Shi Wu Wen

University of Ottawa, Ottawa, Ontario, Canada

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Publications (215)712.81 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Mannose-binding lectin (MBL) and MBL-associated serine proteases 2 (MASP-2) are important proteins in the lectin pathway of the immune system. Polymorphism of MBL and MASP-2 genes may affect the serum concentration of MBL and MASP-2. This study explores the association between MBL and MASP-2 gene polymorphism and their interactions and the susceptibility to tuberculosis (TB). Method A total of 503 patients with TB and 419 healthy controls were recruited to participate in this case-control study. PCR-SSP technology was applied to genotype rs7096206 of MBL genes and rs2273346 and rs6695096 of MASP-2 genes. Demographic data and some exposure information were also obtained from study participants. Unconditional logistic regression analysis was used to identify association between the various factors and TB whilst Marginal Structural Linear Odds Models were used to estimate the interactions. Results Both genotype GC at rs7096206 of MBL genes and genotype TC at rs2273346 and rs6695096 of MASP-2 genes were more prevalent in the TB patient group than the healthy control group (P < 0.05, OR 1.393, 1.302 and 1.426 respectively). The relative excess risk of interaction (RERI) between rs7096206 of MBL genes and rs2273346 and rs6695096 of MASP-2 genes was 0.897 (95% CI: 0.282, 1.513) and 1.142 (95% CI: 0.755, 1.530) respectively (P < 0.05). Conclusion Polymorphisms of MBL (rs7096206) and MASP-2 (rs2273346 and rs6695096) were associated with the susceptibility of TB, and there were gene-gene interactions among them.
    BMC Infectious Diseases 03/2015; 15. DOI:10.1186/s12879-015-0879-y · 2.56 Impact Factor
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    ABSTRACT: The effectiveness of Foley catheter plus misoprostol for cervical ripening has not been convincingly shown in trials. To summarize the evidence comparing Foley catheter plus misoprostol versus misoprostol alone for cervical ripening. Embase, Medline, and Cochrane Collaboration databases were searched with the terms "Foley catheter," "misoprostol," "cervical ripening," and "labor induction." Randomized controlled trials comparing the methods of cervical ripening for delivery of a viable fetus were included. Study characteristics, quality, and outcomes were recorded. Random-effects models were used to combine data. Eight trials were included, with 1153 patients overall. In a pooled analysis of seven high-quality studies, the combination group had a decreased time to delivery (mean difference -2.36hours, 95% confidence interval [CI] -4.07 to -0.66; P=0.007). Risk of chorioamnionitis was significantly increased in the combination group (risk ratio [RR] 2.07, 95% CI 1.04-4.13; P=0.04), and that of tachysystole with fetal heart rate changes was decreased (RR 0.58, 95% CI 0.38-0.91; P=0.02). Frequency of cesarean did not differ (P=0.77). The combined use of Foley catheter and misoprostol results in a reduced time to delivery, a reduced frequency tachysystole with fetal heart rate changes, and an increased incidence of chorioamnionitis. Copyright © 2015. Published by Elsevier Ireland Ltd.
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 03/2015; DOI:10.1016/j.ijgo.2015.01.005 · 1.56 Impact Factor
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    ABSTRACT: Background Recent data indicate that more than half of high-income industrialized countries have a cesarean delivery rate of > 25 percent, which is higher than the appropriate level considered by most health professionals worldwide.Methods Data for 31 high-income industrialized countries in 2010 (or the nearest year) obtained from the World Health Organization, Organization for Economic Cooperation and Development, World Bank, and individual countries were analyzed in this study. We examined the correlation between cesarean delivery rate and infant mortality rate with Pearson correlation coefficient analysis, and examined the independent effect of cesarean delivery on infant mortality with multiple linear regression analyses.ResultsThe cesarean delivery and infant mortality rates varied substantially among the included countries: from 15.6 to 50.0 percent and from 1.9 per to 6.8 per 1,000 live births, respectively. Cesarean delivery rates were positively correlated with infant mortality rates (Pearson correlation coefficient: 0.41, p < 0.05). The association remained after adjustment for maternal age, infant sex, per capita GDP, and the Gini index (p < 0.03), but disappeared after further adjustment for preterm birth (p = 0.07). In a sensitivity analysis, the results were not appreciably affected by excluding births at < 22 weeks of gestation, by weighting the data by the number of births in each country, or by excluding data from particular countries with possible measurement issues (USA, Greece).ConclusionsA higher cesarean delivery rate is associated with higher infant mortality rate among these high-income industrialized countries. One of the mechanisms by which cesarean delivery affects infant mortality is through iatrogenic prematurity.
