Jocelynn Cook - Academia.edu (original) (raw)

Papers by Jocelynn Cook

Research paper thumbnail of Cocaine does not affect prostacyclin, thromboxane or prostaglandin E production in human umbilical veins

Drug and Alcohol Dependence, 1996

Vasoactive prostaglandins have been reported to mediate umbilical/placental blood flow in humans.... more Vasoactive prostaglandins have been reported to mediate umbilical/placental blood flow in humans. Since it has been suggested that cocaine exerts its teratogenic action via vasoconstriction and a corresponding reduction in blood flow, it is reasonable to hypothesize that cocaine influences the vasoactive prostaglandins such that blood flow would be affected. The purpose of this study, therefore, was to determine the effects of cocaine on the vasoactive prostaglandins prostacyclin, thromboxane, and prostaglandin E, using human umbilical veins. Prostacyclin (PGI2), thromboxane (TXA2), and prostaglandin E (PGE) levels were measured from human umbilical veins collected at term. The veins were perfused in a closed system with either a 50 micrograms/ml, a 100 micrograms/ml, a 200 micrograms/ml, or a 400 micrograms/ml cocaine solution for 60 min, and the prostaglandins were measured by radioimmunoassay of their stable metabolites. Data were analyzed by ANOVA, and post-hoc analyses were performed by Fisher's Protected Least Significant Difference Test. Cocaine did not influence PGI2, TXA2, or PGE production (Ps > 0.05) in this series of studies. Thus, contraction of human umbilical vessels and decreased blood flow in human umbilical vessels does not appear to be mediated by changes in the vasoactive prostaglandins.

Research paper thumbnail of Acute effects of alcohol on parturition: role of prostaglandins /

Thesis (Ph. D.)--Medical University of South Carolina, 1997. Includes bibliographical references ... more Thesis (Ph. D.)--Medical University of South Carolina, 1997. Includes bibliographical references (leaves 99-119).

Research paper thumbnail of Early onset of parturition induced by acute alcohol exposure in C57BL/6J mice: role of uterine PGE and PGF2a

Reproduction, Fertility and Development, 1997

These studies were designed to determine the effect of acute alcohol treatment on gestational len... more These studies were designed to determine the effect of acute alcohol treatment on gestational length and to probe for a mechanism underlying alcohol-induced early onset of parturition (EOP) in mice. Experiment 1: alcohol increases the incidence of EOP. Pregnant C57BL/6J mice were given alcohol (0, 4, 5 or 6 g kg(-1), i.g.) on Gestational Day (GD) 10, 15, 16, 17 or 18. Deliveries were monitored every 6 h from GD 18. Results indicated that 6 g kg(-1) alcohol treatment on GD 17 or 18 increased the incidence of EOP. Experiment 2: prostaglandins (PGs) play roles in parturition. The purpose of Experiment 2 was to determine whether PGs mediate alcohol-induced EOP in mice. The results indicated that pretreatment on GD 17 with aspirin, a prostaglandin synthesis inhibitor, prevented alcohol-induced EOP. These data suggest that alcohol-induced EOP in mice may be mediated by PGs. Experiment 3: PGs are influenced by alcohol and are triggers of labour. Experiment 3 measured uterine PGs associated with the onset of alcohol-induced EOP in mice. Alcohol increased uterine PGE and PGF2alpha, with PGE levels higher than control before labour, and elevated PGF2alpha levels correlating with labour. Changes in gestational length have important implications for pregnancy outcome, as well as for normal fetal growth and development.

Research paper thumbnail of Ethanol and parturition: a role for prostaglandins

Prostaglandins, Leukotrienes and Essential Fatty Acids, 1998

A common pattern of birth defects was reported in children born to alcoholic women over 20 years ... more A common pattern of birth defects was reported in children born to alcoholic women over 20 years ago. Shortly thereafter the constellation of defects became known as the Fetal Alcohol Syndrome, and reports from around the world served to acknowledge the pervasiveness of the disorder. Simultaneously with the clinical reports, animal models were developed to characterize the full spectrum of the teratogenic effects of ethanol. Not only did these animal models serve to define the actions of ethanol on fetal growth and development at the molecular pharmacological, neuroanatomical, and behavioral level, but unintentionally, they have resulted in renewed scientific interest in the effects of ethanol on pregnancy and parturition itself. The purpose of this review is twofold. First we will consolidate and summarize data from both clinical and basic research that pertains to ethanol and parturition. These data will demonstrate that ethanol consumption during pregnancy results in both delayed as well as premature delivery depending upon the pattern of consumption and timing of exposure. With these data as a background, the second objective will be to present a theoretical case for prostaglandins as possible mediators of ethanol-induced effects on the onset of parturition.

