Study Results: Women's Health
Browse studies focused on women's health, physical wellness, and pregnancy outcomes.
Differential associations of adverse childhood experience on maternal health
The current study examined whether three distinct antecedent factors related to maternal adverse childhood experiences were differentially associated with maternal health and psychosocial outcomes in the antepartum period.
Path analysis demonstrated that women who had experience with physical/emotional abuse in childhood were significantly more likely to enter pregnancy with a chronic health condition (AOR=1.25, 95% CI=1.02, 1.54) and to have psychosocial difficulties in their pregnancy (AOR=1.60, 95% CI=1.34, 1.89). Women who were exposed to household dysfunction in childhood were also significantly more likely to experience psychosocial difficulties during pregnancy (AOR=2.33, 95% CI=1.49, 3.65).
Conclusions: Adverse childhood experience categories differentially predicted maternal health and psychosocial outcomes prior to and during pregnancy. The overall variance accounted for by adverse childhood experiences was small (3%-19%), suggesting that factors other than childhood adversity likely contribute to maternal health.
The influence of back pain and urinary incontinence on daily tasks of mothers at 12 months postpartum
The present study examined back pain (BP) and/or urinary incontinence (UI) impact on the ability to perform daily tasks at 12 months after childbirth in healthy reproductive women who sought maternity care in community based family practice clinics.
From 1574 women with singleton pregnancies included in the study, 1212 (77%) experienced BP, 773 (49%) UI, and 620 (40%) both BP and UI. From the 821 women reporting impairment of daily tasks due to BP, 199 (24 %) were moderately and 90 (11%) severely affected with the remainder, 532 (64%) being mildly affected. From 267 women with functional impairment due to UI, 52 (19%) reported moderately to severe impairment in their ability to perform daily tasks.
Conclusions: Obesity and parity were risk factors for impairment of daily functioning due to BP, whereas obesity and vaginal delivery increased the risk of moderate to severe impairment due to UI. Maternal performance of daily tasks and women’s health and quality of life are more often impaired due to BP than UI.
Pre-pregnancy Body Mass Index (BMI) and delivery outcomes in a Canadian population
Growing evidence suggests that maternal overweight and obesity is associated with poor maternal and perinatal outcomes. This study evaluated the impact of maternal pre-pregnancy overweight and obesity on pregnancy, labour and delivery outcomes in a cohort of women with term, singleton pregnancies cared for by family physicians in community based practices.
The cohort consisted of 65.8% normal weight, 23.6% overweight and 10.6% obese women. Women with increased pre-pregnancy BMI were more likely to develop pregnancy complications such as preeclampsia (OR 3.5, CI 2.0-4.6 for overweight; OR 5.3, CI 3.3-8.5 for obese) and gestational diabetes (OR 3.0, CI 1.8-5.0 for overweight; OR 6.5, CI 3.7-11.2 for obese) than normal weight women. Spontaneous onset of labour was recorded in 71.2% of women with normal pre-pregnancy BMI, whereas 39.3% of overweight and 49% of obese women had their labour induced. For women with spontaneous labour, pre-pregnancy BMI was not a significant risk factor for mode of delivery, controlling for covariates. Among women with induced labor, obesity was a significant risk factor for delivery by C-section (adjusted OR 2.2; CI 1.2-4.1).
Conclusions: Even among women with term, singleton pregnancies obtaining prenatal care in community-based settings, obese women who undergo labour induction are at increased risk of obstetrical interventions at delivery.
The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum
Emergency and planned c-sections may adversely affect breastfeeding initiation, milk supply and infant breastfeeding receptivity compared to vaginal deliveries. Our study examined mode of delivery and breastfeeding initiation, duration, and difficulties reported by mothers at 4 months postpartum.