    Birth 01/2015; DOI:10.1111/birt.12153 · 2.05 Impact Factor
  • Epidemiology and Infection 01/2015; DOI:10.1017/S095026881500062X · 2.49 Impact Factor
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    ABSTRACT: Objective. To determine a precise estimate for the contribution of maternal obesity to macrosomia. Data Sources. The search strategy included database searches in 2011 of PubMed, Medline (In-Process & Other Non-Indexed Citations and Ovid Medline, 1950-2011), and EMBASE Classic + EMBASE. Appropriate search terms were used for each database. Reference lists of retrieved articles and review articles were cross-referenced. Methods of Study Selection. All studies that examined the relationship between maternal obesity (BMI ≥30 kg/m(2)) (pregravid or at 1st prenatal visit) and fetal macrosomia (birth weight ≥4000 g, ≥4500 g, or ≥90th percentile) were considered for inclusion. Tabulation, Integration, and Results. Data regarding the outcomes of interest and study quality were independently extracted by two reviewers. Results from the meta-analysis showed that maternal obesity is associated with fetal overgrowth, defined as birth weight ≥ 4000 g (OR 2.17, 95% CI 1.92, 2.45), birth weight ≥4500 g (OR 2.77,95% CI 2.22, 3.45), and birth weight ≥90% ile for gestational age (OR 2.42, 95% CI 2.16, 2.72). Conclusion. Maternal obesity appears to play a significant role in the development of fetal overgrowth. There is a critical need for effective personal and public health initiatives designed to decrease prepregnancy weight and optimize gestational weight gain.
    BioMed Research International 12/2014; 2014:640291. DOI:10.1155/2014/640291 · 2.71 Impact Factor
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    ABSTRACT: The relationship between maternal HBV (hepatitis B virus) infection and pregnancy-induced hypertension (PIH) is inconclusive. Few studies have been conducted in rural areas of China. In order to examine the association between maternal chronic HBV infection and risk of PIH in Liuyang rural area China, we enrolled 6,195 eligible pregnant women in 2010-2011 in selected 14 towns of Liuyang on their first prenatal visit to local maternity care unit. A total of 461 subjects (7.44% (95%CI: 6.79%, 8.10%)) were identified with positive HBsAg status (exposed group) and 5734 were non-HBV carriers (unexposed group). Multivariate log-binomial regression models were used to estimate the risk of PIH, gestational hypertension (GH), and preeclampsia (PE) in relation to maternal chronic HBV infection. There are total of 455 subjects diagnosed with PIH (7.34% (95%CI: 6.70%, 7.99%)), including 371 GH (5.99% (95%CI: 5.40%, 6.58%)) and 81 PE (1.31% (95%CI: 1.07%, 1.64%)). The crude risk ratio between PIH, GH, PE and maternal HBV infection were 1.20 (95%CI: 0.88, 1.64), 1.30(95%CI: 0.93, 1.81) and 0.79 (95%CI: 0.32, 1.93), respectively. After adjustment for gravidity history, abortion history, family history of Diabetes Mellitus (DM) and family history of hypertension, positive HBsAg status was still not significantly associated with PIH (RR = 1.18, 95%CI: 0.87, 1.62), GH (RR = 1.27, 95%CI: 0.91, 1.78) or PE (RR = 0.79, 95%CI: 0.32, 1.95). Additional adjustment for maternal age, marital status, parity history, family history of DM, Body Mass Index at first antenatal visit, folic acid supplementation, smoking status during pregnancy and economic status of living area, multivariate analysis provided similar results. In conclusion, our study found that maternal chronic HBV infection prevalence rate is 7.4% among Liuyang rural area and there is no significant association between maternal HBV infection and the risk of PIH, GH or PE.