Research paper thumbnail of Fetal Alcohol Spectrum Disorder Prevention Approaches among Canadian Physicians by Proportion of Native/Aboriginal Patients: Practices during the Preconception and Prenatal Periods

Maternal and Child Health Journal, 2007

To examine if physician knowledge and practices related to fetal alcohol spectrum disorders (FASD... more To examine if physician knowledge and practices related to fetal alcohol spectrum disorders (FASD) and its prevention vary based on the proportion of Native/Aboriginal patients served. A questionnaire was mailed to a national random sample of Canadian physicians between October 2001 and May 2002. The main outcome measure was responses regarding knowledge about and prevention of FASD. Bivariate analysis was used to compare practice patterns and knowledge between those who cared for a higher proportion (>or=10%) and a lower proportion (<10%) of Native/Aboriginal patients. The overall response rate was 39.4% (1,700/4,313), and 21.4% of physicians reported that >or=10% of their clinical practice was comprised of Native/Aboriginal patients. Those caring for a greater proportion of Native/Aboriginal patients were significantly (p<0.05) more likely to discuss sexual and emotional abuse (approximately 20% vs. 10%) and a history of addictions (52% vs. 44%) with women of childbearing age. In prenatal interviews, they were also significantly (p<0.05) more likely to routinely include a history of addictions treatment (70% vs. 62%) and drinking prior to pregnancy awareness (91% vs. 85%), as well as more likely to ask about evidence of alcohol related defects in other children (50% vs. 37%), and discuss the drinking pattern of the patient-s partner (25% vs. 18%). Physicians who had a higher proportion of Native/Aboriginal patients appeared to be more attuned to the issues of FASD and to assess risk in a more comprehensive manner. However, support for improved identification of women at risk and referral opportunities is warranted.

Research paper thumbnail of The effectiveness of alcohol warning labels in the prevention of Fetal Alcohol Spectrum Disorder: A brief review

The International Journal of Alcohol and Drug Research, 2014

Research paper thumbnail of Physiological concentrations of nicotine do not affect prostacyclin, thromboxane or PGE production from perfused human umbilical veins

Addiction Biology, 2001

... JOCELYNN L. COOK,* BRAD A. KEITH,² NANCY M. WHITE & CARRIE L. RANDALL² ... effects, i... more ... JOCELYNN L. COOK,* BRAD A. KEITH,² NANCY M. WHITE & CARRIE L. RANDALL² ... effects, including increased risk of spontaneous abortion,1±4 decreased birth weight,5±8 and an increased incidence of fetal anomalies.1,9,10 Ani-mal models have been used in attempts to ...

Research paper thumbnail of Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan

Canadian Medical Association Journal, 2015

Research paper thumbnail of 451: Progesterone, cervical cerclage and cervical pessary for primary prevention of preterm birth in high risk singleton pregnancies: a systematic review and network meta-analysis

American Journal of Obstetrics and Gynecology, 2016

Research paper thumbnail of Expression of Myometrial Activation and Stimulation Genes in a Mouse Model of Preterm Labor: Myometrial Activation, Stimulation, and Preterm Labor

Myometrial contractions of labor result from an increase in myometrial activation and stimulation... more Myometrial contractions of labor result from an increase in myometrial activation and stimulation. Activation develops through the expression of contraction associated proteins (CAPs), including oxytocin receptors (OTR), connexin-43 (Cx-43), and prostaglandin F 2␣ receptors (FP). Stimulation involves increases in contractile agonists including prostaglandin E 2 (PGE 2 ) and prostaglandin F 2␣ (PGF 2␣ ) that may result from increases in prostaglandin endoperoxide H synthase (PGHS)-2. A mouse model of preterm birth was used to study gene expression involved in myometrial activation and stimulation. To induce preterm birth, pregnant C57BL/6J mice were intubated with 6 g/kg ethanol on gestational day 16 and were killed every 6 h from treatment until birth. RIA was used to measure uterine PGE 2 and PGF 2␣ , while PGHS-2, OTR, Cx-43, and FP messenger RNA levels were measured by ribonuclease protection assay. Increases in CAP mRNA were associated with term and preterm birth. There were differences in stimulation effectors associated with preterm and term birth. Uterine PGF 2␣ values were increased only at the time of term birth, but PGE 2 was elevated during both preterm and term labor. These data suggest that existing levels of PGF 2␣ are sufficient for preterm birth when CAP expression is increased, but term labor requires increases in PGE 2 , PGF 2␣ , and CAPs. The PGHS-2 messenger RNA expression pattern suggests that it is a CAP.

Research paper thumbnail of Using a Common Form for Consistent Collection and Reporting of FASD Data from Across Canada: A Feasibility Study

Journal of population therapeutics and clinical pharmacology = Journal de la thérapeutique des populations et de la pharamcologie clinique, 2015

BackgroundThis study was undertaken to determine the feasibility of collecting information on ind... more BackgroundThis study was undertaken to determine the feasibility of collecting information on individuals newly diagnosed with Fetal Alcohol Spectrum Disorder (FASD) in multi-disciplinary diagnostic programs across Canada. ObjectiveTo determine the frequencies of specific diagnoses within the spectrum, the frequencies and patterns of specific functional deficits, and the range of recommendations made for intervention and management for children and adults. MethodsAll qualifying clinics in Canada were invited to join this project and complete questionnaires on the patients that were seen during the research period. ResultsOver half of all clinics participated (25/45) and submitted the information requested on 307 individuals, ranging in age from 1 to 42 years. Two hundred and eighty-nine individuals had a diagnosis of FASD and were analysed further. The percent of individuals with Fetal Alcohol Syndrome was 2.1% of those with FASD diagnoses, which was lower than expected based on...