More women who delivered by planned c-section had no intention to breastfeed or did not initiate breastfeeding (7.4 % and 4.3 % respectively), when compared to women with vaginal births (3.4 % and 1.8 %, respectively) and emergency c-section (2.7 % and 2.5 %, respectively). Women who delivered by emergency c-section were found to have a higher proportion of breastfeeding difficulties (41 %), and used more resources before (67 %) and after (58 %) leaving the hospital, when compared to vaginal delivery (29 %, 40 %, and 52 %, respectively) or planned c-sections (33 %, 49 %, and 41 %, respectively). Women who delivered with a planned c-section were more likely (OR = 1.61; 95 % CI: 1.14, 2.26; p = 0.014) to discontinue breastfeeding before 12 weeks postpartum compared to those who delivered vaginally.
Conclusions: We found that when controlling for socio-demographic and labor and delivery characteristics, planned c-section is associated with early breastfeeding cessation.
2023
Schmidt RA, Wey TW, Harding KD, Fortier I, Atkinson S, Tough S, Letourneau N, Knight JA, Fraser WD, Bocking A. A harmonized analysis of five Canadian pregnancy cohort studies: exploring the characteristics and pregnancy outcomes associated with prenatal alcohol exposure. BMC Pregnancy Childbirth 23, 128 (2023). https://doi.org/10.1186/s12884-023-05447-2
2022
Hart PMB*, Stephenson N*, Schime N*, Tough S, Slater D, Chaput KH. Second trimester cytokine profiles associated with gestational diabetes and hypertensive disorders of pregnancy. PLOS One. 14 Dec, 2022. doi.org/10.1371/journal.pone.0279072
Horsley KM, Chaput K, Nguyen TV, Dayan N, Tomfohr L, Tough S. Hypertensive Disorders of Pregnancy and Breastfeeding Practices: A Secondary Analysis of Data from the All Our Families Cohort. Acta Obstetricia et Gynecologica Scandinavica (AOGS). 24 May, 2022, 101,8. doi.org/10.1111/aogs.14378
2021
Scime N*, Hetherington E*, Tomfohr-Madsen L, Nettel-Aguirre A, Chaput K, Tough S. Hypertensive disorders in pregnancy and child development at 36 months in the All Our Families prospective cohort study. PLOS One. Dec 2021, 16(12):e0260590. DOI: 10.1371/journal.pone.0260590
Plamondon A, Racine N*, Tough S, Madigan S. Disentangling adversity timing and type: Contrasting theories in the context of maternal postpartum physical and mental health using latent formative models. Development & Psychopathology. May 2021, 1-13, DOI: 10.1017/S0954579421000353.
Racine, N*, McDonald, S, Chaput, K, Tough, S, Madigan, S. Pathways from maternal adverse childhood experiences to substance use in pregnancy: Findings from the All Our Families Cohort. Journal of Women’s Health. February 2021. DOI: 10.1089/jwh.2020.8632.
Currie CL, Tough S. Adverse childhood experiences are associated with illicit drug use among pregnant women with middle to high socioeconomic status: Findings from the All Our Families Cohort. BMC Pregnancy and Childbirth. January 2021, 133:1-9. DOI: 10.21203/rs.3.rs-33576/v1.
2020
Racine N*, McDonald S, Chaput K, Tough S, Madigan S. Maternal substance use in pregnancy: Differential prediction by childhood adversity subtypes. Preventive Medicine. November 2020, 141:106303. DOI: 10.1016/j.ypmed.2020.106303.
Shay M, Tomfohr-Madsen L, Tough S. Maternal psychological distress and child weight at 24 months: Investigating indirect effects through breastfeeding in the All Our Families cohort. Canadian Journal of Public Health. March 2020, 111:543-554. DOI: 10.17269/s41997-020-00312-7.
2019
Racine N*, Plamondon A, McDonald S, Tough S, Madigan, S. The consistency of maternal abuse reporting in pregnancy and the postpartum period. Journal of Women’s Health. November 2019, 29(4):561-569. DOI: 10.1089/jwh.2019.7795.
Vinturache A*, Winn A*, Mannion C, Tough S. Women’s recall of health care provider counselling on gestational weight gain (GWG): A prospective, population-based study. BMC Pregnancy & Childbirth, April 2019, 136(19):1-11. DOI: 10.1186/s12884-019-2283-x.