    PLoS ONE 12/2014; 9(12):e114248. DOI:10.1371/journal.pone.0114248 · 3.53 Impact Factor
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    ABSTRACT: Preventing influenza-like illness (ILI) during pregnancy with antiviral medication use (AVMU) can mitigate serious health risks to mother and foetus. We report on AVMU in pregnant women in Ontario, Canada, and describe characteristics of AVMU during the 2009-2010 H1N1 pandemic. Rates and risk estimates of AVMU were compared across multiple categories and stratified across ILI infection status. Increased AVMU was observed in women with influenza infections, active smokers, those vaccinated against influenza, and those with pre-existing co-morbidities. Decreased AVMU was observed in women with multiple gestations, and those in neighbourhoods of high immigrant concentrations. Our stratified analysis indicated that the observed patterns differed by ILI infection status. We demonstrated that once infected, women across multiple groups were equally likely to use antiviral medications. In this report we also propose possible clinical explanations for the observed differences in AVMU, which will be useful in planning prevention initiatives for future pandemics.
    Journal of Obstetrics and Gynaecology 11/2014; DOI:10.3109/01443615.2014.978846 · 0.60 Impact Factor
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    ABSTRACT: To explore the impact of passive smoking, cooking with solid fuel, mannose-binding lectin (MBL) gene, MBL-associated serine proteases 2 (MASP-2) gene, and gene-environment interactions on the susceptibility to tuberculosis (TB) in non-smokers.
    International Journal of Infectious Diseases 10/2014; 29. DOI:10.1016/j.ijid.2014.08.010 · 2.33 Impact Factor
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    ABSTRACT: Objective: To assess whether singleton pregnancies conceived by assisted reproductive technology (ART) are associated with an increased use of intrapartum interventions when compared with spontaneous singleton pregnancies. Methods: In total, 1327 ART pregnancies and 5222 spontaneous pregnancies during the period 2004 to 2008 were extracted from BORN (Better Outcomes Registry and Network) Ontario's information system. The incidences of common intrapartum interventions were compared, and different classification systems for Caesarean section were used to compare the indications for these between singleton pregnancies following ART with or without intracytoplasmic sperm injection and singleton spontaneously conceived pregnancies. Results: Compared with spontaneous singleton pregnancies, the ART group had increased incidences of internal electronic fetal monitoring (OR 1.60; 95% CI 1.37 to 1.87), artificial rupture of membranes (OR 1.39; 95% CI 1.17 to 1.66), oxytocin augmentation of labour (OR 1.51; 95% CI 1.28 to 1.77), induction of labour (OR 1.31; 95% CI 1.14 to 1.50), and Caesarean section (OR 1.40; 95% CI 1.24 to 1.60). Conclusion: Singleton pregnancies resulting from ART were associated with more frequent use of several intrapartum interventions, including Caesarean section.
  • Laura Gaudet, Shi Wu Wen, Mark Walker
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    ABSTRACT: Objective: To examine the combined effect of macrosomia and maternal obesity on adverse pregnancy outcomes using a retrospective cohort. Methods: Infants with a birth weight of ≥ 4000g (macrosomia) were identified from an institutional birth cohort. Demographic characteristics and maternal, fetal, neonatal, and pregnancy outcomes of macrosomic infants whose mothers were obese were compared with those whose mothers were non-obese. Results: Pregnancies in obese women resulting in macrosomic infants are more likely to be complicated by gestational diabetes, gestational hypertension, and smoking than pregnancies in non-obese women with macrosomic infants. Mothers whose infants are macrosomic are significantly more likely to require induction of labour (OR 1.42; 95% CI 1.10 to 1.98) and delivery by Caesarean section (OR 1.45; 95% CI 1.04 to 2.01), particularly for maternal indications (OR 3.7; 95% CI 1.47 to 9.34), if they are obese. Finally, macrosomic infants of obese mothers are significantly more likely to require neonatal resuscitation in the form of free flow oxygen (OR 1.57; 95% CI 1.03 to 2.42) than macrosomic infants of non-obese mothers. Conclusion: When both maternal obesity and macrosomia are present, adverse pregnancy outcomes are more common than when fetal macrosomia occurs in a woman of normal weight.