Research paper thumbnail of Characteristics of women who consume alcohol before and after pregnancy recognition in a Canadian sample: a prospective cohort study

Alcoholism, clinical and experimental research, 2014

High levels of alcohol consumption during pregnancy are teratogenic to fetal development, yet les... more High levels of alcohol consumption during pregnancy are teratogenic to fetal development, yet less is known about the effects of low levels of consumption. Only a few studies have reported on the predictors and maternal characteristics associated with different alcohol consumption patterns prior to and following pregnancy recognition. The All Our Babies longitudinal study in Alberta, Canada was used to analyze the association of maternal characteristics with binge drinking prior to pregnancy recognition and low to moderate levels after pregnancy recognition among 2,246 women who consumed alcohol 1 year prior to pregnancy. Bivariate and multivariable analyses were conducted. Thirteen percent of women reported binge drinking prior to pregnancy recognition. Forty-six percent reported drinking after pregnancy recognition, almost all at low to moderate levels. Significant, independent predictors (odds ratio, 95% confidence interval) of binge drinking in early pregnancy included high scho...

Research paper thumbnail of Seeking medical help to conceive

Health reports, 2012

The demand for therapies to assist conception is growing in a number of countries including Canad... more The demand for therapies to assist conception is growing in a number of countries including Canada. This study provides estimates of the number and characteristics of couples who sought medical help for conception and identifies the interventions and/or techniques they used. The data are from the Infertility Component of the 2009/2010 Canadian Community Health Survey. The analysis examines couples in which the woman was aged 18 to 44, resulting in 3,656 respondents. Percentages, means and confidence intervals were calculated. Two logistic regression models were run to estimate associations between socio-demographic characteristics and seeking medical help to conceive. About three in four couples reported having tried to become pregnant. Of these, 15% had sought medical help for conception. Among those who had sought help for conception, 68% reported tracking the menstrual cycle and ovulation; 42% reported using fertility-enhancing drugs; 19% reported using assisted reproductive tech...

Research paper thumbnail of Multiple births associated with assisted human reproduction in Canada

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2011

Assisted human reproduction has been associated with increased rates of multiple births. Data sug... more Assisted human reproduction has been associated with increased rates of multiple births. Data suggest that twins and higher order multiple pregnancies are at risk for pre- and postnatal health complications that contribute to stress on both the family and the Canadian health care system. No published Canadian data estimate the contribution of assisted human reproduction to multiple birth rates. This study was designed to determine the contributions of age and assisted human reproduction to multiple birth rates in Canada. We performed analyses of existing Canadian databases, using a mathematical model from the Centers for Disease Control and Prevention. More specifically, data from the Canadian Vital Statistics: Births and Stillbirths database were combined with data from the Canadian Assisted Reproductive Technologies Register collected by the Canadian Fertility and Andrology Society. Datasets were standardized to age distributions of mothers in 1978. RESULTS suggest that in vitro f...

Research paper thumbnail of Assisted reproductive technology-related multiple births: Canada in an international context

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2011

It has been well-documented that the use of assisted reproductive technology (ART) increases the ... more It has been well-documented that the use of assisted reproductive technology (ART) increases the risk for multiple births, which are associated with sub-optimal outcomes for pregnant women and their offspring. The occurrence of multiple births due to infertility treatments has been recognized as a significant problem globally, and a number of countries have developed approaches, policies, statutes, and regulations geared to decreasing the rates of multiple births as a result of ART. This review was designed to explore Canada's position in the international context of ART-related multiple births and to examine the strategies of other countries intended to decrease rates of multiple pregnancy. Data were obtained from publicly available data sources from 21 countries, including Canada, and comparisons were made between pregnancy rates, percentages of live births, percentages of multiple births, numbers of embryos transferred, and governing guidelines and policies. Canada has one of...