Horsley KJ, Tomfohr-Madsen LM, Ditto B, Tough S. Hypertensive disorders of pregnancy and symptoms of depression and anxiety as related to gestational age at birth: Findings from the All Our Families Study. Psychosomatic Medicine. April 2019, 81(5): 458-463. DOI: 10.1097/PSY.0000000000000695.
Adhikari K*, Patten S, Williamson T, Patel A, Premji S, Tough S, Letourneau N, Giesbrecht G, Metcalfe A. Does neighbourhood socioeconomic status predict the risk of preterm birth? A community-based Canadian cohort study. BMJ Open. February 2019, 9(e025341): 1-10. DOI: 10.1136/bmjopen-2018-025341.
Santos S, Eekhout I, Voerman E, Gaillard R, Andersen AN, Barros H, Charles M, Chatzi L, Chevrier C, Chrousos GP, Corpeleijn E, Costet N, Crozier S, Doyon M, Eggesbø M, Fantini MP, Farchi S, Forastiere F, Gagliardi L, Georgiu V, Godfrey KM, Gori D, Grote V, Hanke W, Hertz-Picciotto I, Heude B, Hivert M, Hryhorczuk D, Huang R, Inskip H, Karvonen AM, Koletzko B, Küpers LK, Lagström H, Lawlor DA, Lehmann I, López-Espinosa M, Magnus P, Majewska R, Mäkelä J, Manios Y, McDonald SW, Mommers M, Morgen CS, Moschonis G, Newnham J, Nohr EA, Oken E, Oostvogels AJJM, Pac A, Pekkanen J, Pizzi C, Polanska K, Porta D, Richiardi L, Rifas-Shiman SL, Roeleveld N, Santa-Marina L, Santos AC, Smit HA, Sørensen TIA, Standl M, Stanislawski M, Stoltenberg C, Thiering E, Thijs C, Torrent M, Tough SC, Trnovec T, van Gelder MMHJ, van Rossem L, von Berg A, Vrijheid M, Vrijkotte TGM, Zvinchuk O, van Buuren S, Jaddoe VWV. Impact of maternal body mass index and gestational weight gain on pregnancy complications: An individual participant data meta-analysis of European, North American and Australian cohorts. BJOG. March 2019, 126(9): 984-995. DOI: 10.1111/1471-0528.15661.
Voerman E, Santos S, Golab BP, Amiano P, Andersen AN, Ballester F, Barros H, Bergström A, Charles M, Chatzi L, Chevrier C, Corpeleijn E, Costet N, Crozier S, Devereux G, Eggesbø M, Fantini MP, Farchi S, Forastiere F, Georgiu V, Godfrey KM, Gori D, Grote V, Hanke W, Hertz-Picciotto I, Heude B, Hryhorczuk D, Huang R, Inskip H, Karvonen AM, Kenny LC, Koletzko B, Küpers LK , Lagström H, Lawlor DA, Lehmann I, Magnus P, Majewska R, Mäkelä J, Manios Y, McAuliffe FM, McDonald SW, Mehegan J, Melén E, Mommers M, Morgen CS, Mori T, Moschonis G, Murray D, Nohr EA, Oken E, Oostvogels AJJM, Pac A, Pekkanen J, Pizzi C, Polanska K, Porta D, Richiardi L, Rifas SL, Ronfani L, Santos AC, Smit HA, Sørensen TIA, Standl M, Stigum H, Stoltenberg C, Thiering E, Thijs C, Torrent M, Tough SC, Trnovec T, Turner S, van Rossem L, von Berg A, Vrijheid M, Vrijkotte TGM, West J, Wright J, Zvinchuk O, Gaillard R, Jaddoe VWV. Maternal body mass index, gestational weight gain and the risk of overweight and obesity across childhood: An individual participant data meta-analysis. PLOS Medicine. February 2019, 16(2): e1002744. DOI: 10.1371/journal.pmed.1002744.
2018
Racine N*, Madigan S, Plamondon A, Hetherington E*, McDonald S, Tough S. Maternal adverse childhood experiences and antepartum risks: The moderating role of social support. Archives of Women’s Mental Health, December 2018, 21(6): 663-670. DOI: 10.1007/s00737-018-0826-1.
