Abstract

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Background

Evidence on socioeconomic and ethnocultural disparities in perinatal health in Canada tends to be limited to analyses by neighbourhood or for selected provinces. In 2010, the Canadian Institutes of Health Research awarded funding for a project on perinatal outcomes. This article describes the resulting 2006 Canadian Birth-Census Cohort Database.

Data and methods

From the Canadian Live Birth, Infant Death and Stillbirth Database, 687,340 records of children born in Canada from May 16, 2004 through May 15, 2006 to mothers whose usual place of residence was Canada were selected as in-scope births. Deterministic rules were applied to link each person on the birth record—child, mother, father—to 2006 Census data.The cohort was restricted to records linked to a long-form questionnaire, and a cohort weight was developed. Cohort rates (unweighted and weighted) for five birth outcomes—preterm birth, small-for-gestational age, large-for-gestational age, stillbirth, and infant mortality—were compared with rates for all in-scope births across birth characteristics. Cohort rates for these birth outcomes were examined across selected census characteristics.

Results

Linkage rates were 91% for births surviving to age 1, 76% for stillbirths, and 80% for infant deaths matched to a birth registration. The cohort estimates were similar to those for all in-scope births, particularly after the cohort weight was applied. The cohort data produced plausible estimates of selected birth outcomes across maternal ethnocultural categories and levels of education.

Interpretation

The 2006 Canadian Birth-Census Cohort data can help inform perinatal surveillance and research in Canada.

Keywords

Birth outcomes, ethnocultural, infant mortality, record linkage, socioeconomic, stillbirths

Findings

Reducing health disparities is an ongoing population health goal in Canada and other countries. A step toward achieving this goal is to exploit existing data on the nature and extent of variations in health across socioeconomic and ethnocultural groups. Evidence on disparities in perinatal health in Canada has generally been limited to analyses by neighbourhood characteristics, or for selected provinces, owing to a lack of socioeconomic and ethnocultural information in most routinely collected perinatal data. [Full Text]

Authors

Tracey Bushnik (tracey.bushnik@canada.ca) is with the Health Analysis Division at Statistics Canada. Seungmi Yang and Jay S. Kaufman are with the Department of Epidemiology, Biostatistics and Occupational Health at McGill University. Michael S. Kramer is with the Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health at McGill University and the McGill University Health Centre Research Institute. Amanda J. Sheppard is with the Dalla Lana School of Public Health at the University of Toronto. Russell Wilkins is with the Department of Epidemiology and Community Medicine at the University of Ottawa.

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What is already known on this subject?

  • The analysis of perinatal health disparities in Canada has been limited by a lack of socioeconomic and ethnocultural information in most routinely collected perinatal data.
  • Various studies suggest that disparities exist and that disadvantaged socioeconomic position is associated with higher risk of adverse birth outcomes.

What does this study add?

  • Existing data can be used to uncover the nature and extent of variations in perinatal health across socioeconomic and ethnocultural groups.
  • With the 2006 Canadian Birth-Census Cohort Database, it is possible to examine, for all of Canada, perinatal outcomes such as preterm birth, small and large for gestational age, and fetal and infant mortality across a wide range of parental socioeconomic and ethnocultural characteristics.

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