Shi Wu Wen

University of Ottawa, Ottawa, Ontario, Canada

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Publications (169)567.19 Total impact

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    ABSTRACT: Objectives: To compare the risk factors for gestational hypertension (GH) and preeclampsia (PE) in the same population, which may provide clues to better understanding of their etiologic mechanisms. Methods: We conducted a cohort study in Liuyang, China, during 2010-2011. Twelve potential risk factors were investigated, including maternal age, body mass index at first antenatal visit, gender of newborn, parity, abortion history, smoking history, family history of hypertension, gestational diabetes mellitus, pregnancy complications of diabetes mellitus/renal disease/cardiac disease, reproductive tract infection, season of delivery, and district level average per capita income. Logistic regression were used to estimate odds ratios for potential risk factors. Results: Of 6223 pregnancies, 1.8% was complicated by PE, and 5.4% by GH. Maternal age older than 35, body mass index above 24, and pregnancy complicated with gestational diabetes mellitus increased the risk of both PE and GH, while with different effect sizes. Primiparity and deliver in winter and spring (compared with summer delivery) were risk factors for GH only. Pregnancy complicated with diabetes mellitus/renal disease/cardiac disease was risk factor for PE only. Significantly lower risk of GH was observed for women younger than 25 or with low body mass index in the first trimester. Mothers carrying a male fetus were more likely to develop PE. Conclusions: Risk factors for GH and PE were not exactly the same. Underling those differences might be their different etiology and mechanism. To confirm the similarities and differences been found in single study, it is important to conduct investigation in other population.
    No preview · Article · Nov 2015
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    ABSTRACT: Objective: To assess the impact of search strategies for a different language on systematic review results, using English index searches versus Chinese index searches for Chinese literature pertaining to cerebral palsy (CP) as an example. Methods: We conducted two parallel searches with the same search strategy. Both searches looked for studies published in the Chinese language that examined risk factors for CP. The first was conducted in standard English indexes and the second was in standard Chinese indexes. We compared the results using the two searches using a Z-test. Egger's test and Begg's test were used to assess the potential publication bias. Results: Using the English indexes, nine studies were identified. Using the identical search and inclusion/exclusion criteria in the Chinese indexes, seventeen studies were returned. The association between intracranial hemorrhage and CP was much stronger in the studies found in the search by the English indexes (Odds Ratio {OR} 61.73, 95% Confidence Interval (CI) 19.48 to 195.61) than the results from studies identified by the Chinese indexes (OR 9.57, 95%CI 2.42 to 37.88). The association between hypertension and CP was not significant in studies found using the English indexes (OR 1.67, 95%CI 0.34 to 8.30) but was significant in studies identified by searching the Chinese indexes (OR 2.25, 95%CI 1.06 to 4.77). Egger's test suggested that, for the risk factor of preterm birth, some small studies with negative results might have been missed by the search using the English indexes (Egger's test: P=0.00). Conclusions: Searching Chinese literature using English indexes has the potential to fail to identify a substantial number of publications. This bias can result in significant discrepancies in the pooled estimates of risk factors for CP.
    No preview · Article · Sep 2015 · Journal of clinical epidemiology
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    ABSTRACT: Background Tuberculosis (TB) is a global public health issue posing serious harm to the human health. Many studies have suggested that smoking and excessive alcohol consumption are risk factors for TB. Laboratory evidence suggests that EGCG in tea leaves can arrest the growth of tubercle bacillus. Can drinking tea lead to decreased susceptibility of TB in humans? Methods A total of 574 TB patients and 582 healthy controls were recruited to participate in this case–control study. Self-designed questionnaire was used to collect data. Unconditioned logistic regression analysis was conducted to identify the associations between tea drinking and TB. Results Tea drinking has a negative association with TB, with OR = 0.583(0.423, 0.804) and P < 0.05. Drinking black tea, oolong and green tea are all negative association with TB, with OR being 0.683(0.517, 0.902), 0.674(0.508, 0.894) and 0.534(0.349, 0.817) respectively and P < 0.05. Trend χ2 test indicated a decreasing risk for TB with increased tea consumption, with P < 0.05. Conclusion There is a significance negative association between tea drinking and TB. Promoting the consumption of tea as the daily drink among populations, particularly those with high TB risk, may reduce the incidence of TB in the populations.
    Full-text · Article · May 2015 · BMC Public Health
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    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.
    Preview · Article · Mar 2015 · BMC Infectious Diseases
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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.
    No preview · Article · Mar 2015 · International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
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    No preview · Article · Jan 2015
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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.
    No preview · Article · Jan 2015 · Birth
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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.
    Full-text · Article · Dec 2014 · BioMed Research International
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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.
    Preview · Article · Dec 2014 · PLoS ONE
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    ABSTRACT: Background: 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. Methods: A total of 205 TB patients and 216 healthy controls were recruited to participate in this case-control study. PCR with sequence-specific primers (PCR-SSP) technology was leveraged to genotype rs7096206 of MBL genes and rs2273346 and rs6695096 of MASP-2 genes. Demographic data and information on exposures of participants were collected. Unconditioned logistic regression analysis was conducted to identify associations between the various factors and TB, and marginal structural linear odds models were used to estimate the interactions. Results: Passive smoking and cooking with solid fuel were associated with the risk of TB, with odds ratios (OR) of 1.58 and 2.93, respectively (p<. 0.05). Genotype CG at rs7096206 of MBL genes (OR 2.02) and genotype TC at rs6695096 of MASP-2 genes (OR 1.67) were more prevalent in the TB patients than in healthy controls (p<. 0.05). The relative excess risk of interaction (RERI) between rs7096206 of MBL genes and passive smoking or cooking with solid fuel exposure was 1.86 (95% confidence interval (CI) 0.59-3.16) and 2.66 (95% CI 1.85-3.47), respectively. The RERI between rs6695096 of MASP-2 genes and cooking with solid fuel exposure was 3.70 (95% CI 2.63-4.78), which was also a positive interaction. However, the RERI between rs6695096 of MASP-2 genes and passive smoking was not statistically significant. Conclusions: Passive smoking, cooking with solid fuel, and polymorphisms of MBL (rs7096206) and MASP-2 (rs6695096) genes were associated with susceptibility to TB in non-smokers, and there were gene-environment interactions among them. Further studies are needed to explore details of the mechanisms of association.
    Full-text · Article · Oct 2014 · International Journal of Infectious Diseases
  • 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.
    No preview · Article · Sep 2014 · Journal of obstetrics and gynaecology Canada: JOGC = Journal d'obstetrique et gynecologie du Canada: JOGC
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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.
    No preview · Article · Sep 2014 · Journal of obstetrics and gynaecology Canada: JOGC = Journal d'obstetrique et gynecologie du Canada: JOGC
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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.
    No preview · Article · Jul 2014 · Hypertension in Pregnancy
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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.
    Full-text · Article · May 2014 · Asian Pacific journal of cancer prevention: APJCP
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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.
    Preview · Article · Apr 2014 · International Journal for Equity in Health
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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.
    Full-text · Article · Apr 2014 · European journal of obstetrics, gynecology, and reproductive biology