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    ABSTRACT: Background: Carbon monoxide (CO) is one of the main substances contained in fireworks. Previous studies suggested that CO may have protective effect on the development of hypertension of pregnancy. Method: The authors conducted a prospective cohort study in Liuyang, Hunan, China between January 2010 and December 2011. Demographic and life-style variables of the participating pregnant women were obtained through structured interview with the women and clinical data were retrieved from antenatal medical records. Density of fireworks factories was defined as the number of fireworks factories per 1000 residents in the township where the mothers resided during pregnancy. Multiple logistic regression analysis was used to analyze the independent association between maternal exposure to the production of fireworks and new onset hypertension in pregnancy. Results: A total of 5976 pregnant women were included in the final analysis. Density of fireworks factories was inversely correlated with incidence of new onset hypertension in pregnancy (Pearson correlation coefficient = −0.29, p < 0.001). Multiple logistic regression analysis showed that, compared with women who resided during pregnancy in a township with 0–0.25 fireworks factories per 1000 residents, the rates of new onset hypertension in pregnancy in women who resided in a township with 0.26–1.00 fireworks factories per 1000 residents (Odds Ratio = 0.66, 95% confidence interval: 0.46, 0.96) and >1.5 fireworks factories per 1000 residents (Odds Ratio = 0.65, 95% confidence interval: 0.44, 0.97) were reduced by more than 30%. Conclusion: Maternal exposure to the high density of fireworks factories is associated with reduced risk of developing new onset hypertension in pregnancy.
    Hypertension in Pregnancy 07/2014; 33(4). DOI:10.3109/10641955.2014.938752 · 1.19 Impact Factor
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    ABSTRACT: RASSF1A has been reported to be a candidate tumor suppressor in esophageal squamous cell carcinoma (ESCC). However, the association between RASSF1A promoter methylation and ESCC remains unclear. Eligible studies were identified through searching PubMed, Medline, Web of Science, and the China National Knowledge Infrastucture database. Studies were pooled and odds ratios (ORs) with corresponding confidence intervals (CIs) were calculated. Funnel plots were also performed to evaluate publication bias. Twelve studies involving 859 cases and 675 controls were included in this meta-analysis. A significant association was observed between RASSF1A methylation and ESCC overall (OR = 11.7, 95% CI: 6.59-20.9, z=8.36, P<0.00001). Subgroup analysis showed that the OR for heterogeneous tissues was 5.35 (95% CI = 2.95-9.71) while for autologous tissues it was 16.0 (8.31-30.96). For patient sample size, the OR for the <50 subgroup was 9.92 (95% CI = 2.88-34.2) and for the 50 case group was 13.1 (95% CI = 6.59-25.91). The OR for a relationship between RASSF1A methylation and TNM stages was 0.27 (95% CI=0.10-0.77), whereas there were no significant differences in RASSF1A methylation in relation to gender and differentiation among ESCC cases. This meta-analysis suggests a significant association between RASSF1A methylation and ESCC.
    Asian Pacific journal of cancer prevention: APJCP 05/2014; 15(9):3921-5. DOI:10.7314/APJCP.2014.15.9.3921 · 1.50 Impact Factor
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    ABSTRACT: Major efforts have been made to improve the health care system in Hunan province, China. The aims of this study were to assess whether and to what extent these efforts have impacted on gender and regional disparities of Tuberculosis (TB) incidence in recent years, especially for less developed areas. We obtained data from the 2005-2009 China Information System for Disease Control and Prevention (CISDCP)to conduct this study in Hunan province. Counties within the province were divided into four regions according to quartiles based on the 2007 per capita GDP. Index of Disparity (ID) and Relative Index of Inequality (RII) were used to measure the disparities of TB incidence in relation to gender and region. Bootstrap technique was used to increase the precision. The average annual incidence of TB was 111.75 per 100,000 in males and 43.44 per 100 000 in females in Hunan. The gender disparity was stable, with ID from 42.34 in 2005 to 43.92 in 2009. For regional disparity, ID, RII (mean) and RII (ratio) decreased significantly from 2005 to 2009 in males (P < 0.05) but remained stable among the female population. As interventions such as introduction of the New Rural Cooperative Scheme put in place to reduce health disparities in China, regional disparity in relation to incidence of TB decreased significantly, but the gender disparity remains in the Hunan province.
