Periodontal Disease and Adverse Pregnancy Outcomes: A Prospective Study in a Low-Risk Population.
Identifieur interne : 000143 ( Main/Exploration ); précédent : 000142; suivant : 000144Periodontal Disease and Adverse Pregnancy Outcomes: A Prospective Study in a Low-Risk Population.
Auteurs : Laurence Soucy-Giguère [Canada] ; Amélie Tétu ; Simon Gauthier [Canada] ; Marianne Morand [Canada] ; Fatiha Chandad [Canada] ; Yves Giguère [Canada] ; Emmanuel Bujold [Canada]Source :
- Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC [ 1701-2163 ] ; 2016.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Complications de la grossesse (diagnostic), Deuxième trimestre de grossesse (MeSH), Femelle (MeSH), Grossesse (MeSH), Humains (MeSH), Indice parodontal (MeSH), Issue de la grossesse (MeSH), Jeune adulte (MeSH), Liquide amniotique (métabolisme), Médiateurs de l'inflammation (métabolisme), Parodontite (diagnostic), Parodontite (épidémiologie), Pré-éclampsie (épidémiologie), Pré-éclampsie (étiologie), Québec (MeSH), Statistiques comme sujet (MeSH), Travail obstétrical prématuré (épidémiologie), Travail obstétrical prématuré (étiologie), Études de cohortes (MeSH), Études prospectives (MeSH).
- MESH :
- diagnostic : Complications de la grossesse, Parodontite.
- métabolisme : Liquide amniotique, Médiateurs de l'inflammation.
- épidémiologie : Parodontite, Pré-éclampsie, Travail obstétrical prématuré.
- étiologie : Pré-éclampsie, Travail obstétrical prématuré.
- Adulte, Adulte d'âge moyen, Deuxième trimestre de grossesse, Femelle, Grossesse, Humains, Indice parodontal, Issue de la grossesse, Jeune adulte, Québec, Statistiques comme sujet, Études de cohortes, Études prospectives.
English descriptors
- KwdEn :
- Adult (MeSH), Amniotic Fluid (metabolism), Cohort Studies (MeSH), Female (MeSH), Humans (MeSH), Inflammation Mediators (metabolism), Middle Aged (MeSH), Obstetric Labor, Premature (epidemiology), Obstetric Labor, Premature (etiology), Periodontal Index (MeSH), Periodontitis (diagnosis), Periodontitis (epidemiology), Pre-Eclampsia (epidemiology), Pre-Eclampsia (etiology), Pregnancy (MeSH), Pregnancy Complications (diagnosis), Pregnancy Outcome (MeSH), Pregnancy Trimester, Second (MeSH), Prospective Studies (MeSH), Quebec (MeSH), Statistics as Topic (MeSH), Young Adult (MeSH).
- MESH :
- chemical , metabolism : Inflammation Mediators.
- geographic : Quebec.
- diagnosis : Periodontitis, Pregnancy Complications.
- epidemiology : Obstetric Labor, Premature, Periodontitis, Pre-Eclampsia.
- etiology : Obstetric Labor, Premature, Pre-Eclampsia.
- metabolism : Amniotic Fluid.
- Adult, Cohort Studies, Female, Humans, Middle Aged, Periodontal Index, Pregnancy, Pregnancy Outcome, Pregnancy Trimester, Second, Prospective Studies, Statistics as Topic, Young Adult.
Abstract
BACKGROUND
Periodontal disease has been associated with systemic inflammation and adverse pregnancy outcomes, including preeclampsia and preterm birth.
OBJECTIVE
To examine the relationship between periodontal disease in early pregnancy and the risk of amniotic inflammation, preterm birth, and preeclampsia.
METHODS
We performed a prospective cohort study of women undergoing amniocentesis for fetal karyotype between 15 and 24 weeks' gestation. Participants underwent periodontal examination by a certified dentist, and a sample of amniotic fluid was collected. Periodontal disease was defined as the presence of one or more sites with probing depths ≥ 4 mm and ≥ 10% bleeding on probing. Matrix metalloproteinase-8 and interleukin-6 concentrations in the amniotic fluid were measured. Medical charts were reviewed for perinatal outcomes. Univariate and multivariate logistic regression analyses were used to assess the association between periodontal disease and adverse pregnancy outcomes.
