Grant: Operating Grant: Analyses of Existing Cohorts & Databases - IHDCYH

Monitoring health during pregnancy requires accurate interpretation of laboratory test results. Test results for an individual patient are compared to a reference interval - the range of values expected in a representative healthy population - to determine if the result is abnormal. Drastic physiological changes occur dynamically throughout pregnancy, and can invalidate the use of non-pregnant reference intervals. Modern reference intervals appropriate for the multicultural population of Canadian pregnant women are lacking, compromising the care and health of mother and fetus. Determining reference intervals in pregnant women is challenging because it is difficult to identify women during early pregnancy, requires blood samples at multiple time points, and requires many participants at each gestational age. This adds complexity, time and cost to prospective studies. Studies utilizing existing data are an alternative, and can be achieved by using large volumes of data in laboratory information systems. This approach takes advantage of testing that has already been performed and uses data mining and statistical approaches to identify groups who can represent the reference population. This project will bring together existing clinical databases (BC Perinatal Registry and community and hospital laboratory data). Using five years of data, it will identify which laboratory tests are being used to care for pregnant women, and which pregnancy-related characteristics must be considered when determining reference intervals. Reference intervals will then be developed and changes throughout pregnancy characterized. The findings will provide essential information about factors that affect lab test results during pregnancy and how these should be incorporated into result interpretation. The approach used here will allow laboratories in Canada to provide physicians and patients with pregnancy-specific reference intervals, improving care for women and babies.