Julie Lamoureux

Université de Montréal, Montréal, Quebec, Canada

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Publications (28)55.66 Total impact

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    ABSTRACT: Most previous studies of maternal cytokines and preterm birth have analyzed immunologic biomarkers after the onset of labor or membrane rupture; fewer have examined the systemic (blood) immune response prior to labor onset. We carried out a case-control study nested in a large (n=5337) prospective, multi-center cohort. Cohort women had an interview, examination, and venipuncture at 24-26 weeks. Frozen plasma samples in women with spontaneous preterm birth (n=207) and approximately 2 term controls per case (n=444) were analyzed using Luminex multianalyte profiling technology. Fresh placentas were fixed, stained, and blindly assessed for histologic evidence of infection/inflammation, decidual vasculopathy, and infarction, and vaginal swabs were analyzed for bacterial vaginosis and fetal fibronectin concentration. High maternal matrix metalloproteinase-9 (MMP-9) concentration, but none of the other cytokines or C-reactive protein (CRP), was significantly associated with spontaneous preterm birth [adjusted OR=1.7 (1.1-2.4)] and showed a dose-response relation across quartiles. No association was observed, however, between maternal MMP-9 and placental infection/inflammation, bacterial vaginosis, or vaginal fetal fibronectin concentration. Our results require confirmation in future studies but suggest that a systemic immune response implicating MMP-9 may have an etiologic role in spontaneous preterm birth.
    Cytokine 09/2009; 49(1):10-4. · 2.52 Impact Factor
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    ABSTRACT: Background: Neither macro- nor micronutrient supplements have been clearly demonstrated to reduce the risk of preterm birth. However, there has been little attention to carotenoids, tocopherols, and long-chain fatty acids other than n-3 polyunsaturates. Methods: We conducted a case-control study nested in a large (n = 5337) prospective, multicenter cohort. All cohort women had an interview, examination, and venipuncture at 24-26 weeks' gestation. Frozen plasma samples in spontaneous preterm births (n = 207) and approximately 2-term controls per case (n = 443) were analyzed for carotenoids, retinol, tocopherols, and long-chain fatty acids. Fresh placentas were fixed, stained, and assessed (without knowledge of pregnancy outcome) for histologic evidence of infection or inflammation, decidual vasculopathy, and infarction. Results: High (above the median) plasma concentrations of α- and β-carotene, α- and β-cryptoxanthin, and lycopene were all associated with reductions in risk of spontaneous preterm birth, with evidence of dose-response effects across quartiles. Modest increases in risk were observed with elevated total monounsaturated, total polyunsaturated, and total n-6 polyunsaturated long-chain fatty acids concentrations. Paradoxically, a high γ-tocopherol concentration was associated with increased preterm birth risk (adjusted odds ratio = 1.8 [95% confidence interval = 1.2-2.6]). Only one of the studied micronutrients (lutein) was independently associated with a reduced risk of decidual vasculopathy (0.5 [0.3-0.9]). Conclusions: Carotenoids and long-chain fatty acids warrant further investigation in in vitro, animal, and human studies of preterm birth.
    Epidemiology 08/2009; 20(5):707-713. · 5.74 Impact Factor
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    ABSTRACT: The authors investigated a large number of stressors and measures of psychological distress in a multicenter, prospective cohort study of spontaneous preterm birth among 5,337 Montreal (Canada)-area women who delivered from October 1999 to April 2004. In addition, a nested case-control analysis (207 cases, 444 controls) was used to explore potential biologic pathways by analyzing maternal plasma corticotrophin-releasing hormone (CRH), placental histopathology, and (in a subset) maternal hair cortisol. Among the large number of stress and distress measures studied, only pregnancy-related anxiety was consistently and independently associated with spontaneous preterm birth (for values above the median, adjusted odds ratio = 1.8 (95% confidence interval: 1.3, 2.4)), with a dose-response relation across quartiles. The maternal plasma CRH concentration was significantly higher in cases than in controls in crude analyses but not after adjustment (for concentrations above the median, adjusted odds ratio = 1.1 (95% confidence interval: 0.8, 1.6)). In the subgroup (n = 117) of participants with a sufficient maternal hair sample, hair cortisol was positively associated with gestational age. Neither maternal plasma CRH, hair cortisol, nor placental histopathologic features of infection/inflammation, infarction, or maternal vasculopathy were significantly associated with pregnancy-related anxiety or any other stress or distress measure. The biologic pathways underlying stress-induced preterm birth remain poorly understood.
    American journal of epidemiology 05/2009; 169(11):1319-26. · 5.59 Impact Factor
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    ABSTRACT: This study investigated which factors collected early in the acute care setting (age, education, cerebral imaging, Glasgow Coma Scale score) would predict initial impairments of language comprehension and expression in patients with traumatic brain injury (TBI) of all severity. Results of language tests carried out during the patients' stay in an acute tertiary trauma centre were obtained. These tests measured performance in the areas of confrontation naming, auditory comprehension, semantic and letter category naming and comprehension of verbal absurdities. Data for the predictive variables were gathered by retrospective chart review. Stepwise multiple linear regressions were carried out on the predictive variables. Education and TBI severity as measured with the GCS score were the most significant factors predicting language deficits in the acute care setting. These findings will serve to guide health care professionals in predicting prognosis for cognitive-communication deficits post-TBI and in planning for appropriate resources in speech-language pathology to meet these patients' needs.