RESULTS
We recruited 273 women at a median gestational age of 16 weeks (range 15 to 24), and 258 (95%) agreed to undergo periodontal examination. Periodontal disease was observed in 117 of the participants (45%). We observed no significant association between periodontal disease and preterm birth (relative risk [RR] 2.27; 95% CI 0.74 to 6.96) or spontaneous preterm birth (RR 0.90; 95% CI 0.20 to 4.11). However, women with periodontal disease were more likely to develop preeclampsia, and this association remained significant after adjustment for potential confounders (adjusted RR 5.89; 95% CI 1.24 to 28.05). Periodontal disease was not associated with significant differences in the intra-amniotic concentration of matrix metalloproteinase-8 (13.0 ± 46.6 vs 5.7 ± 10.4 ng/mL, P = 0.098) or interleukin-6 (3.3 ± 20.3 vs 1.0 ± 1.6 ng/mL, P = 0.23), although a non-significant trend was observed.
CONCLUSION
Periodontal disease is associated with preeclampsia but not with spontaneous preterm birth. The current study cannot exclude an association between periodontal disease and intra-amniotic inflammation.
DOI: 10.1016/j.jogc.2016.02.012
PubMed: 27208603
Affiliations:
Links toward previous steps (curation, corpus...)
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type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Amniotic Fluid (metabolism)</term><term>Cohort Studies (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Inflammation Mediators (metabolism)</term><term>Middle Aged (MeSH)</term><term>Obstetric Labor, Premature (epidemiology)</term><term>Obstetric Labor, Premature (etiology)</term><term>Periodontal Index (MeSH)</term><term>Periodontitis (diagnosis)</term><term>Periodontitis (epidemiology)</term><term>Pre-Eclampsia (epidemiology)</term><term>Pre-Eclampsia (etiology)</term><term>Pregnancy (MeSH)</term><term>Pregnancy Complications (diagnosis)</term><term>Pregnancy Outcome (MeSH)</term><term>Pregnancy Trimester, Second (MeSH)</term><term>Prospective Studies (MeSH)</term><term>Quebec (MeSH)</term><term>Statistics as Topic (MeSH)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Complications de la grossesse (diagnostic)</term><term>Deuxième trimestre de grossesse (MeSH)</term><term>Femelle (MeSH)</term><term>Grossesse (MeSH)</term><term>Humains (MeSH)</term><term>Indice parodontal (MeSH)</term><term>Issue de la grossesse (MeSH)</term><term>Jeune adulte (MeSH)</term><term>Liquide amniotique (métabolisme)</term><term>Médiateurs de l'inflammation (métabolisme)</term><term>Parodontite (diagnostic)</term><term>Parodontite (épidémiologie)</term><term>Pré-éclampsie (épidémiologie)</term><term>Pré-éclampsie (étiologie)</term><term>Québec (MeSH)</term><term>Statistiques comme sujet (MeSH)</term><term>Travail obstétrical prématuré (épidémiologie)</term><term>Travail obstétrical prématuré (étiologie)</term><term>Études de cohortes (MeSH)</term><term>Études prospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en"><term>Inflammation Mediators</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Quebec</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Periodontitis</term><term>Pregnancy Complications</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Complications de la grossesse</term><term>Parodontite</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Obstetric Labor, Premature</term><term>Periodontitis</term><term>Pre-Eclampsia</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Obstetric Labor, Premature</term><term>Pre-Eclampsia</term></keywords><keywords scheme="MESH" qualifier="metabolism" xml:lang="en"><term>Amniotic Fluid</term></keywords><keywords scheme="MESH" qualifier="métabolisme" xml:lang="fr"><term>Liquide amniotique</term><term>Médiateurs de l'inflammation</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Parodontite</term><term>Pré-éclampsie</term><term>Travail obstétrical prématuré</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Pré-éclampsie</term><term>Travail obstétrical prématuré</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Cohort Studies</term><term>Female</term><term>Humans</term><term>Middle Aged</term><term>Periodontal Index</term><term>Pregnancy</term><term>Pregnancy Outcome</term><term>Pregnancy Trimester, Second</term><term>Prospective Studies</term><term>Statistics as Topic</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Deuxième trimestre de grossesse</term><term>Femelle</term><term>Grossesse</term><term>Humains</term><term>Indice parodontal</term><term>Issue de la grossesse</term><term>Jeune adulte</term><term>Québec</term><term>Statistiques comme sujet</term><term>Études de cohortes</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Periodontal disease has been associated with systemic inflammation and adverse pregnancy outcomes, including preeclampsia and preterm birth.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>To examine the relationship between periodontal disease in early pregnancy and the risk of amniotic inflammation, preterm birth, and preeclampsia.