Dr. Brunet’s research focuses on identifying genetic variants contributing to depressive symptoms in adolescence, and determining whether physical activity plays a role in moderating this relationship while also exploring sex differences and investigating the role of timing and intensity of physical activity. Findings from this study will lead to a better understanding of the etiology of depression in adolescence, and shed light on which subgroups may benefit most from physical activity interventions. Further, the study of physical activity and depressive symptoms over time will inform optimal age windows for intervention delivery, and help us to understand what patterns of physical activity lead to decreases in depressive symptoms. Twitter: Websites: |
Impacts of Canada’s minimum age for tobacco sales (MATS) laws on youth smoking behaviour, 2000-2014Name: Russell C. Callaghan Recently, the US Institute of Medicine and Health Canada have proposed that raising the minimum age for tobacco purchasing /sales to 21 years would likely lead to reductions in smoking behavior among young people. Surprisingly few studies, however, have assessed the potential impacts of minimum-age tobacco restrictions on youth smoking. As such, the current study aimed to evaluate the impacts of Canadian minimum age for tobacco sales (MATS) laws on youth smoking behavior. Study results demonstrated that Canadian MATS laws were associated with a significant impact on smoking behaviour among young people. In comparison to persons slightly younger than the MATS, age groups just older had sharply higher prevalence of current smoking and daily smoking, as well as higher rates of past-month cigarette consumption. Given these findings, it seems reasonable to argue that raising Canada’s MATS laws would likely attenuate young people’s initiation to current-smoker or daily-smoker status and total cigarette volume consumption in newly restricted age groups. Twitter: Website: |
In through the out door: Do increasing pediatric emergency mental health presentations reflect poorer access to primary and outpatient mental health care?Name: Leslie Campbell |
Can parenting behaviours influence adolescent mental health?Name: Ian Colman Our research sought to clarify how parenting practices influence adolescent mental health. We used data from a long-running study of several thousand Canadian children. When the children were young, parents reported on positive behaviours (e.g., frequently praising the child) and the use of harsh discipline (e.g., yelling at the child). When the children reached age 12, they completed structured assessments of their mental health, including symptoms of depression, hyperactivity, conduct disorder, and suicidal thought. We found that positive parenting was linked to better adolescent mental health, particularly among girls, while harsh discipline was linked to worse adolescent mental health, particularly among boys. These results held after accounting for numerous other factors associated with parenting behaviours and mental health, such as poverty, parental education, and parental mental health. This suggests that programs aimed at supporting parents may have beneficial effects on their children’s mental health. Twitter: Website: |
Infertility treatment and severe maternal morbidityName: Natalie Dayan Infertility Treatment (IT) is increasingly used in Canada to achieve pregnancy and in some cases is publicly funded. Research strongly suggests that obstetric complications are more common in IT than non-IT pregnancies but fewer studies have examined maternal complications specifically. In this study, we measured the link between IT and severe maternal morbidity (life-threatening complications occurring to a woman during pregnancy or up to 42 days after delivery) in Ontario. We found that while severe maternal morbidity or death was thankfully rare, occurring in overall 1.5% of women, those who had undergone IT were 40% more likely to experience one of these serious outcomes even after accounting for maternal factors more common in IT users. This risk was particularly concentrated among women who had undergone more invasive forms of IT such as in vitro fertilization (IVF). We are currently developing a risk score to identify women at risk for severe maternal morbidity. This work will help in the pre-conception counseling of all women, including those who use IT. Future planned studies will evaluate different IVF protocols and their relative contribution to severe maternal morbidity. Twitter: Websites: |
Perinatal use of immunosuppressant therapies and risk of infections in mothers and babiesName: Mary De Vera |
Flu shots during pregnancy
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Mothers' well-being in pregnancy and associations with biological measures of stress in mothers, the placenta and newbornsName: Catherine Herba Mothers' stress, depression and/or anxiety (SDA) in pregnancy have been associated with poorer child neurobehavioural outcomes, even after accounting for postnatal SDA and inherited influences. Elevated SDA may render the placenta less able to protect the fetus against harmful physiological effects of stress, increasing the child's vulnerability to stress. Using the 3D pregnancy cohort and biobank, we examine how SDA in pregnancy affects the child by studying stress markers in the glucocorticoid and serotonin signaling pathways. Our study is unique in its ability to assess associations among stress markers in mothers, placenta and newborns in relation to prenatal maternal SDA. At birth, placenta samples and mother and newborn hair samples were obtained. Hair cortisol concentration (HCC) can capture biological stress response in mothers and fetuses over the last pregnancy months. Placental glucocorticoid and serotonin gene expression was measured. First analyses suggest elevated mothers' HCC may be associated with altered placental glucocorticoid gene expression, whereas elevated newborn HCC may be associated with alterations in serotonin gene expression. Sexual dimorphism was observed in placental glucocorticoid and serotonin signaling pathways. Once completed, results from this study will help improve our understanding of how maternal SDA links to stress markers in the mother, fetus and placenta. Twitter: Websites: |
