Browsing by Author "Tough, Suzanne C"

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    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
    (2021-02-13) Currie, Cheryl L; Tough, Suzanne C
    Abstract Background Adverse childhood experiences (ACEs) are associated with illicit drug use among pregnant women who are socioeconomically vulnerable. While it is assumed that the impact of ACEs on illicit drug use in pregnancy is reduced among women with higher socioeconomic status (SES), this assumption is not well tested in the literature. The objective of this study was to examine the impact of maternal ACEs on illicit drug use in a community-based sample of pregnant women with middle to high SES. Methods This study is a secondary analysis of a prospective cohort study that collected data from 1660 women during and after pregnancy in Calgary, Canada between 2008 and 2011 using mailed surveys. Illicit drug use in pregnancy was self-reported by women at 34–36 weeks gestation. An established scale examined maternal ACEs before 18 years. Logistic regression models and 95% confidence intervals tested associations between maternal ACE scores and illicit drug use in pregnancy. Results Overall, 3.1% of women in this predominantly married, well-educated, middle and upper middle income sample reported illicit drug use in pregnancy. Women with 2–3 ACEs had more than a two-fold increase, and women with 4 or more ACEs had almost a four-fold increase in illicit drug use in pregnancy, relative to women with 0–1 ACEs after adjustment for confounders. Exposure to child abuse was more consistently associated with illicit drug use in pregnancy than exposure to household dysfunction in childhood. Conclusions Maternal ACEs were common and associated with a moderate increase in the odds of illicit drug use in pregnancy among Canadian women with middle to high SES.
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    Breastfeeding intentions, difficulties, and outcomes in mothers with chronic physical health conditions: the Motherhood and Chronic Illness (MaCI) prospective cohort study
    (2022-07-11) Scime, Natalie V.; Chaput, Kathleen H; Tough, Suzanne C; Metcalfe, Amy; Nettel-Aguirre, Alberto
    Breastfeeding from birth to 6 months has numerous benefits for maternal and child health. Mothers with chronic conditions are at risk for suboptimal breastfeeding outcomes, yet the underlying reasons for this are poorly understood. This thesis research investigated the factors associated with breastfeeding intentions, difficulties, and outcomes in mothers with chronic conditions. We conducted a prospective, community-based pregnancy cohort study called the Motherhood and Chronic Illness (MaCI) Study following 405 women from Alberta who reported living with a long-term physical health condition, carrying a singleton pregnancy, and intending to try breastfeeding. Women completed questionnaires at 32 weeks gestation, 6 weeks postpartum, and 6 months postpartum (overall response rate, 86.7%). In the prenatal period, we found that women who perceived their chronic condition to worsen during pregnancy were less likely to plan to exclusively breastfeed to 6 months per the global recommendation (adjusted odds ratio [OR] 0.50, 95% CI 0.30–0.82). From birth to 6 weeks postpartum, we identified three clusters of breastfeeding difficulties corresponding to physiologically expected lactation changes (51.1% of women), low milk production (15.4%), and ineffective latch (33.5%). Mothers with endocrine (adjusted relative risk ratio [RRR] 2.41, 95% CI 1.13–5.13), cardiovascular (adjusted RRR 2.87, 95% CI 1.02–8.09), and gastrointestinal (adjusted RRR 2.57, 95% CI 1.13–5.82) conditions were more likely to belong to the low milk production cluster and mothers with gastrointestinal (adjusted RRR 2.47, 95% CI 1.27–4.81) conditions were more likely to belong to the ineffective latch cluster, relative to the physiologically expected cluster. By 6 months postpartum, we found that one third (31.2%) of mothers had stopped breastfeeding, nearly all of whom did so earlier than planned. Compared to mothers who adhered to their pre-existing medications, mothers who did not adhere to pre-existing medications had shorter breastfeeding duration (adjusted hazard ratio [HR] 1.69, 95% CI 1.04–2.74) and greater odds of earlier than planned breastfeeding cessation (adjusted OR 1.85, 1.01–3.41). The MaCI Study highlighted three unique determinants of breastfeeding in mothers with chronic conditions, which can be addressed through person-centred support that jointly considers the ways in which breastfeeding patterns influence, and are influenced by, chronic condition status and management.
