Grant: Project Grant

There has been a temporal increase in chronic health conditions, such as metabolic, circulatory, and respiratory disease in reproductive-age women. Maternal chronic illness is associated with pregnancy and neonatal complications, which in turn may influence neuro-developmental health in offspring. However, there is a paucity of information on the role of pre-existing chronic conditions and their influence on long-term morbidity in offspring. Aims To conduct population-based cohort studies in British Columbia (BC), Canada and Sweden to examine if maternal chronic diseases (e.g., diabetes, hypertension, lung or heart disease) influence risks of neuro-developmental disorders (i.e., neurological and psychiatric disorders) in offspring. We also propose to investigate: •possible pathways linking maternal chronic diseases with the outcomes, using mediation analyses. •if maternal chronic illness in matched mother-sibling comparisons (i.e., analyses of mother-sister pairs) influence risks. This design accounts for familial (environmental and genetic) confounding factors. Methods We will carry out a longitudinal study of approximately 3.7 million births from 1992-2019 in Sweden and BC, with information on maternal chronic illness, pregnancy and neonatal complications, and long-term outcomes in children obtained from perinatal databases. In Sweden and BC we have access to longitudinal health data that are not available in Canada at the national level. Importance: In recent decades, the prevalence of advanced maternal age, obesity, and births to refugee mothers has more than doubled in Canada. Consequently, the prevalence of chronic diseases during pregnancy has also increased. Maternal diseases influence pregnancy and delivery complications, but little is known about impacts on long-term offspring morbidity. This will be the first study to use large birth cohorts with long term follow-up to examine neuro-developmental outcomes in offspring.