Parenting and children’s BMIName: Lisa Kakinami Our research aimed to investigate whether general parent-child interactions might predict children’s future body mass index (BMI). A secondary objective was to investigate whether the child’s behaviours or BMI would affect the way the parents interacted with them. To answer these objectives, we used data from the Quebec Longitudinal Study of Child Development (QLSCD), a representative cohort of singleton births born in Quebec in 1998. Data from when the children were six to 12 years of age were utilized. Although preliminary, two different sets of analyses (a linear mixed model, and a structural equation model utilizing path analysis) suggest that children with parents who were more permissive toward them (eg: not disciplining them for misbehaving) were more likely to have higher BMIs than children with parents who set expectations and enforced boundaries. We found no evidence that the BMI of the child, or the child’s behaviours (eg: if they were more withdrawn, or more aggressive) affected the way the parents interacted with them. Website: |
Mental health outcomes in pediatric survivors of traumatic injury compared to matched controls: A population based, retrospective studyName: Sarvesh Logsetty |
Innovation prediction models for risk assessment of preterm birth: A key step to improve care and outcomesName: Sarah McDonald Preterm birth is a heterogeneous syndrome resulting from the interaction of numerous genetic and environmental factors. Given the heterogeneity of preterm birth, developing a comprehensive and uniform classification approach to examine clinical subtypes of preterm birth was seen as a priority by the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), to improve preterm surveillance, reporting and ultimately management. We used the GAPPS classification approach to study the following research question: What are the prevalences of preterm birth phenotypes and their association with cesarean section and adverse neonatal outcomes for singleton births in multiparous women? In this population-based cohort study of 8775 preterm births of multiparous women, two-thirds met criteria for at least one predefined phenotype. The distribution of preterm birth phenotypes varied in first and recurrent preterm births, although their associations with maternal and neonatal outcomes were similar. Meaning: The consistency of the associations between preterm birth clinical conditions and adverse outcomes in the different levels of exposures provides validation for the phenotypic classification model. Twitter: Website: |
Intergenerational transmission of maternal ACEs on child behaviour at age 5: Risk and resilience factorsName: Sheila Mcdonald |
Prenatal biochemical screening and the long-term risk of cardiovascular disease and cancerName: Joel Ray |
Do we preferentially prescribe insulin pumps to wealthier kids?: The Quebec and Manitoba experienceName: Celia Rodd All Canadian provinces have invested in programs to fund insulin pumps for children with Type 1 (juvenile) diabetes mellitus. The initial cost for the pump is approximately $7000 with ongoing annual costs of about $4000 for supplies. Intensive teaching is also required to ensure that the cutting edge technology is used safely and effectively. Although Quebec provides funding to cover all pump-related costs, this is not true in Manitoba or Ontario, and an Ontario study has shown that wealthier and more educated families were more likely to receive pumps than disadvantaged families. By comparing data from Manitoba and Quebec, we hoped to answer the question of whether funding support and other program differences might lead to differences in access to pump therapy or complication rates due to diabetes or pump failures based on family income and education levels. To date, our work has shown that wealthier and more educated families in both provinces were more likely to move to the pump than those with less income or education. We are currently comparing emergency room visits and hospital admissions to assess the impact of different program models on diabetes control and complications. |
Copy number variation and mental illness in a pediatric community sampleName: Russell Schachar |
Adults born at extremely low birth weight (ELBW): Evidence of premature aging?Name: Louis Schmidt |
The nutritional vulnerability associated with food insecurity in CanadaName: Valerie Tarasuk Food insecurity, the inadequate access to food due to financial constraints, is a serious social and public health problem in our country, affecting more than 4 million Canadians. Drawing on data from the 2004 and 2015 Nutrition-focused Canadian Community Health Surveys, we examined the nutritional implications of food insecurity for children and adults in Canada. We found a clear gradient whereby the more severe the household food insecurity, the poorer dietary intakes, with people in severely food insecure households having substantially lower intakes of essential nutrients and lower intakes of the foods recommended by the 2019 Canada’s Food Guide (i.e., fruits and vegetables, protein foods, and whole grains). Our results are consistent with other Canadian research showing greater budgetary compromises and higher rates of morbidity and mortality with more severe food insecurity. A comparison of the dietary intakes of adults in food insecure households in 2015 with the intakes of those in similarly food-insecure households in 2004 suggests that the dietary compromises associated with food insecurity have worsened over time. Our findings highlight the need for more effective policy interventions to reduce the prevalence and severity of food insecurity in Canada. Twitter: Website: |
Do the patterns of health care use in early life predict subsequent risks of childhood respiratory conditions?
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What works best for children with autism?
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Providing end-of-life care to children – We can do better!Name: Kimberley Widger Children with life-threatening conditions deserve the highest quality of care aimed at maximizing quality of life and ensuring a good death in the preferred location Unfortunately, research with bereaved parents highlights the use of intensive medical treatments (e.g., intensive care unit admissions, ventilator support) at end-of-life with a high degree of associated suffering. In this study we aimed to improve our understanding of how many children with life-threatening conditions died in hospital and received intensive treatments as well as the specific patient characteristics associated with differences in the care provided. We found that 89% of children with a life-threatening condition died in hospital and 40% received high intensity healthcare at the end of life. Not surprisingly, age and diagnosis were associated with differences in location of death and high intensity health care use, however, differences based on province, distance from tertiary care center and living in rural areas are concerning indicators of potential inequities in the ability to access high quality care at end-of life. Twitter: Website: |
Contact Information
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