Santos S, Eekhout I, Voerman E, Gaillard R, Barros H, Charles M, Chatzi L, Chevrier C, Chrousos GP, Corpeleijn E, Costet N, Crozier S, Doyon M, Eggesbø M, Fantini MP, Farchi S, Forastiere F, Gagliardi L, Georgiu V, Godfrey KM, Gori D, Grote V, Hanke W, Hertz-Picciotto I, Heude B, Hivert M, Hryhorczuk D, Huang R, Inskip H, Jusko TA, Karvonen AM, Koletzko B, Küpers LK, Lagström H, Lawlor DA, Lehmann I, López-Espinosa M, Magnus P, Majewska R, Mäkelä J, Manios Y, McDonald SW, Mommers M, Morgen CS, Moschonis G, Murínová Ľ, Newnham J, Nohr EA, Andersen AN, Oken E, Oostvogels AJJM, Pac A, Papadopoulou E, Pekkanen J, Pizzi C, Polanska K, Porta D, Richiardi L, Rifas-Shiman SL, Roeleveld N, Santa-Marina L, Santos AC, Smit HA, Sørensen TIA, Standl M, Stanislawski M, Stoltenberg C, Thiering E, Thijs C, Torrent M, Tough SC, Trnovec T, van Gelder MMHJ, van Rossem L, von Berg A, Vrijheid M, Vrijkotte TGM, Zvinchuk O, van Buuren S, Jaddoe VWV. Gestational weight gain charts for different body mass index groups for women in Europe, North America and Oceania. BMC Medicine. November 2018, 16(201): 1-15. DOI: 10.1186/s12916-018-1189-1.
Golab BP, Santos S, Voerman E, Lawlor DA, Jaddoe VWV, Gaillard R, MOCO Study Group Authors. Influence of maternal obesity on the association between common pregnancy complications and risk of childhood obesity: an individual participant data meta-analysis. Lancet Child & Adolescent Health. November 2018, 2(1):812-821. DOI: 10.1016/S2352-4642(18)30273-6.
Racine N*, Madigan S, Plamondon A, Hetherington E*, McDonald S, Tough S. Maternal psychosocial risk profiles in pregnancy: Associations with postpartum maternal health and child outcomes. Clinical Psychological Science, August 2018, 6(6): 783-796. DOI: 10.1177/2167702618788863.
Racine N*, Plamondon A, Madigan S, McDonald S, Tough S. Maternal adverse childhood experiences and infant development. Pediatrics. March 2018, 141(2): e20172495. DOI: 10.1542/peds.2017-2495.
Racine NM*, Madigan SL, Plamondon AR, McDonald SW, Tough SC. Differential associations of adverse childhood experience on maternal health. American Journal of Preventive Medicine. March 2018, 54(3): 368-375. DOI: 10.1016/j.amepre.2017.10.028.
2017
Vinturache A*, Winn A*, Tough S. Recall of prenatal counselling among obese and overweight women from a Canadian population: A population based-study. Maternal and Child Health Journal. November 2017, 21(11): 2092-2101. DOI: 10.1007/s10995-017-2324-x.
Tough SC, McDonald SW, Collisson BA, Graham SA, Kehler H, Kingston D, Benzies K. Cohort profile: the All Our Babies cohort (AOB). International Journal of Epidemiology. October 2017, 46(5): 1389-1390k. DOI: 10.1093/ije/dyw363.
2016
Heng YJ, Pennell CE, McDonald SW, Vinturache AE*, Xu J, Lee MWF, Briollais L, Lyon AW, Slater DM, Bocking AD, de Koning L, Olson DM, Dolan SM, Tough SC, Lye SJ. Maternal whole blood gene expression at 18 and 28 weeks of gestation associated with spontaneous preterm birth in asymptomatic women. PLoS ONE. June 2016. 11(6): e0155191. DOI: 10.1371/journal.pone.0155191.
Hobbs AJ*, Mannion CA, McDonald SW, Brockway M, Tough SC. The impact of caesarean section on breastfeeding initiation, duration, and difficulties in the first four months postpartum. BMC Pregnancy and Childbirth. April 2016, 16(90): 1-9. DOI: 10.1186/s12884-016-0876-1.
