The Ontario Birth Study (OBS) is a research platform developed by the Lunenfeld-Tanenbaum Research Institute and Mount Sinai Hospital (MSH) with support from Ontario Institute of Cancer Research (OICR) and the Fraser Mustard Institute for Human Development at the University of Toronto.
The Ontario Birth Study is an open longitudinal pregnancy cohort designed to serve as a platform for research on pregnancy complications, maternal and infant health, and, ultimately, to assemble a cohort for future studies on the developmental origins of health and disease. One of the goals of the OBS is to streamline research, reducing the burden of research on both clinical care and patients, while increasing research opportunities (lower cost, increased feasibility, and data availability) and enhancing clinical care.
See below for: Protocol | Lifestyle Questionnaires | Diet Questionnaire | The Biological Samples | The Clinical Data
Protocol
Pregnant women are approached by OBS staff at their first ultrasound or prenatal visit at Mount Sinai Hospital and St. Michael’s Hospital obstetrics clinics. Subjects are recruited based on the following criteria:
Inclusion criteria
- Pregnant women less than 17 weeks gestational age
- At least 18 years of age
- English speaking
- Delivering at an OBS Hospital
- Antenatal care at an OBS Hospital
Exclusion criteria
- Non-viable fetus
- Unable to provide informed consent
- Known significant abnormalities
The consent obtained from all women covers questionnaire data, biospecimens, ultrasounds, and access to clinical records. As outlined in table 1, OBS participants are asked to complete four questionnaires: three lifestyle questionnaires and the Canadian Diet History Questionnaire II*Web. The scheduled collection of biospecimens, including maternal blood, infant blood spot cards, and vaginal swabs, is also shown in the table.
Table 1. Ontario Birth Study Data Collection Timeline
Time of your routine visit | Blood work | Vaginal Swabs | Lifestyle Questionnaire | Diet Questionnaire | Approximate Time Commitment |
---|---|---|---|---|---|
Week 11-14 | 30-40 cc | 2-4 swabs* | ✔ (LSQ1) | - | 45 min |
Week 16 | 30-40 cc | - | - | ✔ | 45 min |
Week 28 | 30-40 cc | - | ✔ (LSQ2) | - | 30 min |
Week 34-38 | - | 2 swabs | - | - | 10 min |
Delivery | 30 cc; Infant blood spot card | - | - | - | 10 min |
6 weeks after Delivery | - | - | ✔ (LSQ3) | - | 30 min |
*Women with a previous preterm delivery will be asked to provide 2 additional swabs (for a total of 4) at their first vaginal swab collection
Lifestyle Questionnaires
Women enrolled complete three lifestyle questionnaires using Research Electronic Data Capture (REDCap). Data collection fields are harmonized with the Better Outcomes Registry and Network (BORN). Some examples of the available data are provided below.
Table 2. Summary of maternal OBS survey instruments by timing of questionnaires
Timing of Questions | ||||
Topic | Detailed items | 12-16 wks GA | 28-32 wks GA | 6-10 wks Postpartum |
Demographic info and family characteristics | Date of birth | X | ||
Marital status | X | X | X | |
Details about Father | X | |||
Mother’s siblings | X | |||
Adopted | X | |||
Education | X | |||
Anthropometry | Right/left handed | X | ||
Ability to stand | X | |||
Height | X | |||
Weight (current and usual) | X | X | X | |
Weight loss and control | X | X | ||
Health Status | Self-reported health | X | X | X |
Last check-up and dental | X | |||
Sexual orientation | X | |||
Sexual partners | X | |||
Bowel movement | X | |||
Oral Health | Last dental visit, gum disease & dental problems during pregnancy | X | ||
Menstrual History | Age at first period | X | ||
Women’s health history | Contraceptive use | X | ||
Sexual activity | X | |||
Uterine fibroids or defect | ||||
Screening | Mammogram | X | ||
Pap smear, cervical biopsy | X | X | ||
Colorectal cancer screening | ||||
Current Pregnancy | Last menstrual period | X | ||
When did you know | X | |||
Feelings about pregnancy | X | |||
Intention to raise child | X | |||
Fertility treatment | Drugs, procedures, cost, elapsed time | X | ||
Health during pregnancy | Bleeding, nausea, swelling | X | X | |
Fever & other infections | X | |||
Pregnancy conditions | X | |||
Progesterone | X | |||
X-rays, vaccines | X | |||
Hospitalization | X | |||
