Jan 10, 2024

Leong Fellow studies medication use during pregnancy

Dr. Andi Camden is an Epidemiologist and CIHR-funded postdoctoral fellow at the Edwin S.H. Leong Centre for Healthy Children, University of Toronto Scarborough, and ICES. Andi holds a PhD in Public Health Sciences in Epidemiology and an MPH in Epidemiology from the Dalla Lana School of Public Health, University of Toronto. Andi is also a Canadian Mother-Child Collaborative (CAMCCO-L) Trainee and Co-Chair of the Ontario Public Health Association Reproductive Health Workgroup. She highlights her research on medication use in pregnancy.

My postdoctoral research uses administrative health and demographic data to investigate medication use in pregnancy in two projects, including: 1) opioid use in pregnancy and 2) medication use in pregnancy in people with disabilities.

The first study focuses on opioid use in pregnancy under the supervision of, Dr. Astrid Guttmann. Co-Director of the Edwin S.H. Leong Centre for Healthy Children. This work builds on my CIHR-funded doctoral research where we developed methods to identify prenatal opioid use in administrative health data, which we then applied to understand the epidemiology of prenatal opioid use in Ontario and associated child and maternal health outcomes. An important finding from this work was that only 1 in 3 children with prenatal opioid exposure received recommended well-child care and developmental screening by 2 years of age in Ontario. Further, there are no detailed federal or provincial clinical practice guidelines in Canada to support these children post-hospital discharge. This is concerning given the growing body of evidence suggesting neurodevelopmental concerns in children with prenatal opioid exposure. Thus, in my postdoctoral work, Dr. Guttmann and I are collaborating with the Fraser Mustard Institute for Human Development Policy Bench to summarize key strategies used in other jurisdictions to improve the developmental health of children with prenatal opioid exposure post-hospital discharge. Findings generated from this rapid review will inform recommendations to strengthen Canada’s approach to optimize child development in this population. Dr. Guttmann and I are also exploring the impact of the COVID-19 pandemic on rates of prenatal opioid use and describing trends in pregnancy-associated opioid toxicity and mortality – a perinatal health issue of growing concern.

 The second study of my postdoctoral research uses inclusive research methods to investigate medication use in pregnancy in people with disabilities under the supervision of Dr. Hilary Brown, Associate Professor at the University of Toronto Scarborough. As a Leong Fellow, I have benefitted from mentorship from Dr. Priscilla Medeiros, Knowledge Mobilization and Community Engagement Specialist at the Edwin S.H. Leong Centre for Healthy Children, and participation in the Trainee Hub Community Engagement series, which have supported me to create a research advisory group. Advisory group members have lived/living experience of disability, medication use, and pregnancy, and have identified research priorities and will be involved throughout the research process. Together we are examining patterns and trajectories of medication use in pregnancy in people with disabilities, including polypharmacy and teratogenic medication use, opioid use and opioid-related harm, and the mediating role of prenatal medication use between maternal disability and perinatal complications.

Together, the information generated from my postdoctoral projects addresses critical knowledge gaps in underserved populations. Findings from this research will inform the development of tailored, comprehensive preconception and perinatal supports/services, medication counselling for pregnant people, and maternal and child health policy.