Research paper thumbnail of Anticipatory Guidance for Children and Adolescents with Fetal Alcohol Spectrum Disorder (FASD): Practice Points for Primary Health Care Providers

Journal of population therapeutics and clinical pharmacology = Journal de la thérapeutique des populations et de la pharamcologie clinique, 2015

BackgroundFetal Alcohol Spectrum Disorder (FASD) is an umbrella term that describes the range of ... more BackgroundFetal Alcohol Spectrum Disorder (FASD) is an umbrella term that describes the range of effects that can occur in an individual who was prenatally exposed to alcohol and includes an array of complex neurodevelopmental and physical findings. ObjectivesTo give primary healthcare providers (PHCP) evidence-based recommendations for supporting and managing the symptoms of FASD after patients have received a diagnosis. MethodsPrimary health recommendations for the management of children and adolescents with FASD were developed based on expert clinical judgment and supported by evidence-based research, where appropriate. The format was adapted from other health supervision practice guidelines as developed by the American Academy of Pediatrics. Clinical practice "Points" for the PHCP are highlighted. A reference table of anticipatory recommendations by age is presented. ResultsIn most cases, the initial screening and referral for diagnosis will be made by the PHCP, and...

Research paper thumbnail of “Doc, I didn’t know I was pregnant. Does my baby have fetal alcohol spectrum disorder?”

The International Journal of Alcohol and Drug Research, 2014

How much alcohol is "safe" during pregnancy? This is a question for which there is no conclusive ... more How much alcohol is "safe" during pregnancy? This is a question for which there is no conclusive answer.

Research paper thumbnail of Myometrial Activation and Preterm Labour: Evidence Supporting a Role for the Prostaglandin F Receptor—A Review

Placenta, 2003

An increase in the myometrial expression of the prostaglandin (PG) receptors, and especially the ... more An increase in the myometrial expression of the prostaglandin (PG) receptors, and especially the PGF 2 receptor (FP), may be an important component of the process initiating preterm labour. In this review of the literature and presentation of new possibilities, evidence will be discussed that demonstrates an increase in mouse uterine FP mRNA occurs at preterm birth whereas uterine PGF 2 concentrations do not increase, suggesting elevated uterine receptor expression and sensitivity is a mechanism for preterm labour initiation. The first examination of the complete human myometrial FP promoter will be described and evidence presented that demonstrates the pro-inflammatory cytokine, interleukin-1 , stimulates FP mRNA expression. Finally new data showing that administration of a specific FP antagonist delays preterm birth in sheep will be presented.

Research paper thumbnail of Alcohol Plus Cocaine Prenatally Is More Deleterious Than Either Drug Alone

Neurotoxicology and Teratology, 1999

RANDALL, C. L., J. L. COOK, S. E. THOMAS AND N. M. WHITE. Alcohol plus cocaine prenatally is more... more RANDALL, C. L., J. L. COOK, S. E. THOMAS AND N. M. WHITE. Alcohol plus cocaine prenatally is more deleterious than either drug alone. NEUROTOXICOL TERATOL 21 (6) 673-678, 1999.-A C57BL/6J mouse model was used to examine the coteratology of alcohol and cocaine. Plugged female mice were assigned to one of four treatment groups: control, cocaine only, alcohol only, or alcohol-cocaine. Experimental animals were treated from gestation day (GD) 6-18 and were killed the morning of GD 19. Alcohol was administered in a liquid diet containing 25% ethanol-derived calories (25% EDC), and cocaine was administered daily in subcutaneous injections of 60 mg/kg. All groups were pair-fed to the alcoholcocaine group. The results showed that the cocaine-only and the alcohol-cocaine group had fewer successful pregnancies. The alcohol-only group had the lowest maternal weight gain from GD 1-19. There were no treatment group effects on litter size, sex ratio, or prenatal mortality. Importantly, fetuses in the alcohol-cocaine group weighed less than all other groups and had the greatest occurrence of fetal anomalies. These data confirm the teratogenic effects of alcohol and cocaine and suggest that the combination of the two drugs, if administered chronically, is more deleterious to pregnancy and fetal outcome than either drug alone.

Research paper thumbnail of Estimating the prevalence of infertility in Canada

Human Reproduction, 2012

Over the past 10 years, there has been a significant increase in the use of assisted reproductive... more Over the past 10 years, there has been a significant increase in the use of assisted reproductive technologies in Canada, however, little is known about the overall prevalence of infertility in the population. The purpose of the present study was to estimate the prevalence of current infertility in Canada according to three definitions of the risk of conception. Data from the infertility component of the 2009-2010 Canadian Community Health Survey were analyzed for married and common-law couples with a female partner aged 18-44. The three definitions of the risk of conception were derived sequentially starting with birth control use in the previous 12 months, adding reported sexual intercourse in the previous 12 months, then pregnancy intent. Prevalence and odds ratios of current infertility were estimated by selected characteristics. Estimates of the prevalence of current infertility ranged from 11.5% (95% CI 10.2, 12.9) to 15.7% (95% CI 14.2, 17.4). Each estimate represented an increase in current infertility prevalence in Canada when compared with previous national estimates. Couples with lower parity (0 or 1 child) had significantly higher odds of experiencing current infertility when the female partner was aged 35-44 years versus 18-34 years. Lower odds of experiencing current infertility were observed for multiparous couples regardless of age group of the female partner, when compared with nulliparous couples. The present study suggests that the prevalence of current infertility has increased since the last time it was measured in Canada, and is associated with the age of the female partner and parity.

