What question did this study set out to answer?

This research aims to create a nationally representative pregnancy cohort in Canada that integrates clinical, social, and environmental data for maternal health research.

March 14, 2026Open Access

Data resource profile: a nationally representative linked pregnancy cohort in Canada integrating clinical, social, and environmental data

SCSabrina ChiodoUniversity of Toronto SGSonia M. GrandiPreventive Cardiology JGJessica GronsbellUniversity of Toronto

Key Points

This research aims to create a nationally representative pregnancy cohort in Canada that integrates clinical, social, and environmental data for maternal health research.
Linked Canadian Community Health Survey to Discharge Abstract Database using Statistics Canada's Social Data Linkage Environment.
Included females aged 15-49 years with a hospital delivery within two years of their CCHS interview.
Excluded multifetal gestations and retained only first deliveries per individual.
Appended area-level and environmental exposures via residential postal codes using Postal Code Conversion File Plus.
Cohort includes 13,360 singleton births.
Pre-pregnancy data encompass sociodemographics, health behaviours, chronic conditions, psychosocial factors, and reproductive history.
Similar characteristics observed between individuals who reported being pregnant and those who did not, except for age and marital status.
Data quality validated by Statistics Canada's survey protocols and CIHI's hospital validation processes.

Abstract

IntroductionPerinatal outcomes are shaped by clinical, social, and environmental factors, yet Canada lacks a nationally representative pregnancy cohort capturing these influences at the individual-level. This gap has limited the ability to address multifactorial drivers of maternal and fetal health. To fill this need, we established a linked cohort integrating survey, clinical, and contextual data to support equity-focused, precision public health research in maternal health. MethodsWe linked the Canadian Community Health Survey (CCHS; 2000--2017) to the Discharge Abstract Database (DAD) using Statistics Canada's Social Data Linkage Environment. Eligible participants were female (as defined by the binary CCHS sex variable), aged 15-49 years, with a hospital delivery within two years of their CCHS interview. We excluded multifetal gestations and retained only the first delivery per individual. Area-level and environmental exposures (i.e., neighbourhood inequity, pollution, greenspace, neighbourhood walkability, etc.) were appended via residential postal codes using the Postal Code Conversion File Plus (PCCF+). ResultsThe cohort includes 13,360 singleton births. Pre-pregnancy data include sociodemographics, health behaviours, chronic conditions, psychosocial factors, and reproductive history. Contextual measures capture neighbourhood marginalization, air pollution, greenness, and built environment characteristics. In the CCHS, individuals who reported being pregnant at interview and those who did not (but later delivered) had similar characteristics (SMDs < 0.1), except for age and marital status. Data quality is supported by Statistics Canada's survey protocols, CIHI's hospital validation processes, and standardised geocoding. ConclusionApproved researchers can recreate this dataset within Statistics Canada's Research Data Centres using reproducible R code, which will become openly available on GitHub. The cohort enables research across descriptive epidemiology, causal inference, predictive modelling, and health equity evaluation, supporting investigations into multilevel determinants of maternal health. Future work should prioritise national mother--child linkages to expand life course research.

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