Survey of Mode of Delivery and Maternal and Perinatal Outcomes in Canada.

Objective: To identify determinants of cesarean delivery (CD) and examine associations between mode of delivery (MOD) and maternal and perinatal outcomes.

Methods: We conducted a retrospective analysis of a Canadian multicentre birth cohort derived from provincial data collected in 2008/2009. Maternal and perinatal characteristics and outcomes were compared between vaginal and cesarean birth and between the following MOD subgroups: spontaneous vaginal delivery (VD), assisted VD, planned cesarean delivery (CD), and intrapartum CD.

Education Outcomes of Children Born Late Preterm: A Retrospective Whole-Population Cohort Study.

Background: Early life exposures can have an impact on a child's developmental trajectory and children born late preterm (34-36 weeks gestational age) are increasingly recognized to have health and developmental setbacks that extend into childhood.

Objectives: The purpose of this study was to assess whether late preterm birth was associated with poorer developmental and educational outcomes in the early childhood period, after controlling for health and social factors.

Methods: We conducted a retrospective cohort study using administrative databases housed at the Manitoba Centre for Health Policy, including all children born late preterm (34-36 weeks gestational age (GA)) and at full-term (39-41 weeks GA) between 2000 and 2005 in urban Manitoba (N = 28,100).

The effects of early pregnancy loss on health outcomes and health care utilization and costs.

Objective: To evaluate the effects of early pregnancy loss on subsequent health care use and costs.

Data Sources: Linked administrative health databases from Manitoba, Canada.

Study Design: This was a population-based cohort study.

Prevalence and clinical, social, and health care predictors of miscarriage.

Background: Pregnancy loss is common and several factors (e.g. chromosomal anomalies, parental age) are known to increase the risk of occurrence.

Factors obstetricians, family physicians and midwives consider when counselling women about a trial of labour after caesarean and planned repeat caesarean: a qualitative descriptive study.

Background: Repeat caesarean sections (CSs) are major contributors to the high rate of CS in Canada and globally. Women's decisions to have a planned repeat CS (PRCS) or a trial of labour after CS (TOLAC) are influenced by their maternity care providers. This study explored factors maternity care providers consider when counselling pregnant women with a previous CS, eligible for a TOLAC, about delivery method.

Predictors of Women's Satisfaction with Prenatal Care in a Canadian Setting.

Objective: Prenatal care is a vital and important part of a healthy pregnancy, providing many maternal and health benefits. Despite Canada's publically funded health care system with universal access, inadequate rates of prenatal care continue to be observed. As a modifiable risk factor, the process variables that influence satisfaction with prenatal care in Canadian settings have received little attention.

Evaluating the Manitoba Infant Feeding Database: a Canadian infant feeding surveillance system.

Objective: The Manitoba Infant Feeding Database (MIFD) is being piloted as a surveillance system leveraging infant vaccination visits as a point of contact to collect infant feeding data during the first year of life. The objective of this study was to assess data quality and acceptability of the MIFD as a sustainable population-based surveillance system.

Methods: Internal completeness and internal validity were measured to assess data quality.

The Association of Inadequate and Intensive Prenatal Care With Maternal, Fetal, and Infant Outcomes: A Population-Based Study in Manitoba, Canada.

Objective: Little is known about how prenatal care influences health outcomes in Canada. The objective of this study was to examine the association of prenatal care utilization with maternal, fetal, and infant outcomes in Manitoba.

Methods: This retrospective cohort study conducted at the Manitoba Centre for Health Policy investigated all deliveries of singleton births from 2004-2005 to 2008-2009 (N = 67 076).

Inequities in utilization of prenatal care: a population-based study in the Canadian province of Manitoba.

Background: Ensuring high quality and equitable maternity services is important to promote positive pregnancy outcomes. Despite a universal health care system, previous research shows neighborhood-level inequities in utilization of prenatal care in Manitoba, Canada. The purpose of this population-based retrospective cohort study was to describe prenatal care utilization among women giving birth in Manitoba, and to determine individual-level factors associated with inadequate prenatal care.

Protocol for establishing an infant feeding database linkable with population-based administrative data: a prospective cohort study in Manitoba, Canada.

Introduction: Breast feeding is associated with many health benefits for mothers and infants. But despite extensive public health efforts to promote breast feeding, many mothers do not achieve their own breastfeeding goals; and, inequities in breastfeeding rates persist between high and low-income mother-infant dyads. Developing targeted programme to support breastfeeding dyads and reduce inequities between mothers of different socioeconomic status are a priority for public health practitioners and health policy decision-makers; however, many jurisdictions lack the timely and comprehensive population-level data on infant-feeding practices required to monitor trends in breastfeeding initiation and duration.

Examining Early Childhood Health Outcomes of Children Born Late Preterm in Urban Manitoba.

Objective The late preterm population [34-36 weeks gestational age (GA)] is known to incur increased morbidity in the infancy stage compared to the population born at term (39-41 weeks GA). This study aimed to examine the health of these children during their early childhood years, with specific attention to the role of socioeconomic status. Methods A retrospective cohort study was conducted using data from the Manitoba Centre for Health Policy, including all live-born children born at 34-36 and 39-41 weeks GA in urban Manitoba between 2000 and 2005 (n = 28,100).

Partner Disengagement from Pregnancy and Adverse Maternal and Infant Outcomes.

Objective: To assess whether partner disengagement from pregnancy is associated with adverse maternal and infant outcomes.