Research paper thumbnail of Cocaine does not affect prostacyclin, thromboxane or prostaglandin E production in human umbilical veins

Drug and Alcohol Dependence, 1996

Vasoactive prostaglandins have been reported to mediate umbilical/placental blood flow in humans.... more Vasoactive prostaglandins have been reported to mediate umbilical/placental blood flow in humans. Since it has been suggested that cocaine exerts its teratogenic action via vasoconstriction and a corresponding reduction in blood flow, it is reasonable to hypothesize that cocaine influences the vasoactive prostaglandins such that blood flow would be affected. The purpose of this study, therefore, was to determine the effects of cocaine on the vasoactive prostaglandins prostacyclin, thromboxane, and prostaglandin E, using human umbilical veins. Prostacyclin (PGI2), thromboxane (TXA2), and prostaglandin E (PGE) levels were measured from human umbilical veins collected at term. The veins were perfused in a closed system with either a 50 micrograms/ml, a 100 micrograms/ml, a 200 micrograms/ml, or a 400 micrograms/ml cocaine solution for 60 min, and the prostaglandins were measured by radioimmunoassay of their stable metabolites. Data were analyzed by ANOVA, and post-hoc analyses were performed by Fisher's Protected Least Significant Difference Test. Cocaine did not influence PGI2, TXA2, or PGE production (Ps > 0.05) in this series of studies. Thus, contraction of human umbilical vessels and decreased blood flow in human umbilical vessels does not appear to be mediated by changes in the vasoactive prostaglandins.

Research paper thumbnail of Acute effects of alcohol on parturition: role of prostaglandins /

Thesis (Ph. D.)--Medical University of South Carolina, 1997. Includes bibliographical references ... more Thesis (Ph. D.)--Medical University of South Carolina, 1997. Includes bibliographical references (leaves 99-119).

Research paper thumbnail of Early onset of parturition induced by acute alcohol exposure in C57BL/6J mice: role of uterine PGE and PGF2a

Reproduction, Fertility and Development, 1997

These studies were designed to determine the effect of acute alcohol treatment on gestational len... more These studies were designed to determine the effect of acute alcohol treatment on gestational length and to probe for a mechanism underlying alcohol-induced early onset of parturition (EOP) in mice. Experiment 1: alcohol increases the incidence of EOP. Pregnant C57BL/6J mice were given alcohol (0, 4, 5 or 6 g kg(-1), i.g.) on Gestational Day (GD) 10, 15, 16, 17 or 18. Deliveries were monitored every 6 h from GD 18. Results indicated that 6 g kg(-1) alcohol treatment on GD 17 or 18 increased the incidence of EOP. Experiment 2: prostaglandins (PGs) play roles in parturition. The purpose of Experiment 2 was to determine whether PGs mediate alcohol-induced EOP in mice. The results indicated that pretreatment on GD 17 with aspirin, a prostaglandin synthesis inhibitor, prevented alcohol-induced EOP. These data suggest that alcohol-induced EOP in mice may be mediated by PGs. Experiment 3: PGs are influenced by alcohol and are triggers of labour. Experiment 3 measured uterine PGs associated with the onset of alcohol-induced EOP in mice. Alcohol increased uterine PGE and PGF2alpha, with PGE levels higher than control before labour, and elevated PGF2alpha levels correlating with labour. Changes in gestational length have important implications for pregnancy outcome, as well as for normal fetal growth and development.

Research paper thumbnail of Ethanol and parturition: a role for prostaglandins

Prostaglandins, Leukotrienes and Essential Fatty Acids, 1998

A common pattern of birth defects was reported in children born to alcoholic women over 20 years ... more A common pattern of birth defects was reported in children born to alcoholic women over 20 years ago. Shortly thereafter the constellation of defects became known as the Fetal Alcohol Syndrome, and reports from around the world served to acknowledge the pervasiveness of the disorder. Simultaneously with the clinical reports, animal models were developed to characterize the full spectrum of the teratogenic effects of ethanol. Not only did these animal models serve to define the actions of ethanol on fetal growth and development at the molecular pharmacological, neuroanatomical, and behavioral level, but unintentionally, they have resulted in renewed scientific interest in the effects of ethanol on pregnancy and parturition itself. The purpose of this review is twofold. First we will consolidate and summarize data from both clinical and basic research that pertains to ethanol and parturition. These data will demonstrate that ethanol consumption during pregnancy results in both delayed as well as premature delivery depending upon the pattern of consumption and timing of exposure. With these data as a background, the second objective will be to present a theoretical case for prostaglandins as possible mediators of ethanol-induced effects on the onset of parturition.

