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Background: As a key aspect of poverty, material hardship describes day-to-day struggles in affording necessities. In explorations of policy initiatives that mitigate material hardship, evidence suggests direct income support can be effective in alleviating hardship. However, research investigating the long-term effects of income supports is limited, and it remains uncertain as to how benefit receipt may mitigate material hardship for families with children across time. Methods: To explore the associations between income assistance and material hardship longitudinally, we utilised data from four waves of the Growing Up in New Zealand birth-cohort study (n = 5964), where family experiences were tracked between birth and adolescence. The variables of interest included mother-reported receipt of income benefits and material hardship from when the children were aged 9-months, 54-months, 8-years, and 12-years. Multilevel logistic regression analysis was employed to examine the associations between benefit receipt and material hardship in the short- and long-term. Interaction terms between benefit receipt and time were incorporated in the modelling to determine whether receiving benefits corresponded with significant changes in the likelihood of experiencing material hardship at specific time points. Results: The key results suggest that benefit receipt in early childhood reduced the likelihood of experiencing material hardship at subsequent time points at least until adolescence, when controlling for key sociodemographic characteristics. Conclusion: These findings provide insight into the associations between early childhood income supports and reductions in the likelihood of experiencing material hardship in the long-term, to emphasise the potential for such interventions to have longstanding effects. By elucidating the associations between benefit receipt and subsequent material hardship, this research gives direction for policy interventions and timely support for families.
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To test the transmission of mental health difficulties from mother to child, we examined mediation through emotion reminiscing conversations and child language. Maternal depression symptoms were measured at 9 months post-partum, and child mental health outcomes were measured at age 8 years. Emotion reminiscing conversations between 1,234 mother-child pairs (624 boys, 610 girls) were recorded as part of a large, diverse, longitudinal cohort Growing Up in New Zealand. The 1,234 reminiscing conversations were transcribed and coded for maternal elaboration and emotion resolution quality (mother and child). The coded reminiscing variables did not mediate the pathway from maternal depression to child mental health outcomes; however, each maternal reminiscing variable together with child language skill serially mediated the relationship from maternal depression symptoms to child-reported anxiety and depression symptoms, and parent-reported child externalizing symptoms. Language as a skill and it's use as a tool for making shared meaning from past events are highlighted as possible mechanisms for the intergenerational transmission of mental health difficulties. These findings point to potential opportunities for early interventions, including prevention of and support for postnatal depression, family intervention in reminiscing training, and supporting child language development.
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BACKGROUND: Many people fear failure and making mistakes. This fear can be transmitted from parents to children, suggesting that parental communication regarding failures and setbacks may play a critical role in shaping a child's perception of mistakes. AIMS: In this study, we investigated how everyday parent-child conversations about setbacks influence children's fear of making mistakes. SAMPLE: Drawing on the large pre-birth Growing Up in New Zealand cohort, we focused on a sub-sample of 231 mother-child dyads who engaged in a recorded conversations about a "recent disappointment or setback" when the children were 8 years old. METHOD: Conversations between mothers and children about the recent disappointments were coded to identify whether parents recognised or acknowledge their child's emotional response, if action plans were discussed, and the types of resources that the child could draw on. The children also completed a questionnaire about their global self-worth and their fear of making mistakes. RESULTS AND CONCLUSIONS: The discussion of clear action plans, in the absence of a discussion about collaborative resources, was found to be associated with an increased fear of making mistakes among children. Conversely, when mothers clearly acknowledged their child's emotions and discussed ways to work collaboratively with their child on future problems, there was a notable decrease in the child's fear of mistakes. However, it is noteworthy that many mothers in our study either minimally acknowledged or dismissed their child's emotions(40%), rarely discussed action plans (55%), or collaborative resources (79%)when discussing the recent setback.