  • No preview · Conference Paper · Mar 2014
  • 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.
    No preview · Article · Feb 2014 · Medical Hypotheses
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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.
    No preview · Article · Feb 2014 · Chinese medical journal
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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.
    Full-text · Article · Jan 2014 · Journal of Thrombosis and Haemostasis

Publication Stats

5k Citations
567.19 Total Impact Points


  • 2002-2015
    • University of Ottawa
      • • Department of Obstetrics and Gynecology
      • • Department of Epidemiology and Community Medicine
      Ottawa, Ontario, Canada
    • Dalhousie University
      • Department of Obstetrics and Gynaecology
      Halifax, Nova Scotia, Canada
    • Robert Wood Johnson University Hospital
      New Brunswick, New Jersey, United States
    • University of Alabama at Birmingham
      Birmingham, Alabama, United States
  • 2004-2014
    • Ottawa Hospital Research Institute
      • Clinical Epidemiology Program
      Ottawa, Ontario, Canada
  • 2001-2010
    • The Ottawa Hospital
      • Clinical Epidemiology and Research Program
      Ottawa, Ontario, Canada
    • Laval University
      Quebec City, Quebec, Canada
  • 2005-2008
    • Central South University
      • School of Public Health
      Ch’ang-sha-shih, Hunan, China
    • The Scarborough Hospital
      Pickering, Ontario, Canada
  • 2001-2004
    • Health Canada
      Ottawa, Ontario, Canada
  • 2003
    • People's Hospital of Qingyuan
      Ch’ing-hsü, Shanxi Sheng, China
  • 2002-2003
    • The Ottawa Hospital
      Ottawa, Ontario, Canada
  • 1993-2002
    • McGill University
      • • Department of Pediatrics
      • • Faculty of Medicine
      Montréal, Quebec, Canada
  • 2000-2001
    • BC Centre for Disease Control
      Vancouver, British Columbia, Canada
  • 1996
    • University of Toronto
      Toronto, Ontario, Canada