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We performed a prospective cohort study of women undergoing amniocentesis for fetal karyotype between 15 and 24 weeks' gestation. Participants underwent periodontal examination by a certified dentist, and a sample of amniotic fluid was collected. Periodontal disease was defined as the presence of one or more sites with probing depths ≥ 4 mm and ≥ 10% bleeding on probing. Matrix metalloproteinase-8 and interleukin-6 concentrations in the amniotic fluid were measured. Medical charts were reviewed for perinatal outcomes. Univariate and multivariate logistic regression analyses were used to assess the association between periodontal disease and adverse pregnancy outcomes.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>We recruited 273 women at a median gestational age of 16 weeks (range 15 to 24), and 258 (95%) agreed to undergo periodontal examination. Periodontal disease was observed in 117 of the participants (45%). We observed no significant association between periodontal disease and preterm birth (relative risk [RR] 2.27; 95% CI 0.74 to 6.96) or spontaneous preterm birth (RR 0.90; 95% CI 0.20 to 4.11). However, women with periodontal disease were more likely to develop preeclampsia, and this association remained significant after adjustment for potential confounders (adjusted RR 5.89; 95% CI 1.24 to 28.05). Periodontal disease was not associated with significant differences in the intra-amniotic concentration of matrix metalloproteinase-8 (13.0 ± 46.6 vs 5.7 ± 10.4 ng/mL, P = 0.098) or interleukin-6 (3.3 ± 20.3 vs 1.0 ± 1.6 ng/mL, P = 0.23), although a non-significant trend was observed.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Periodontal disease is associated with preeclampsia but not with spontaneous preterm birth. The current study cannot exclude an association between periodontal disease and intra-amniotic inflammation.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27208603</PMID><DateCompleted><Year>2016</Year><Month>08</Month><Day>30</Day></DateCompleted><DateRevised><Year>2016</Year><Month>05</Month><Day>22</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">1701-2163</ISSN><JournalIssue CitedMedium="Print"><Volume>38</Volume><Issue>4</Issue><PubDate><Year>2016</Year><Month>Apr</Month></PubDate></JournalIssue><Title>Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC</Title><ISOAbbreviation>J Obstet Gynaecol Can</ISOAbbreviation></Journal><ArticleTitle>Periodontal Disease and Adverse Pregnancy Outcomes: A Prospective Study in a Low-Risk Population.</ArticleTitle><Pagination><MedlinePgn>346-50</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jogc.2016.02.012</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S1701-2163(16)00096-7</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Periodontal disease has been associated with systemic inflammation and adverse pregnancy outcomes, including preeclampsia and preterm birth.</AbstractText><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To examine the relationship between periodontal disease in early pregnancy and the risk of amniotic inflammation, preterm birth, and preeclampsia.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We performed a prospective cohort study of women undergoing amniocentesis for fetal karyotype between 15 and 24 weeks' gestation. Participants underwent periodontal examination by a certified dentist, and a sample of amniotic fluid was collected. Periodontal disease was defined as the presence of one or more sites with probing depths ≥ 4 mm and ≥ 10% bleeding on probing. Matrix metalloproteinase-8 and interleukin-6 concentrations in the amniotic fluid were measured. Medical charts were reviewed for perinatal outcomes. Univariate and multivariate logistic regression analyses were used to assess the association between periodontal disease and adverse pregnancy outcomes.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">We recruited 273 women at a median gestational age of 16 weeks (range 15 to 24), and 258 (95%) agreed to undergo periodontal examination. Periodontal disease was observed in 117 of the participants (45%). We observed no significant association between periodontal disease and preterm birth (relative risk [RR] 2.27; 95% CI 0.74 to 6.96) or spontaneous preterm birth (RR 0.90; 95% CI 0.20 to 4.11). However, women with periodontal disease were more likely to develop preeclampsia, and this association remained significant after adjustment for potential confounders (adjusted RR 5.89; 95% CI 1.24 to 28.05). Periodontal disease was not associated with significant differences in the intra-amniotic concentration of matrix metalloproteinase-8 (13.0 ± 46.6 vs 5.7 ± 10.4 ng/mL, P = 0.098) or interleukin-6 (3.3 ± 20.3 vs 1.0 ± 1.6 ng/mL, P = 0.23), although a non-significant trend was observed.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Periodontal disease is associated with preeclampsia but not with spontaneous preterm birth. The current study cannot exclude an association between periodontal disease and intra-amniotic inflammation.