Cohorts and sources of data
The Quebec Pregnancy Cohort
The population-based Quebec Pregnancy Cohort is a widely used administrative database. It was put in place by the Dr. Anick Bérard and her research team at CHU Sainte-Justine, Montreal, with the linkage of three administrative databases of the province of Quebec: the Régie de l'Assurance Maladie du Québec (RAMQ), the MedEcho database, and the Fichier des événements démographiques du Québec, administered by the Institut de la Statistique du Québec (ISQ). A self-administrated questionnaire was also used to obtain data on socioeconomic risk factors, natural products and over-the-counter medications use, and lifestyle that were not available from the three databases.
The RAMQ database contains information on medical services (diagnoses and procedures) received by all Quebec residents. Although RAMQ covers all residents for the cost of physician visits, hospitalisations, and procedures, it only covers a portion of them for the cost of medications. The RAMQ prescription claims database (RAMQ-Rx) covers individuals 65 years and older, recipients of social assistance, and workers and their families (adherents) who do not have access to a private drug insurance program, accounting for approximately 43% of the overall Quebec population and 36% of women between 15-45 years of age. MedEcho is a provincial database which records acute care hospitalisation data, including emergency visits, for all Quebec residents; it also records gestational age for deliveries. Le fichier des événements démographiques du Québec provides demographic information on the mother, father and baby as well as birth weight and gestational age for live births and stillbirths. Globally, the Quebec Pregnancy Cohort contains data on pregnant women in Quebec that received a diagnostic of pregnancy from 1998 to 2003, regrouping 150 000 pregnancies. The cohort will soon be updated. Access to information needed for the creation of the Cohorte des Grossesses du Québec was approved by the Commission d'accès à l'information du Québec (CAI) and ethical approval was obtained from the CHU Sainte-Justine's ethics committee.
Pharmacoepidemiologic studies using administrative databases such as the Quebec Pregnancy Cohort are important and yield valuable information, especially for pregnant women who are excluded from most drug trials. Although several observational human studies on the risks and benefits of medication use during pregnancy have been performed and published, it remains that their sample sizes are often insufficient to rule out low-to-moderate increased risks for even the more commonly occurring adverse perinatal outcomes such as heart defects, neural tube defects, and oral clefts. Globally, the Quebec Pregnancy Cohort gives the opportunity to identify numerous expositions and outcomes of interests for perinatal pharmacoepidemiologic research in the province of Quebec.
Fonds de la Recherche en Santé du Québec (FRSQ), Réseau Québécois de Recherche sur l'Usage des Médicaments (RQRUM), Réseau FRSQ pour le bien-être des enfants.