Research paper thumbnail of Fetal Alcohol Spectrum Disorder Prevention Approaches among Canadian Physicians by Proportion of Native/Aboriginal Patients: Practices during the Preconception and Prenatal Periods

Maternal and Child Health Journal, 2007

To examine if physician knowledge and practices related to fetal alcohol spectrum disorders (FASD... more To examine if physician knowledge and practices related to fetal alcohol spectrum disorders (FASD) and its prevention vary based on the proportion of Native/Aboriginal patients served. A questionnaire was mailed to a national random sample of Canadian physicians between October 2001 and May 2002. The main outcome measure was responses regarding knowledge about and prevention of FASD. Bivariate analysis was used to compare practice patterns and knowledge between those who cared for a higher proportion (>or=10%) and a lower proportion (<10%) of Native/Aboriginal patients. The overall response rate was 39.4% (1,700/4,313), and 21.4% of physicians reported that >or=10% of their clinical practice was comprised of Native/Aboriginal patients. Those caring for a greater proportion of Native/Aboriginal patients were significantly (p<0.05) more likely to discuss sexual and emotional abuse (approximately 20% vs. 10%) and a history of addictions (52% vs. 44%) with women of childbearing age. In prenatal interviews, they were also significantly (p<0.05) more likely to routinely include a history of addictions treatment (70% vs. 62%) and drinking prior to pregnancy awareness (91% vs. 85%), as well as more likely to ask about evidence of alcohol related defects in other children (50% vs. 37%), and discuss the drinking pattern of the patient-s partner (25% vs. 18%). Physicians who had a higher proportion of Native/Aboriginal patients appeared to be more attuned to the issues of FASD and to assess risk in a more comprehensive manner. However, support for improved identification of women at risk and referral opportunities is warranted.

Research paper thumbnail of The effectiveness of alcohol warning labels in the prevention of Fetal Alcohol Spectrum Disorder: A brief review

The International Journal of Alcohol and Drug Research, 2014

Research paper thumbnail of Physiological concentrations of nicotine do not affect prostacyclin, thromboxane or PGE production from perfused human umbilical veins

Addiction Biology, 2001

... JOCELYNN L. COOK,* BRAD A. KEITH,² NANCY M. WHITE & CARRIE L. RANDALL² ... effects, i... more ... JOCELYNN L. COOK,* BRAD A. KEITH,² NANCY M. WHITE & CARRIE L. RANDALL² ... effects, including increased risk of spontaneous abortion,1±4 decreased birth weight,5±8 and an increased incidence of fetal anomalies.1,9,10 Ani-mal models have been used in attempts to ...

Research paper thumbnail of Fetal alcohol spectrum disorder: a guideline for diagnosis across the lifespan

Canadian Medical Association Journal, 2015

Research paper thumbnail of 451: Progesterone, cervical cerclage and cervical pessary for primary prevention of preterm birth in high risk singleton pregnancies: a systematic review and network meta-analysis

American Journal of Obstetrics and Gynecology, 2016

Research paper thumbnail of Expression of Myometrial Activation and Stimulation Genes in a Mouse Model of Preterm Labor: Myometrial Activation, Stimulation, and Preterm Labor

Myometrial contractions of labor result from an increase in myometrial activation and stimulation... more Myometrial contractions of labor result from an increase in myometrial activation and stimulation. Activation develops through the expression of contraction associated proteins (CAPs), including oxytocin receptors (OTR), connexin-43 (Cx-43), and prostaglandin F 2␣ receptors (FP). Stimulation involves increases in contractile agonists including prostaglandin E 2 (PGE 2 ) and prostaglandin F 2␣ (PGF 2␣ ) that may result from increases in prostaglandin endoperoxide H synthase (PGHS)-2. A mouse model of preterm birth was used to study gene expression involved in myometrial activation and stimulation. To induce preterm birth, pregnant C57BL/6J mice were intubated with 6 g/kg ethanol on gestational day 16 and were killed every 6 h from treatment until birth. RIA was used to measure uterine PGE 2 and PGF 2␣ , while PGHS-2, OTR, Cx-43, and FP messenger RNA levels were measured by ribonuclease protection assay. Increases in CAP mRNA were associated with term and preterm birth. There were differences in stimulation effectors associated with preterm and term birth. Uterine PGF 2␣ values were increased only at the time of term birth, but PGE 2 was elevated during both preterm and term labor. These data suggest that existing levels of PGF 2␣ are sufficient for preterm birth when CAP expression is increased, but term labor requires increases in PGE 2 , PGF 2␣ , and CAPs. The PGHS-2 messenger RNA expression pattern suggests that it is a CAP.

Research paper thumbnail of Using a Common Form for Consistent Collection and Reporting of FASD Data from Across Canada: A Feasibility Study

Journal of population therapeutics and clinical pharmacology = Journal de la thérapeutique des populations et de la pharamcologie clinique, 2015

BackgroundThis study was undertaken to determine the feasibility of collecting information on ind... more BackgroundThis study was undertaken to determine the feasibility of collecting information on individuals newly diagnosed with Fetal Alcohol Spectrum Disorder (FASD) in multi-disciplinary diagnostic programs across Canada. ObjectiveTo determine the frequencies of specific diagnoses within the spectrum, the frequencies and patterns of specific functional deficits, and the range of recommendations made for intervention and management for children and adults. MethodsAll qualifying clinics in Canada were invited to join this project and complete questionnaires on the patients that were seen during the research period. ResultsOver half of all clinics participated (25/45) and submitted the information requested on 307 individuals, ranging in age from 1 to 42 years. Two hundred and eighty-nine individuals had a diagnosis of FASD and were analysed further. The percent of individuals with Fetal Alcohol Syndrome was 2.1% of those with FASD diagnoses, which was lower than expected based on...

