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Changes in Caregiver Health in the Years Surrounding the Birth of a Child With Health Problems

Administrative Data From British Columbia

Brehaut, Jamie C., PhD*,†; Guèvremont, Anne, MA; Arim, Rubab G., PhD; Garner, Rochelle E., PhD; Miller, Anton R., MBChB§; McGrail, Kimberlyn M., PhD; Brownell, Marni, PhD; Lach, Lucy M., PhD#; Rosenbaum, Peter L., MD**; Kohen, Dafna E., PhD†,‡

doi: 10.1097/MLR.0000000000001098
Original Articles

Background: Caregivers of children with health problems (CHPs; usually mothers) experience more physical and psychological health problems than those of children without health problems (non-CHPs). Primarily cross-sectional and survey-driven, this literature has not yet explored whether these health differences existed before the birth of the CHPs, or are exacerbated postbirth.

Methods: Using linked administrative health data on all mother-child dyads for children born in the year 2000 in British Columbia, Canada, we examined maternal health before, during, and after the birth of CHPs, and compared it between mothers of CHPs and non-CHPs with piecewise growth curve modeling.

Results: Compared with mothers of non-CHPs, mothers of CHPs had more physician visits (8.09 vs. 11.07), more medication types (1.81 vs. 2.60), and were more likely to be diagnosed with selected health conditions (30.9% vs. 42.5%) 4 years before the birth of the child. Over the 7-year postbirth period, the health of the 2 groups of mothers further diverged: while mothers of CHPs showed increases on physician visits and types of medication, mothers of non-CHPs did not experience any changes in physician visits and had less steep increases for types of medication.

Conclusions: Health issues associated with having a child with a health problem may begin well before the birth of the child, but also appear to be exacerbated postbirth. The health challenges of caregivers of CHPs may be multifactorial, involving both preexisting conditions and the stresses associated with caring for a child with health problems.

*Centre for Practice-Changing Research, Ottawa Hospital Research Institute, Clinical Epidemiology Program, The Ottawa Hospital

School of Epidemiology & Public Health, University of Ottawa

Health Analysis Division, Statistics Canada, Ottawa, ON

§Department of Pediatrics, Faculty of Medicine, University of British Columbia

School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC

Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB

#School of Social Work, McGill University, Montreal, QC

**Department of Paediatrics, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada

Supported by the Canadian Institutes of Health Research Operating Grant (MOP#102614). The funding agency had no role in the study design, collection, analysis or interpretation of data, writing of the manuscript or in the decision to submit the manuscript for publication.

All inferences, opinions, and conclusions drawn in this article are those of the authors and do not reflect the opinions or policies of the Data Stewards.

The authors declare no conflict of interest.

Reprints: Jamie C. Brehaut, PhD, Centre for Practice-Changing Research, Ottawa Hospital Research Institute, Clinical Epidemiology Program, The Ottawa Hospital, General Campus, 501 Smyth Road, Room 1284, P.O. Box 201B, Ottawa, ON, Canada K1H 8L6. E-mail:

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