    International Journal for Equity in Health 04/2014; 13(1):32. DOI:10.1186/1475-9276-13-32 · 1.71 Impact Factor
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    ABSTRACT: Objective Labetalol and methyldopa are the two antihypertensive drugs most frequently used to control blood pressure for hypertensive disorders of pregnancy. The objective of this study was to assess if labetalol is associated with poor infant outcomes. Study design: Retrospective population-based cohort study using the linked maternal/infant databases in the Province of Saskatchewan. Women with a diagnosis of a hypertensive disorder of pregnancy who delivered a singleton in Saskatchewan from January 1, 1990 to December 31, 2005 and who were dispensed only labetalol or only methyldopa were included in the study. Occurrences of small for gestational age (SGA) < 10th percentile, SGA < 3rd percentile, preterm birth, stillbirth, hospitalization for respiratory distress syndrome (RDS), sepsis, and seizure during infancy, and infant death were compared. Multiple logistic regression analysis was performed to adjust for potential confounding. Results A total of 1,223 eligible women were included in the final analysis. Among them, 300 received labetalol only and 923 received methyldopa only during pregnancy. For women with chronic hypertension, the rate of hospitalization for RDS, sepsis, and seizure during infancy was significantly higher for infants born to mothers who were dispensed labetalol only as compared with infants born to mothers who were dispensed methyldopa only (adjusted odds ratio (OR) 1.51, 95% confidence interval (CI) 1.02–2.22). Conclusion Compared with methyldopa, the use of labetalol for chronic hypertension of pregnancy may be associated with increased rate of hospitalization during infancy.
    European journal of obstetrics, gynecology, and reproductive biology 04/2014; 175. DOI:10.1016/j.ejogrb.2014.01.019 · 1.63 Impact Factor
  • Society for Gynecological Investigation Annual Scientific Meeting, Florence, Italy; 03/2014
  • Society for Gynecological Investigation Annual Scientific Meeting., Florence, Italy; 03/2014
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    ABSTRACT: Objective To compare infant outcomes between mothers with hypertension treated by beta-blockers alone and by methyldopa alone during pregnancy.DesignHistorical cohort study.SettingSaskatchewan, Canada.PopulationWomen who delivered a singleton birth in Saskatchewan during the periods from 1 January 1980 to 30 June 1987 or from 1 January 1990 to 31 December 2005 (women who delivered between 1 July 1987 and 31 December 1989 were excluded because the information recorded on maternal drug use during pregnancy is incomplete) with a diagnosis of a hypertensive disorder during pregnancy, and who were dispensed only beta-blockers (n = 416) or only methyldopa (n = 1000).Methods Occurrences of adverse infant outcomes were compared between women who received beta-blockers only and women who received methyldopa only during pregnancy, first in all eligible women, and then in women with chronic hypertension and in women with gestational hypertension or pre-eclampsia/eclampsia, separately. Multiple logistic regression analyses were performed to adjust for potential confounding. Main outcome measuresSmall for gestational age (SGA) < 10th percentile, SGA < 3rd percentile, preterm birth, stillbirth, institutionalisation for respiratory distress syndrome (RDS), sepsis, seizure during infancy, and infant death.ResultsAdjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for infants born to mothers with chronic hypertension who were dispensed beta-blockers only, as compared with infants born to mothers who were dispensed methyldopa only, during pregnancy were: 1.95 (1.21–3.15), 2.17 (1.06–4.44), and 2.17 (1.09–4.34), respectively, for SGA < 10th percentile, SGA < 3rd percentile, and being institutionalised during infancy.Conclusions For infants born to mothers with chronic hypertension, compared with those treated by methyldopa alone, those treated by beta-blockers appear to be at increased rates of SGA and hospitalisation during infancy.
    BJOG An International Journal of Obstetrics & Gynaecology 03/2014; 121(9). DOI:10.1111/1471-0528.12678 · 3.86 Impact Factor
  • Wendy Wen, Shi Wu Wen
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    ABSTRACT: On average, males have a stronger preference for physical systems and machines over interpersonal interactions; they have lower average levels of cognitive empathy or social cognition than females; and they have higher rates of 'extreme' intelligence when it comes to abstract concepts such as those found in mathematics and sciences. All three traits are also commonly associated with individuals with an autism spectrum disorder or ASD; clearly, it is not coincidental that incidence rates of autism are reportedly four times higher in males than in females. The common link between the majority of risk factors assessed in this review (including technological advancements, advanced parental age, socioeconomic status, and genetic predispositions towards ASDs in families of scientists and engineers) can be traced to a specific hormone, testosterone. It was established that traits which are typically associated with males are also typically associated with ASDs as well as individuals with antisocial personality disorder, or APD. The key distinction between individuals who are considered to be 'autistic' as opposed to those who are considered 'sociopathic' lies in the difference between their empathy deficits: whereas those who are 'autistic' are said to lack cognitive empathy (the ability to identify and understand the thoughts and feelings of others and to respond to these with appropriate emotions), those who are 'sociopathic' are said to lack emotional empathy (which is responsible for inhibiting acts of physical aggression or violence). This would explain why autistic individuals can have elevated testosterone levels without becoming physically aggressive.