Research paper thumbnail of Characteristics of women who consume alcohol before and after pregnancy recognition in a Canadian sample: a prospective cohort study

Alcoholism, clinical and experimental research, 2014

High levels of alcohol consumption during pregnancy are teratogenic to fetal development, yet les... more High levels of alcohol consumption during pregnancy are teratogenic to fetal development, yet less is known about the effects of low levels of consumption. Only a few studies have reported on the predictors and maternal characteristics associated with different alcohol consumption patterns prior to and following pregnancy recognition. The All Our Babies longitudinal study in Alberta, Canada was used to analyze the association of maternal characteristics with binge drinking prior to pregnancy recognition and low to moderate levels after pregnancy recognition among 2,246 women who consumed alcohol 1 year prior to pregnancy. Bivariate and multivariable analyses were conducted. Thirteen percent of women reported binge drinking prior to pregnancy recognition. Forty-six percent reported drinking after pregnancy recognition, almost all at low to moderate levels. Significant, independent predictors (odds ratio, 95% confidence interval) of binge drinking in early pregnancy included high scho...

Research paper thumbnail of Seeking medical help to conceive

Health reports, 2012

The demand for therapies to assist conception is growing in a number of countries including Canad... more The demand for therapies to assist conception is growing in a number of countries including Canada. This study provides estimates of the number and characteristics of couples who sought medical help for conception and identifies the interventions and/or techniques they used. The data are from the Infertility Component of the 2009/2010 Canadian Community Health Survey. The analysis examines couples in which the woman was aged 18 to 44, resulting in 3,656 respondents. Percentages, means and confidence intervals were calculated. Two logistic regression models were run to estimate associations between socio-demographic characteristics and seeking medical help to conceive. About three in four couples reported having tried to become pregnant. Of these, 15% had sought medical help for conception. Among those who had sought help for conception, 68% reported tracking the menstrual cycle and ovulation; 42% reported using fertility-enhancing drugs; 19% reported using assisted reproductive tech...

Research paper thumbnail of Multiple births associated with assisted human reproduction in Canada

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2011

Assisted human reproduction has been associated with increased rates of multiple births. Data sug... more Assisted human reproduction has been associated with increased rates of multiple births. Data suggest that twins and higher order multiple pregnancies are at risk for pre- and postnatal health complications that contribute to stress on both the family and the Canadian health care system. No published Canadian data estimate the contribution of assisted human reproduction to multiple birth rates. This study was designed to determine the contributions of age and assisted human reproduction to multiple birth rates in Canada. We performed analyses of existing Canadian databases, using a mathematical model from the Centers for Disease Control and Prevention. More specifically, data from the Canadian Vital Statistics: Births and Stillbirths database were combined with data from the Canadian Assisted Reproductive Technologies Register collected by the Canadian Fertility and Andrology Society. Datasets were standardized to age distributions of mothers in 1978. RESULTS suggest that in vitro f...

Research paper thumbnail of Assisted reproductive technology-related multiple births: Canada in an international context

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2011

It has been well-documented that the use of assisted reproductive technology (ART) increases the ... more It has been well-documented that the use of assisted reproductive technology (ART) increases the risk for multiple births, which are associated with sub-optimal outcomes for pregnant women and their offspring. The occurrence of multiple births due to infertility treatments has been recognized as a significant problem globally, and a number of countries have developed approaches, policies, statutes, and regulations geared to decreasing the rates of multiple births as a result of ART. This review was designed to explore Canada's position in the international context of ART-related multiple births and to examine the strategies of other countries intended to decrease rates of multiple pregnancy. Data were obtained from publicly available data sources from 21 countries, including Canada, and comparisons were made between pregnancy rates, percentages of live births, percentages of multiple births, numbers of embryos transferred, and governing guidelines and policies. Canada has one of...