Materials And Methods: We analyzed data from the 2006-2007 Canadian Maternity Experiences Survey, comprising a cross-sectional representative sample of 6,421 childbearing women. Multiple logistic regression assessed the association between adverse outcomes and three indicators of partner disengagement: (1) partner did not want the pregnancy, (2) partner argued more than usual in the year prior to the baby's birth, and (3) partner was absent at the delivery.

Breastfeeding Initiation Associated With Reduced Incidence of Diabetes in Mothers and Offspring.

Objective: To examine associations between breastfeeding initiation and subsequent diabetes among First Nations (indigenous people in Canada who are not Métis or Inuit) and non-First Nations mothers and their offspring with and without gestational diabetes mellitus (GDM).

Methods: This retrospective database study included 334,553 deliveries (1987-2011) in Manitoba with up to 24 years of follow-up for diabetes using population-based databases. Information of breastfeeding initiation before hospital discharge was obtained from hospital abstracts recorded by nurses in postpartum wards.

Exposure to Gestational Diabetes Mellitus: Impact on the Development of Early-Onset Type 2 Diabetes in Canadian First Nations and Non-First Nations Offspring.

Objective: Type 2 diabetes is increasing in children worldwide, with Canadian First Nations (FN) children disproportionally affected. The prevalence of gestational diabetes mellitus (GDM) also is increasing. The objective of this study was to evaluate the impact of GDM exposure in utero and FN status on the subsequent risk of type 2 diabetes in offspring in the first 30 years of life.

Choosing an out-of-hospital birth centre: Exploring women's decision-making experiences.

Objective: the primary objective for this study was to explore women's experiences of choosing to plan a birth at an out-of-hospital birth centre. We sought to understand how women make the choice to plan for an out-of-hospital birth and the meaning that women ascribe to this decision-making process.

Design, Setting, And Participants: a qualitative phenomenological study was conducted in Winnipeg, Canada with a sample of seventeen post partum women who represent the socio-demographic characteristics of the actual users of the Birth Centre in Winnipeg.

Barriers and facilitators related to implementation of regulated midwifery in Manitoba: a case study.

Background: In 2000, midwifery was regulated in the Canadian Province of Manitoba. Since the establishment of the midwifery program, little formal research has analyzed the utilization of regulated midwifery services. In Manitoba, the demand for midwifery services has exceeded the number of midwives in practice.

Factors Associated With High Levels of Perceived Prenatal Stress Among Inner-City Women.

Objective: To explore the factors associated with high rates of perceived prenatal stress among inner-city women.

Design: Observational cross-sectional study.

Setting/participants: We conducted a secondary analysis of data from 603 inner-city women.

Pregnant Women's Perceptions of Harms and Benefits of Mental Health Screening.

Background: A widely held concern of screening is that its psychological harms may outweigh the benefits of early detection and treatment. This study describes pregnant women's perceptions of possible harms and benefits of mental health screening and factors associated with identifying screening as harmful or beneficial.

Methods: This study analyzed a subgroup of women who had undergone formal or informal mental health screening from our larger multi-site, cross-sectional study.

Correlates of Abuse Around the Time of Pregnancy: Results from a National Survey of Canadian Women.

Objectives: Although several studies have examined risk factors associated with abuse during pregnancy or postpartum periods, many used clinic-based or small regional samples, and few were national or population-based, limiting their generalizability and clinical utility. The purpose of this study was to describe the correlates of abuse around the time of pregnancy among a nationally representative sample of women in Canada.

Methods: Using data from 6421 postpartum women (weighted n = 76,500) who completed the Canadian Maternity Experiences Survey from 10/2006 to 01/2007, we explored the association between demographic, psychosocial, behavioral, medical/obstetric factors and 'any' and 'severe' abuse.

Psychometric Testing of the French Language Quality of Prenatal Care Questionnaire.

Background And Purpose: To assess the psychometrics of the French language Quality of Prenatal Care Questionnaire (QPCQ).

Methods: Data from 302 women were used in a confirmatory factor analysis and in assessment of construct validity through hypothesis testing and internal consistency reliability using Cronbach's alpha.

Results: The 6 factors (subscales) were verified and confirmed.

Trends in Midwifery Use in Manitoba.

Objective: To describe the trends in numbers of midwives and midwifery-attended births and the characteristics of women who used midwifery health care services in Manitoba from 2001-2002 to 2009-2010.

Methods: We conducted a quantitative descriptive analysis using population-based, de-identified administrative data from the Population Health Research Data Repository at the Manitoba Centre for Health Policy in Winnipeg, Manitoba to study the use of midwifery care. Trends in the numbers of practising and non-practising midwives were based on data from the College of Midwives of Manitoba registries and its annual reports.

Does First Nations ancestry modify the association between gestational diabetes and subsequent diabetes: a historical prospective cohort study among women in Manitoba, Canada.

Background: Over the past 30 years, the prevalence of diabetes has steadily increased among Canadians, and is particularly evident among First Nations (FN) women. The interplay between FN ancestry, gestational diabetes and the development of subsequent diabetes among mothers remains unclear.

Methods: After excluding known pre-existing diabetes, we explored whether FN ancestry may modify the association between gestational diabetes and post-partum diabetes among women in Manitoba (1981-2011) via a historical prospective cohort database study.

Quality of prenatal care questionnaire: psychometric testing in an Australia population.

Background: The quality of antenatal care is recognized as critical to the effectiveness of care in optimizing maternal and child health outcomes. However, research has been hindered by the lack of a theoretically-grounded and psychometrically sound instrument to assess the quality of antenatal care. In response to this need, the 46-item Quality of Prenatal Care Questionnaire (QPCQ) was developed and tested in a Canadian context.