Canadian perinatal opioid project: a protocol for a national health data system

Opioids are widely used during pregnancy and can lead to health complications for pregnant people, parents and their children. Yet, little is known about the long- and short-term effects of perinatal opioid exposures on health outcomes in Canada. Evidence is needed to inform optimal support for maternal and child health following perinatal opioid exposures.

We aim to develop the Canadian Perinatal Opioid Project, a pan-Canadian federated health data system to capture perinatal opioid exposures across multiple provinces, along with subsequent maternal and child health outcomes.

This health data system uses population-based administrative health records from Alberta, British Columbia, Manitoba, Ontario and Saskatchewan, each with two population-based cohorts: (1) all pregnancies among people aged 12-49 years, 2013-2023 and (2) liveborn infants from these pregnancies. Pregnant people will be followed for 1 year after the end of pregnancy; live births will be followed for 8 years. Data will be obtained from outpatient prescription opioid records, mother-infant linked hospitalisation records, emergency department visits, outpatient physician visits, birth registries and vital statistics. This work is being conducted in collaboration with Indigenous and non-Indigenous people with lived/living experience of perinatal opioid use and knowledge users.

We will use descriptive statistics to describe incidence and cohort characteristics and Poisson regression to assess annual trends. Patient-level analysis will occur in each province, and province-level aggregated results will be meta-analysed.

Ethics approval was granted by research ethics boards at the University of British Columbia (H24-03406), University of Calgary (REB24-1721), University of Manitoba (HS26640), University of Toronto (46764) and University of Saskatchewan (5348). We will develop knowledge dissemination plans and products with people with lived/living experience of perinatal opioid use and knowledge users. Health data indicators will be featured in an open-access online dashboard. We expect to share methods and research findings through peer-reviewed publications in high-impact journals, presentations at national and international conferences, presentations to community members and knowledge users, and research summaries for the general population.