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In a new study, researchers in London, Ontario found that women who used marijuana while pregnant were almost three times more likely to have an infant with low birth weight than women who did not use marijuana.

The study analyzed data from perinatal and neonatal databases at London Health Sciences Centre (LHSC) and is the first large-scale study in Canada to show this association between marijuana use among pregnant women and low birth-weight infants.

It was conducted by researchers at Lawson Health Research Institute, Western University and Brescia University College.

Maternal amphetamine use, chronic hypertension and smoking were identified as other top risk factors for low birth weight. The study also examined predictors of preterm birth, which included previously diagnosed diabetes, maternal narcotic use and insulin-controlled gestational diabetes.

“Low birth weight and preterm birth are serious public health problems. Both are associated with a higher risk of infant mortality,” says principal investigator Dr. Jamie Seabrook, a Lawson associate scientist; and professor at Brescia University College, an affiliate of Western University, and Western University’s Schulich School of Medicine & Dentistry.

Low birth weight can lead to respiratory problems and asthma, and poor cognitive development during childhood. It also increases an infant’s risk of developing type 2 diabetes, hypertension and cardiovascular disease later in life. Preterm birth can cause childhood neurologic disability, as well as long-term medical consequences including respiratory, gastrointestinal and cardiovascular diseases and decreased immunity.

The research team investigated many potential factors that could be linked to birth outcomes, including demographics, prenatal factors and medical risks. The objective of the study was to determine the relationship between socioeconomic status and adverse birth outcomes, particularly low birth weight and preterm birth, in Southwestern Ontario.

However, they found that socioeconomic status had little influence on birth outcomes.

“There is a widely-held view that socioeconomic status is highly associated with low birth weight and preterm birth. However, there have been few population-based studies investigating this relationship in Canada. Most of this research has come from other developed countries, particularly the United States,” says Dr. Seabrook, who is also a Faculty Associate at Western’s Human Environments Analysis Laboratory. “It’s possible that Canada’s universal health care system provides a larger safety net for these mothers and their children.”

Live births between February 2009 and February 2014 at LHSC were included in the study. Infants with a birth weight of less than 2500 grams were classified as low birth weight. Preterm birth was defined as a live birth at a gestational age of less than 37 weeks.

The rates of low birth weight and preterm birth found in the study were 6.4 per cent and 9.7 per cent, respectively. The study notes that these rates are comparable to those reported by the Canadian Institute for Health Information in 2010-11, which found that 6.6 per cent of infants in Canada had low birth weight and 8.1 per cent were preterm births.

Median neighbourhood income was used as an indicator of socioeconomic status. Postal codes of the mothers were entered into a Geographic Information System and mapped to determine the location of home neighbourhoods, defined by boundaries of census dissemination areas. Dr. Seabrook adds that while the database used in the study included a large population-based sample, it is possible there may be incomplete or inaccurate data since it was obtained from chart records. For example, information on individual household income and length of time at an address was not available.

Along with Dr. Seabrook, the research team included Dr. Jason Gilliland, a scientist at Children’s Health Research Institute (a program of Lawson), Director of the Human Environments Analysis Laboratory at Western and professor at Schulich Medicine & Dentistry; Dr. Barbra de Vrijer, associate scientist at Children’s Health Research Institute, consultant in LHSC’s Obstetrics & Gynaecology department and associate professor at Schulich Medicine & Dentistry; Dr. Debbie Penava, Lawson scientist, LHSC physician and associate professor at Schulich Medicine & Dentistry; Dr. Paula Dworatzek, Chair and Associate Professor, School of Food and Nutritional Sciences at Brescia University College; and Emily Campbell, MScFN, RD, who was a graduate student at Brescia University College at the time of the study.

“Socioeconomic status and adverse birth outcomes: A population-based Canadian sample” was published in the Journal of Biosocial Science.

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Above: Dr. Jamie Seabrook

On Friday, November 23, 2018, the Mental Health INcubator for Disruptive Solutions (MINDS) of London-Middlesex welcomed community members and stakeholders at Innovation Works for an update on the work of the MINDS team and announced the generous contributions of the Ontario Trillium Foundation. 

Local MPPs Peggy Sattler (London West) and Terence Kernaghan (London North Centre), with OTF Grant Review Team member Chris Harding were on hand to congratulate the MINDS members, including Pillar Nonprofit Network, and hear more about how the $75,000 OTF Grant will contribute to the mental health of transitional aged youth in the London and Middlesex region. 

As a research project through Lawson Health Research Institute, MINDS is taking a unique approach to improving the mental health of the community’s transitional age youth – people ages 17 to 25. 

A key aspect is to successfully work in partnership with youth to make sense of and address this complex challenge. 

“Today’s youth are unlike any generation before,” explains Dr. Arlene MacDougall, Director and Principal Investigator for MINDS. “Many of our processes, structures, models and concepts that we have used to serve, educate, employ, care for and communicate with youth in the past are no longer appropriate, relevant or effective for the youth of today.”

Dr. MacDougall is also Director of Research and Innovation for mental health care at St. Joseph’s Health Care London and Assistant Director for mental health research at Lawson. 

Youth today are more diverse, connected and educated. Although many are reaping benefits from these qualities, others are facing significant challenges such as finding a full time job, being social excluded, negative effects of digital life including cyberbullying and physical health challenges like rising obesity. 

“Evidence from acute care and community sectors shows an increase in the number and acuity of mental health and addiction challenges experienced by our local transitional age youth,” states Dr. MacDougall. “We see this as a persistent and ‘wicked’ challenge – it is difficult to define and many factors contribute to it.” 

Over the last few years, across Canada and locally, there have been higher rates of emergency visits and inpatient hospitalizations for youth with mental disorders; an increase in the number of youth seeking help for mental illnesses; and, youth experiencing increased rates of anxiety, depression and suicidal thoughts and attempts. 

“We have been listening to local youth and their adult allies. We are hearing from youth with lived experience of mental illness and those who do not have a lived experience. And we are working on making sense of the upstream social drivers and components of poor mental health for transitional age youth,” explains Dr. MacDougall.

“On the flip side, we are exploring the potential action areas, levers and opportunities for shifting our community and our system to promote youth mental and emotional wellbeing – reaching them sooner and in the way they need.” 

As a social innovation lab, MINDS will use a collective impact framework to develop and test high impact solutions. This provides a structured process and creative environment where the team can prototype radical but possible innovations, while merging with youth-led participatory action research. 

“The collective impact framework enables us to can tackle deeply entrenched and complex social problems. It is an innovative yet structured approach to making collaboration work across government, business, philanthropy, non-profit organizations and citizens to achieve significant and lasting social change.” 

MINDS has the support of a diverse network of key individuals and partnering organizations including cross-sectoral service providers, community leaders, mental health advocates and youth from the region. This includes Lawson, St. Joseph’s, London Health Sciences Centre, Western University, mindyourmind, Goodwill Industries and CMHA Middlesex. The project has also received funding support from St. Joseph’s Health Care Foundation.

“We are thrilled that many partners in the community are coming together to look for disruptive solutions that will create a lasting impact for youth,” explains Dr. MacDougall. “To the best of our knowledge, this is the first social innovation lab dedicated to improving community mental health to be established in Canada.

The Ontario Trillium Foundation (OTF) is an agency of the Government of Ontario, and one of Canada’s leading granting foundations. OTF awarded more than $120 million to some 700 projects last year to build healthy and vibrant communities in Ontario.