    Brain Injury 01/2007; 20(13-14):1391-401. · 1.51 Impact Factor
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    ABSTRACT: Many previous studies of agreement in identifying placental histopathologic lesions have been based on small sample sizes, and none has examined whether individual histologic features cluster robustly together within and between observers. We studied 767 placental specimens from case-control studies of preterm birth and preeclampsia nested within a prospective cohort of pregnant women recruited from 4 large Montreal maternity hospitals. The specimens were fixed, embedded, stained, and examined using a standardized protocol; a 10% random sample (n = 81) was then blindly reexamined at least 6 months later by the same pathologist and a second pathologist. Intra- and interobserver agreement were high (kappa > or = 0.50) for membrane inflammation, funisitis, and umbilical cord vasculitis, and these 3 features were robustly clustered statistically, consistent with an underlying mechanism of ascending infection. Agreement and clustering were also high or moderate for features of placental underperfusion: infarction, decidual vasculopathy, and syncytial knotting. Our results should help researchers to interpret future findings relating placental histopathology to preterm birth, preeclampsia, and other adverse pregnancy outcomes, and to their etiologic determinants and causal pathways.
    American journal of obstetrics and gynecology 01/2007; 195(6):1674-9. · 3.28 Impact Factor
  • E de Guise, J Leblanc, M Feyz, J Lamoureux
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    ABSTRACT: To determine a predictive model for cognitive functional outcome of patients with traumatic brain injury (TBI) at discharge from acute care. Three hundred and thirty-five patients were included in this analysis. Variables considered were age, education, initial score on the Glasgow Coma Scale (GCS), duration of post-traumatic amnesia (PTA), cerebral imaging results and the need for neurosurgical intervention. Functional Independence Measure (FIM). Results of this analysis indicated better cognitive FIM at discharge from acute care settings for patients with TBI when PTA was less than 24 hours, when level of education was higher, when no parietal lesion was identified, when no neurosurgical intervention was required, for patients with TBI who were younger and who presented with a higher GCS score upon admission. This model will help to plan resource allocation for treatment and discharge planning within the first weeks following TBI.
    Brain Injury 01/2006; 19(13):1087-93. · 1.51 Impact Factor
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    ABSTRACT: To compute outcome probabilities for persons with traumatic brain injury at discharge from acute care. Three hundred thirty-nine patients with traumatic brain injury (239 mild, 48 moderate, 52 severe). Level I trauma center. Predictor variables considered were age, education, Glasgow Coma Scale score, duration of posttraumatic amnesia, cerebral imaging results, and need for neurosurgical intervention. Outcome measures were Extended Glasgow Outcome Scale and discharge destination. Logistic regressions showed that a shorter posttraumatic amnesia decreased the probability of moderate to severe disability. Moreover, discharge home was less probable for patients with positive cerebral imaging. This model can help predict rehabilitation needs upon discharge from an acute care hospital.
    Journal of Head Trauma Rehabilitation 01/2006; 21(6):527-36. · 4.44 Impact Factor
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    ABSTRACT: The goal of this study was to provide a general descriptive and cognitive portrait of a population with traumatic brain injury (TBI) at the time of their acute care stay. Three hundred and forty-eight TBI patients were assessed. The following data were collected for each patient: age, level of education, duration of post-traumatic amnesia, Galveston Orientation Amnesia Test score, Glasgow Coma Scale score, results of cerebral imaging, Neurobehavioral Rating Scale score, the Functional Independence Measure cognitive score and the Glasgow Outcome Scale score. The clinical profile of the population revealed a mean age of 40.2 (+/-18.7) and a mean of 11.5 (+/-3.6) years of education. Most patients presented with frontal (57.6%) and temporal (40%) lesions. Sixty-two percent had post-traumatic amnesia of less than 24 hours. Seventy percent presented with mild TBI, 14% with moderate and 15% with severe TBI. The cognitive deficits most frequently observed on the Neurobehavioral Rating Scale were in the areas of attention, memory and mental flexibility as well as slowness and mental fatigability. Most patients had good cognitive outcome on the Functional Independence Measure and scores of 2 and 3 were frequent on the GOS. Forty-five percent of the patients returned home after discharge, 51.7% were referred to in or out patient rehabilitation and 3.2% were transferred to long-term care facilities. Because of the specialized mandate of acute care institutions, the information provided here concerning characteristics of our TBI population is essential for more efficient decision-making and planning/programming with regards to care and service delivery.
    The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques 06/2005; 32(2):186-93. · 1.33 Impact Factor

Publication Stats

196 Citations
55.66 Total Impact Points

Institutions

  • 2007–2014
    • Université de Montréal
      • Department of Social and Preventive Medicine
      Montréal, Quebec, Canada
  • 2005–2012
    • McGill University
      • Department of Neurology and Neurosurgery
      Montréal, Quebec, Canada
  • 2011
    • Brigham Young University - Provo Main Campus
      Provo, Utah, United States