Bed rest | X | |||
Previous Pregnancies | Mothers age, father, fertility treatments, multiples, pregnancy conditions, outcome, birthweight, gestational age, delivery type, child death, breastfeeding | X | ||
Other children | Adopted, foster, other | X | ||
Personal medical history | List of conditions from OHS (predominately chronic diseases and cancer) | X | ||
Family health history | List of conditions for parents, siblings and previous children | X | ||
Mother’s own birth | Birth weight, gestational age | X | ||
Medication | Prescription and non-prescription | X | X | |
Vitamins, supplements | Before and during pregnancy | X | X | X |
Fiber supplements | X | X | ||
Smoking and tobacco products | Before pregnancy, during pregnancy, Other tobacco products | X | X | X |
X | ||||
Environmental tobacco exposure | Before and during pregnancy at home, work and social | X | X | |
Physical Activity | Vigorous and moderate activity before and during pregnancy; | X | X | |
Sedentary activity | X | X | ||
Sleep | Duration at night and day, disrupted breathing, snoring | X | X | |
Infant sleep | X | |||
Sunlight & skin type | Skin response to sun | X | ||
Sunbed use | X | X | ||
Alcohol | Before and during pregnancy, type of alcohol, binge drinking | X | X | X |
Food intake | Vegetables, fruit, juice | X | ||
Food insecurity | X | |||
Dietary restrictions | X | |||
Emotional Health | Depression (DHQ-2 item) | X | X | X |
Anxiety (GAD-2 item) | X | X | X | |
Depression (EPDS) | X | X | ||
Anxiety (STAI-SF) | X | X | ||
Perceived stress (4-item) | X | X | X | |
Attachment (Bartholomew Horowitz) | X | X | ||
Intimate partner violence (WAST) | X | |||
Adverse Childhood Experiences (ACE) | X | |||
Childbearing Attitudes | X | X | X | |
Pregnancy Experiences Scale | X | |||
Background | Ethnicity and Country | X | ||
Work | Work status, Job description | X | X | X |
Occupational exposures | Shift work | X | X | |
Chemical exposures | X | |||
Residence | Length of time lived there | X | ||
Income | Household income | X | ||
Number of people in home | X | X | X | |
Number of rooms | X | X | ||
Owning house and car | X | |||
Environmental exposures | Pets, pesticides, proximity to farm, busy roads, chemical dump | X | ||
Questions about the baby’s biologic father | Age, siblings/twin, adopted, education, height, weight, alcohol, smoking, ethnicity, left/right handed, restricted diet, sexual partners & infections | X | ||
Other Questions | Permission to contact family members (mothers and baby’s father) | X | X | |
Name of pediatrician or family doctor | X | X | ||
Labour and delivery | Type of delivery, hospitalization | X | ||
Infant Health | Medication use | X | ||
Circumcision | X | |||
Jaundice | X | |||
Hospitalization | X | |||
General health | X | |||
Infant feeding | Intention to breastfeed | X | ||
Breastfeeding | X | |||
Formula type | X | |||
Vitamin use | X | |||
Crying | Crying Patterns Questionnaire | X |
Diet Questionnaire
The web-based Canadian Diet History Questionnaire II*Web queries the participant’s diet over the past month. The questionnaire asks questions about Canadian-specific types, brands, and proportions of food. Based on questionnaire answers, the daily nutrient intake (e.g., total fat, total calorie intake, other vitamins and minerals) is then calculated.
The Biological Samples
Biospecimens are collected and processed at the Mount Sinai Hospital’s Biospecimen Repository and Processing Lab. Collection of placentas is done through the Mount Sinai Hospital’s Biobank. The collection of biological samples includes:
Maternal Blood
- maternal DNA
- leukocytes
- plasma
- serum
Infant Blood Spot Cards
- infant DNA
Vaginal Swabs
- bacterial DNA
- cytokines
The Clinical Data
Additional data collected from the antenatal records and hospital medical charts are abstracted and entered into Medidata RAVE, an electronic data capture and storage platform, housed at the Applied Health Research Centre. Some of the available data includes:
Routine Demographic
- age
- height
- weight
Medical History and Pregnancy Obstetrical History
- medications
- gravidity
- parity
Current Pregnancy
- blood pressure
- blood work
- urine test
- ultrasound reports
- interventions
- labour details
Infant Assessment
- gestational age
- birth weight
- gender