    Medical Hypotheses 02/2014; DOI:10.1016/j.mehy.2014.02.020 · 1.15 Impact Factor
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    ABSTRACT: Changing health care providers frequently breaks the continuity of care, which is associated with many health care problems. The purpose of this study was to examine the association between a change of health care providers and pregnancy exposure to FDA category C, D and X drugs. A 50% random sample of women who gave a birth in Saskatchewan between January 1, 1997 and December 31, 2000 were chosen for this study. The association between the number of changes in health care providers and with pregnancy exposure to category C, D, and X drugs for those women with and without chronic diseases were evaluated using multiple logistical regression, with adjusted odds ratios (ORs) and its 95% confidence intervals (CIs) as the association measures. A total of 18 568 women were included in this study. Rates of FDA C, D, and X drug uses were 14.35%, 17.07%, 21.72%, and 31.14%, in women with no change of provider, 1-2 changes, 3-5 changes, and more than 5 changes of health care providers. An association between the number of changes of health care providers and pregnancy exposure to FDA C, D, and X drugs existed in women without chronic diseases but not in women with chronic disease. Change of health care providers is associated with pregnancy exposure to FDA category C, D and X drugs in women without chronic diseases.
    Chinese medical journal 02/2014; 127(4):702-6. · 1.02 Impact Factor
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    ABSTRACT: Case control studies suggest that genetic thrombophilias increase the risk of placenta-mediated pregnancy complications (pregnancy loss, small for gestational age (SGA), preeclampsia, and/or placental abruption). Cohort studies have not supported this association but were underpowered to detect small effects. To determine if factor V Leiden (FVL) or the prothrombin gene mutation (PGM) were associated with placenta-mediated pregnancy complications. A prospective cohort of unselected, consenting pregnant women at three Canadian tertiary care hospitals had blood drawn in the early second trimester and were genotyped for FVL and PGM after delivery. The main outcome measure was a composite of pregnancy loss, SGA <10(th) percentile, preeclampsia, or placental abruption. Complete primary outcome and genetic data were available for 7,343 women. Most were Caucasian (77.7%, n=5,707), mean age was 30.4 (±5.1) years, and half were nulliparous. There were 507 (6.9%) women with FVL and/or PGM; 11.64% had a placenta-mediated pregnancy complication. Of the remaining 6,836 women, 11.23% experienced a complication. FVL and/or PGM was associated with a relative risk of 1.04 (95% CI 0.81-1.33) for the composite outcome with similar results after adjustment for important covariates. Carriers of FVL or PGM are not at significantly increased risk of these pregnancy complications. This article is protected by copyright. All rights reserved.
    Journal of Thrombosis and Haemostasis 01/2014; 12(4). DOI:10.1111/jth.12509 · 5.55 Impact Factor

Publication Stats

5k Citations
712.81 Total Impact Points

Institutions

  • 2001–2015
    • University of Ottawa
      • Department of Obstetrics and Gynecology
      Ottawa, Ontario, Canada
  • 2004–2014
    • Ottawa Hospital Research Institute
      • Clinical Epidemiology Program
      Ottawa, Ontario, Canada
  • 1993–2013
    • McGill University
      • • Department of Pediatrics
      • • Faculty of Medicine
      Montréal, Quebec, Canada
  • 2004–2012
    • Central South University
      • School of Public Health
      Ch’ang-sha-shih, Hunan, China
  • 2002–2011
    • The Ottawa Hospital
      • Clinical Epidemiology and Research Program
      Ottawa, Ontario, Canada
    • Robert Wood Johnson University Hospital
      New Brunswick, New Jersey, United States
    • French Institute of Health and Medical Research
      • Unité de Recherche Épidémiologique en Santé Périnatale et Santé des Femmes et des Enfants U953
      Paris, Ile-de-France, France
  • 2005
    • The Scarborough Hospital
      Pickering, Ontario, Canada
  • 1999–2004
    • Health Canada
      Ottawa, Ontario, Canada
  • 2003
    • People's Hospital of Qingyuan
      Ch’ing-hsü, Shanxi Sheng, China
  • 1997–2001
    • BC Centre for Disease Control
      Vancouver, British Columbia, Canada
  • 1996
    • University of Toronto
      Toronto, Ontario, Canada