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    Gestational weight gain charts for different body mass index groups for women in Europe, North America, and Oceania
    (2018-11-05) Santos, Susana; Eekhout, Iris; Voerman, Ellis; Gaillard, Romy; Barros, Henrique; Charles, Marie-Aline; Chatzi, Leda; Chevrier, Cécile; Chrousos, George P; Corpeleijn, Eva; Costet, Nathalie; Crozier, Sarah; Doyon, Myriam; Eggesbø, Merete; Fantini, Maria P; Farchi, Sara; Forastiere, Francesco; Gagliardi, Luigi; Georgiu, Vagelis; Godfrey, Keith M; Gori, Davide; Grote, Veit; Hanke, Wojciech; Hertz-Picciotto, Irva; Heude, Barbara; Hivert, Marie-France; Hryhorczuk, Daniel; Huang, Rae-Chi; Inskip, Hazel; Jusko, Todd A; Karvonen, Anne M; Koletzko, Berthold; Küpers, Leanne K; Lagström, Hanna; Lawlor, Debbie A; Lehmann, Irina; Lopez-Espinosa, Maria-Jose; Magnus, Per; Majewska, Renata; Mäkelä, Johanna; Manios, Yannis; McDonald, Sheila W; Mommers, Monique; Morgen, Camilla S; Moschonis, George; Murínová, Ľubica; Newnham, John; Nohr, Ellen A; Andersen, Anne-Marie N; Oken, Emily; Oostvogels, Adriëtte J J M; Pac, Agnieszka; Papadopoulou, Eleni; Pekkanen, Juha; Pizzi, Costanza; Polanska, Kinga; Porta, Daniela; Richiardi, Lorenzo; Rifas-Shiman, Sheryl L; Roeleveld, Nel; Santa-Marina, Loreto; Santos, Ana C; Smit, Henriette A; Sørensen, Thorkild I A; Standl, Marie; Stanislawski, Maggie; Stoltenberg, Camilla; Thiering, Elisabeth; Thijs, Carel; Torrent, Maties; Tough, Suzanne C; Trnovec, Tomas; van Gelder, Marleen M H J; van Rossem, Lenie; von Berg, Andrea; Vrijheid, Martine; Vrijkotte, Tanja G M; Zvinchuk, Oleksandr; van Buuren, Stef; Jaddoe, Vincent W V
    Abstract Background Gestational weight gain differs according to pre-pregnancy body mass index and is related to the risks of adverse maternal and child health outcomes. Gestational weight gain charts for women in different pre-pregnancy body mass index groups enable identification of women and offspring at risk for adverse health outcomes. We aimed to construct gestational weight gain reference charts for underweight, normal weight, overweight, and grades 1, 2 and 3 obese women and to compare these charts with those obtained in women with uncomplicated term pregnancies. Methods We used individual participant data from 218,216 pregnant women participating in 33 cohorts from Europe, North America, and Oceania. Of these women, 9065 (4.2%), 148,697 (68.1%), 42,678 (19.6%), 13,084 (6.0%), 3597 (1.6%), and 1095 (0.5%) were underweight, normal weight, overweight, and grades 1, 2, and 3 obese women, respectively. A total of 138, 517 women from 26 cohorts had pregnancies with no hypertensive or diabetic disorders and with term deliveries of appropriate for gestational age at birth infants. Gestational weight gain charts for underweight, normal weight, overweight, and grade 1, 2, and 3 obese women were derived by the Box-Cox t method using the generalized additive model for location, scale, and shape. Results We observed that gestational weight gain strongly differed per maternal pre-pregnancy body mass index group. The median (interquartile range) gestational weight gain at 40 weeks was 14.2 kg (11.4–17.4) for underweight women, 14.5 kg (11.5–17.7) for normal weight women, 13.9 kg (10.1–17.9) for overweight women, and 11.2 kg (7.0–15.7), 8.7 kg (4.3–13.4) and 6.3 kg (1.9–11.1) for grades 1, 2, and 3 obese women, respectively. The rate of weight gain was lower in the first half than in the second half of pregnancy. No differences in the patterns of weight gain were observed between cohorts or countries. Similar weight gain patterns were observed in mothers without pregnancy complications. Conclusions Gestational weight gain patterns are strongly related to pre-pregnancy body mass index. The derived charts can be used to assess gestational weight gain in etiological research and as a monitoring tool for weight gain during pregnancy in clinical practice.
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    Impact of prenatal care provider on the use of ancillary health services during pregnancy
    (BioMed Central, 2013-03-11) Metcalfe, Amy; Grabowska, Kristen; Weller, Carol; Tough, Suzanne C
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    Maternal perceptions of partner support during breastfeeding
    (BioMed Central, 2013-05-08) Mannion, Cynthia A; Hobbs, Amy J; McDonald, Sheila W; Tough, Suzanne C
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    Mental health outcomes of mothers who conceived using fertility treatment
    (BioMed Central, 2014-02-28) Raguz, Nikolett; McDonald, Sheila; Metcalfe, Amy; O'Quinn, Candace; Tough, Suzanne C
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    Sharing longitudinal, non-biological birth cohort data: a cross-sectional analysis of parent consent preferences
    (2018-11-12) Manhas, Kiran P; Dodd, Shawn X; Page, Stacey; Letourneau, Nicole; Adair, Carol E; Cui, Xinjie; Tough, Suzanne C
    Abstract Background Mandates abound to share publicly-funded research data for reuse, while data platforms continue to emerge to facilitate such reuse. Birth cohorts (BC) involve longitudinal designs, significant sample sizes and rich and deep datasets. Data sharing benefits include more analyses, greater research complexity, increased opportunities for collaboration, amplification of public contributions, and reduced respondent burdens. Sharing BC data involves significant challenges including consent, privacy, access policies, communication, and vulnerability of the child. Research on these issues is available for biological data, but these findings may not extend to BC data. We lack consensus on how best to approach these challenges in consent, privacy, communication and autonomy when sharing BC data. We require more stakeholder engagement to understand perspectives and generate consensus. Methods Parents participating in longitudinal birth cohorts completed a web-based survey investigating consent preferences for sharing their, and their child’s, non-biological research data. Results from a previous qualitative inquiry informed survey development, and cognitive interviewing methods (n = 9) were used to improve the question quality and comprehension. Recruitment was via personalized email, with email and phone reminders during the 14-day window for survey completion. Results Three hundred and forty-six of 569 parents completed the survey in September 2014 (60.8%). Participants preferred consent processes for data sharing in future independent research that were less-active (i.e. no consent or opt-out). Parents’ consent preferences are associated with their communication preferences. Twenty percent (20.2%) of parents generally agreed that their child should provide consent to continue participating in research at age 12, while 25.6% felt decision-making on sharing non-biological research data should begin at age 18. Conclusions These finding reflect the parenting population’s preference for less project-specific permission when research data is non-biological and de-identified and when governance practices are highly detailed and rigourous. Parents recognize that children should become involved in consent for secondary data use, but there is variability regarding when and how involvement occurs. These findings emphasize governance processes and participant notification rather than project-specific consent for secondary use of de-identified, non-biological data. Ultimately, parents prefer general consent processes for sharing de-identified, non-biological research data with ultimate involvement of the child.