</AbstractText><CopyrightInformation>Copyright © 2016 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Soucy-Giguère</LastName><ForeName>Laurence</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Faculty of Medicine, Université Laval, Quebec QC; Centre de recherche du CHU de Québec, Quebec QC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tétu</LastName><ForeName>Amélie</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Centre de recherche du CHU de Québec, Quebec QC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gauthier</LastName><ForeName>Simon</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Faculty of Dentistry, Université Laval, Quebec City QC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Morand</LastName><ForeName>Marianne</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Faculty of Dentistry, Université Laval, Quebec City QC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chandad</LastName><ForeName>Fatiha</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Faculty of Dentistry, Université Laval, Quebec City QC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Giguère</LastName><ForeName>Yves</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Centre de recherche du CHU de Québec, Quebec QC; Department of Molecular Biology, Medical Biochemistry and Pathology, Faculty of Medicine, Université Laval, Quebec QC.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bujold</LastName><ForeName>Emmanuel</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Centre de recherche du CHU de Québec, Quebec QC; Department of Obstetrics and Gynecology, Faculty of Medicine, Université Laval, Quebec QC.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>04</Month><Day>19</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>J Obstet Gynaecol Can</MedlineTA><NlmUniqueID>101126664</NlmUniqueID><ISSNLinking>1701-2163</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D018836">Inflammation Mediators</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000653" MajorTopicYN="N">Amniotic Fluid</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018836" MajorTopicYN="N">Inflammation Mediators</DescriptorName><QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007752" MajorTopicYN="N">Obstetric Labor, Premature</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010512" MajorTopicYN="N">Periodontal Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010518" MajorTopicYN="N">Periodontitis</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011225" MajorTopicYN="N">Pre-Eclampsia</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011247" MajorTopicYN="N">Pregnancy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011248" MajorTopicYN="N">Pregnancy Complications</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011256" MajorTopicYN="Y">Pregnancy Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011262" MajorTopicYN="N">Pregnancy Trimester, Second</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011792" MajorTopicYN="N" Type="Geographic">Quebec</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013223" MajorTopicYN="N">Statistics as Topic</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Pregnancy</Keyword><Keyword MajorTopicYN="N">amniotic fluid</Keyword><Keyword MajorTopicYN="N">periodontitis</Keyword><Keyword MajorTopicYN="N">preeclampsia</Keyword><Keyword MajorTopicYN="N">preterm birth</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>11</Month><Day>25</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>12</Month><Day>22</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>5</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>5</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>8</Month><Day>31</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">27208603</ArticleId><ArticleId IdType="pii">S1701-2163(16)00096-7</ArticleId><ArticleId IdType="doi">10.1016/j.jogc.2016.02.012</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Canada</li></country><region><li>Québec</li></region><settlement><li>Québec (ville)</li></settlement><orgName><li>Université Laval</li></orgName></list><tree><noCountry><name sortKey="Tetu, Amelie" sort="Tetu, Amelie" uniqKey="Tetu A" first="Amélie" last="Tétu">Amélie Tétu</name></noCountry><country name="Canada"><region name="Québec"><name sortKey="Soucy Giguere, Laurence" sort="Soucy Giguere, Laurence" uniqKey="Soucy Giguere L" first="Laurence" last="Soucy-Giguère">Laurence Soucy-Giguère</name></region><name sortKey="Bujold, Emmanuel" sort="Bujold, Emmanuel" uniqKey="Bujold E" first="Emmanuel" last="Bujold">Emmanuel Bujold</name><name sortKey="Chandad, Fatiha" sort="Chandad, Fatiha" uniqKey="Chandad F" first="Fatiha" last="Chandad">Fatiha Chandad</name><name sortKey="Gauthier, Simon" sort="Gauthier, Simon" uniqKey="Gauthier S" first="Simon" last="Gauthier">Simon Gauthier</name><name sortKey="Giguere, Yves" sort="Giguere, Yves" uniqKey="Giguere Y" first="Yves" last="Giguère">Yves Giguère</name><name sortKey="Morand, Marianne" sort="Morand, Marianne" uniqKey="Morand M" first="Marianne" last="Morand">Marianne Morand</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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