Six Nations Maternal and Newborn Health

Understanding the maternal and newborn characteristics that increase the risk of early development of adiposity can help inform strategies that prevent obesity and type 2 diabetes in the Six Nations community.

McMaster Researcher

Citation

Oliveira A.P., Kalra S., Wahi G., McDonald S., Desai D., Wilson J., Jacobs L., Smoke S., Hill P., Hill K., Kandasamy S., Morrison K., Teo K., Miller R., Anand S.S., "Maternal and newborn health profile in a First Nations community in Canada," Journal of Obstetrics and Gynaecology Canada, 35, 10, (2013). 

Wahi G., Wilson J., Miller R., Anglin R., McDonald S., Morrison K.M., Teo K.K., Anand S.S., "Aboriginal birth cohort (ABC): a prospective cohort study of early life determinants of adiposity and associated risk factors among Aboriginal people in Canada," BMC Public Health, 13, 608, (2013). 

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What is this research about?

Researchers worked in partnership with the Six Nations Birthing Centre in Brant County, Ontario to understand the factors that influence maternal and newborn weight and health on the Six Nations Reserve. There is increasing evidence to support that certain maternal exposures and early life determinants can program the developing fetus to be at risk for excess adiposity. The purpose of this research was to understand the average maternal and newborn health profile on the Reserve and to explore the maternal and newborn characteristics that may underlie the early development of adiposity and type 2 diabetes in the Six Nations community.  

What did the researchers do?

Working in Partnership with the Six Nations Birthing Centre , the researchers reviewed the medical charts of 453 women on the Six Nations Reserve who were pregnant between January 1, 2005 and December 31, 2010. They collected information on newborn birth weight, maternal weight, gestational diabetes, and smoking exposure  before and during pregnancy. The researchers then compared this data to an existing group of non-First Nation women and their newborns recruited as part of the Family Atherosclerosis Monitoring In earLY life (FAMILY) study. 

The chart review informed the development and initiation of an ongoing study called the Aboriginal Birth Cohort. In this study, the researchers  are recruiting up to 300 Aboriginal pregnant women from the Six Nations Reserve  with plans to follow them throughout their pregnancy and up until their newborn is 3 years old. The researchers will measure characteristics such as maternal socioeconomic status, depression during or after pregnancy, and offspring adiposity. As part of this study, the researchers have also completed in-depth interviews with grandmothers from the Six Nations community to understand their beliefs on the best health practices for women before, during, and after pregnancy.  

What did the researchers find?

In the first study the researchers found that, compared to the non-First Nation mothers, the Aboriginal mothers had a higher average pre-pregnancy BMI, used tobacco more during pregnancy, and gained more weight during pregnancy than the upper limit of weight gain recommended by Health Canada. The average birth weight in the Aboriginal newborns was greater than the non-First Nation newborns. However, more positively, the proportion of newborns considered too small or too large for their gestational age was slightly smaller in the Aboriginal cohort.   
 
The results from the interviews with the grandmothers from the Six Nations community can be seen in this video, which was developed by a Sujane Kandasamy, and received Special Commendation at the 2015 IHDCYH Talks.

How can you use this research?

This research is particularly important to the Six Nations community, and other Aboriginal communities across Canada. It emphasizes the need for strategies to prevent excess weight gain and smoking among pregnant women. Ultimately, this research can help the Six Nations community make evidence-based, culturally aligned changes that address the early development of adiposity and type 2 diabetes among newborns. 

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