Research paper thumbnail of Anticipatory Guidance for Children and Adolescents with Fetal Alcohol Spectrum Disorder (FASD): Practice Points for Primary Health Care Providers

Journal of population therapeutics and clinical pharmacology = Journal de la thérapeutique des populations et de la pharamcologie clinique, 2015

BackgroundFetal Alcohol Spectrum Disorder (FASD) is an umbrella term that describes the range of ... more BackgroundFetal Alcohol Spectrum Disorder (FASD) is an umbrella term that describes the range of effects that can occur in an individual who was prenatally exposed to alcohol and includes an array of complex neurodevelopmental and physical findings. ObjectivesTo give primary healthcare providers (PHCP) evidence-based recommendations for supporting and managing the symptoms of FASD after patients have received a diagnosis. MethodsPrimary health recommendations for the management of children and adolescents with FASD were developed based on expert clinical judgment and supported by evidence-based research, where appropriate. The format was adapted from other health supervision practice guidelines as developed by the American Academy of Pediatrics. Clinical practice "Points" for the PHCP are highlighted. A reference table of anticipatory recommendations by age is presented. ResultsIn most cases, the initial screening and referral for diagnosis will be made by the PHCP, and...

Research paper thumbnail of “Doc, I didn’t know I was pregnant. Does my baby have fetal alcohol spectrum disorder?”

The International Journal of Alcohol and Drug Research, 2014

How much alcohol is "safe" during pregnancy? This is a question for which there is no conclusive ... more How much alcohol is "safe" during pregnancy? This is a question for which there is no conclusive answer.

Research paper thumbnail of Myometrial Activation and Preterm Labour: Evidence Supporting a Role for the Prostaglandin F Receptor—A Review

Placenta, 2003

An increase in the myometrial expression of the prostaglandin (PG) receptors, and especially the ... more An increase in the myometrial expression of the prostaglandin (PG) receptors, and especially the PGF 2 receptor (FP), may be an important component of the process initiating preterm labour. In this review of the literature and presentation of new possibilities, evidence will be discussed that demonstrates an increase in mouse uterine FP mRNA occurs at preterm birth whereas uterine PGF 2 concentrations do not increase, suggesting elevated uterine receptor expression and sensitivity is a mechanism for preterm labour initiation. The first examination of the complete human myometrial FP promoter will be described and evidence presented that demonstrates the pro-inflammatory cytokine, interleukin-1 , stimulates FP mRNA expression. Finally new data showing that administration of a specific FP antagonist delays preterm birth in sheep will be presented.

Research paper thumbnail of Alcohol Plus Cocaine Prenatally Is More Deleterious Than Either Drug Alone

Neurotoxicology and Teratology, 1999

RANDALL, C. L., J. L. COOK, S. E. THOMAS AND N. M. WHITE. Alcohol plus cocaine prenatally is more... more RANDALL, C. L., J. L. COOK, S. E. THOMAS AND N. M. WHITE. Alcohol plus cocaine prenatally is more deleterious than either drug alone. NEUROTOXICOL TERATOL 21 (6) 673-678, 1999.-A C57BL/6J mouse model was used to examine the coteratology of alcohol and cocaine. Plugged female mice were assigned to one of four treatment groups: control, cocaine only, alcohol only, or alcohol-cocaine. Experimental animals were treated from gestation day (GD) 6-18 and were killed the morning of GD 19. Alcohol was administered in a liquid diet containing 25% ethanol-derived calories (25% EDC), and cocaine was administered daily in subcutaneous injections of 60 mg/kg. All groups were pair-fed to the alcoholcocaine group. The results showed that the cocaine-only and the alcohol-cocaine group had fewer successful pregnancies. The alcohol-only group had the lowest maternal weight gain from GD 1-19. There were no treatment group effects on litter size, sex ratio, or prenatal mortality. Importantly, fetuses in the alcohol-cocaine group weighed less than all other groups and had the greatest occurrence of fetal anomalies. These data confirm the teratogenic effects of alcohol and cocaine and suggest that the combination of the two drugs, if administered chronically, is more deleterious to pregnancy and fetal outcome than either drug alone.

Research paper thumbnail of Estimating the prevalence of infertility in Canada

Human Reproduction, 2012

Over the past 10 years, there has been a significant increase in the use of assisted reproductive... more Over the past 10 years, there has been a significant increase in the use of assisted reproductive technologies in Canada, however, little is known about the overall prevalence of infertility in the population. The purpose of the present study was to estimate the prevalence of current infertility in Canada according to three definitions of the risk of conception. Data from the infertility component of the 2009-2010 Canadian Community Health Survey were analyzed for married and common-law couples with a female partner aged 18-44. The three definitions of the risk of conception were derived sequentially starting with birth control use in the previous 12 months, adding reported sexual intercourse in the previous 12 months, then pregnancy intent. Prevalence and odds ratios of current infertility were estimated by selected characteristics. Estimates of the prevalence of current infertility ranged from 11.5% (95% CI 10.2, 12.9) to 15.7% (95% CI 14.2, 17.4). Each estimate represented an increase in current infertility prevalence in Canada when compared with previous national estimates. Couples with lower parity (0 or 1 child) had significantly higher odds of experiencing current infertility when the female partner was aged 35-44 years versus 18-34 years. Lower odds of experiencing current infertility were observed for multiparous couples regardless of age group of the female partner, when compared with nulliparous couples. The present study suggests that the prevalence of current infertility has increased since the last time it was measured in Canada, and is associated with the age of the female partner and parity.