Vinturache AE*, Chaput KH, Tough SC. Pre-pregnancy body mass index (BMI) and macrosomia in a Canadian birth cohort. Journal Maternal-Fetal & Neonatal Medicine. April 2016, 1-8. DOI: 10.3109/14767058.2016.1163679.
Metcalfe A*, Talavlikar R, du Prey B, Tough SC. Exploring the relationship between socioeconomic factors, method of contraception and unintended pregnancy. Reproductive Health. March 2016, 13(28):1-8. DOI: 10.1186/s12978-016-0151-y.
2015
Mannion CA, Vinturache AE*, McDonald SW, Tough SC. The influence of back pain and urinary incontinence on daily tasks of mothers at 12 months postpartum. PLoS ONE. June 2015, 10(6): 1-18. DOI: 10.1371/journal.pone.0129615.
Vinturache AE*, McDonald S, Slater D, and Tough S. Perinatal outcomes of maternal overweight and obesity in term infants: a population-based cohort study in Canada. Scientific Reports. March 2015, 5(9334): 1-6. DOI: 10.1038/srep09334.
2014
Mannion CA, Vinturache AE*, McDonald SW, Tough SC. The influence of back pain and urinary incontinence on daily tasks of mothers at 12 months postpartum. PLoS ONE. June 2015, 10(6): 1-18. DOI: 10.1371/journal.pone.0129615.
Vinturache AE*, McDonald S, Slater D, and Tough S. Perinatal outcomes of maternal overweight and obesity in term infants: a population-based cohort study in Canada. Scientific Reports. March 2015, 5(9334): 1-6. DOI: 10.1038/srep09334.
2013
McDonald SW*, Benzies KM, Gallant JE, McNeil DA, Dolan SM, Tough SC. A comparison between late preterm and term infants on breastfeeding and maternal mental health. Maternal and Child Health Journal. October 2013, 17(8):1468-1477. DOI: 10.1007/s10995-012-1153-1.
Nagulesapillai T*, McDonald SW*, Fenton TR, Mercader HF*, Tough SC. Breastfeeding difficulties and exclusivity among late preterm and term infants: Results from the All Our Babies Study. Canadian Journal of Public Health. July 2013, 104(4):e351-e356. DOI: 10.17269/cjph.104.3803.
Metcalfe A*, Grabowska K, Weller C*, Tough S. Impact of prenatal care provider on the use of ancillary health services during pregnancy. BMC Pregnancy and Childbirth. March 2013, 13:62. DOI: 10.1186/1471-2393-13-62.
McDonald SW*, Lyon AW, Benzies KM, McNeil DA, Lye SJ, Dolan SJ, Pennell CE, Bocking AD, Tough SC. The All Our Babies pregnancy cohort: design, methods, and participant characteristics. BMC Pregnancy and Childbirth. January 2013, 13(Suppl 1):S2. DOI: 10.1186/1471-2393-13-S1-S2.
2012
O’Quinn C, Metcalfe A*, McDonald S*, Raguz N, and Tough S. Exclusive breastfeeding and assisted reproductive technologies: a Calgary cohort. Reproductive Systems & Sexual Disorders. April 2012, S2:1-4. DOI: 10.4172/2161-038X.S2-002.
2011
Gracie S*, Metcalfe A*, Dolan SM, Kehler H, Siever J, Tough S. Utilization of the 2009 H1N1 vaccine by pregnant women in a pandemic year. Journal of Obstetrics and Gynaecology Canada. February 2011, 33(2):127-133. DOI: 10.1016/S1701-2163(16)34797-1.
2010
Gracie SK*, Lyon AW, Kehler HL, Pennell CE, Dolan SM, McNeil DA, Siever JE, McDonald SW, Bocking AD, Lye SJ, Hegadoren KM, Olson DM, Tough SC. All Our Babies Cohort Study: Recruitment of a cohort to predict women at risk of preterm birth through the examination of gene expression profiles and the environment. BMC Pregnancy and Childbirth. December 2010, 10(87). DOI: 10.1186/1471-2393-10-87.