Reproductive and Perinatal Epidemiology

Landmark Studies

• Folic acid and NTD prevention– Case-control studies– Intervention studies– Public health interventions

• PROBIT study – promotion of breastfeeding trial– Showed that BF has an effect on infections in 1st yr

of life, on IQ at 6.5 yrs– No effect on various other outcomes

Why is this exciting?

• Potential for huge impact on public health/society– The “value” of preventing a single birht defect or

infant death• Easy to see studies through to completion– Pregnancy lasts 9 months – exposure—outcome

windows are short• Methodological challenges– Lots of problems with existing methods; some simple

solutions

Data Sources

• Prospective studies– These are relatively short, but sample sizes often

need to be large

• Databases– McGill Obstetric/Neonatal Database (MOND) – all

births at the RVH since 1976, detailed clinical and demographic information

– RVH ultrasound databases– Existing studies (e.g., PROBIT)

Funding Sources

• CIHR– Population/public health– Pediatrics– IHDCYH special programs

• NIH• March Of Dimes• MCH and SickKids foundations

Career Opportunities

• Small but growing field• Several small but strong academic groups in

Canada• Public Health Agency of Canada• Other Public Health groups• SPER (Paediatric and Perinatal)– Offshoot of SER that meets the day before the

annual SER meeting

People at McGill

• Michael Kramer– PROBIT– Prematurity and socioeconomic status– Methods

• Claire Infante-Rivard– Genetic epidemiology and perinatal outcomes

• Robert Platt– Methods