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The biological mechanisms that explain how adverse early life events influence adult disease risk are poorly understood. One proposed mechanism is via the induction of accelerated biological aging, for which telomere length is considered a biomarker. We aimed to determine if maternal depression pre- and post-partum was associated with telomere length in children at 4 years of age (n = 4299). Mothers completed structured questionnaires assessing depression during pregnancy (Edinburgh Depression Scale), at 9 months (Edinburgh Depression Scale), and at 54 months postpartum (Patient Health Questionnaire 9). Regression methods were used to investigate the relationship between telomere length (DNA from saliva) and maternal depression score recorded at each stage. Significant covariates included in the final model were: maternal age at pregnancy; child sex; child ethnicity; gestational age group, and rurality group. Child telomere length was found to be longer if their mother had a higher depression score at both postpartum time points tested (9 months of age; coefficient 0.003, SE = 0.001, P = 0.01, 54 months of age; coefficient 0.003, SE = 0.002, P = 0.02). Although these findings seem paradoxical, increased telomere length may be an adaptive response to early life stressors. We propose several testable hypotheses for these results and to determine if the positive association between depression and telomere length is a developmental adaptation or an indirect consequence of environmental factors.
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Depressão , Humanos , Feminino , Pré-Escolar , Masculino , Adulto , Gravidez , Lactente , Mães/estatística & dados numéricos , Telômero , Encurtamento do Telômero/fisiologia , Complicações na Gravidez , Depressão Pós-Parto , Escalas de Graduação PsiquiátricaRESUMO
There is increasing interest in the potential long-term outcomes of participation in contact and collision sports, driven by evidence of higher rates of neurodegenerative diseases among former athletes. Recent research has capitalised on large-scale administrative health data to examine health outcomes in contact sport athletes. However, there is limited research on outcomes associated with participation in rugby union, a contact sport with a relatively high incidence of head trauma and musculoskeletal injuries. Additionally, there is scope to investigate a greater range of health outcomes using large, population-based administrative data. The Kumanu Tangata project is a retrospective cohort study that will use linked information from the New Zealand Rugby Register and health records within a comprehensive deidentified whole-population administrative research database known as the Integrated Data Infrastructure. First-class male rugby union players (N=13 227) will be compared with a general population comparison group (N=2 438 484; weighting will be applied due to demographic differences) on a range of mortality and morbidity outcomes (neurodegenerative diseases, musculoskeletal conditions, chronic physical conditions, mental health outcomes). A range of player-specific variables will also be investigated as risk factors. Analyses will consist primarily of Cox proportional hazards models. Ethics approval for the study has been granted by the Auckland Health Research Ethics Committee (Ref. AH23203). Primary research dissemination will be via peer-reviewed journal articles.
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AIM: Approaches to understanding child injury tend to focus on short-term proximal influences. Previous analyses have found higher rates of injury among Maori and Pacific children in Aotearoa New Zealand (NZ). This study aimed to investigate how combinations of situations and multiple events act across the life-course to either protect preschool children from, or place them at risk of, repeated injuries requiring medical attention. METHODS: Longitudinal data were used to identify parent-reported injuries requiring medical attention among 6114 preschool NZ children. The environments experienced by children with multiple and/or severe injury were explored using multivariable analyses. RESULTS: Eight percent of children (n=505) experienced 1-3 injuries with at least one hospitalisation or ≥4 injuries (high injury group) from birth to 4.5 years of age. After accounting for antenatal, sociodemographic and psychosocial variables, children of Maori mothers (OR=0.7, 95% CI 0.5 to 0.97) and children of Asian mothers (OR=0.5, 95% CI 0.3 to 0.7) were less likely to be in the high injury group than children of European mothers. After adjusting for maternal ethnicity and child variables (gender, temperament, level of activity and behaviour difficulties), cumulative exposure to factors in four domains was associated with injury category: maternal, family, social and service use. CONCLUSION: This study identified social and economic opportunities to lower rates of injury among preschool children, that might reduce associated direct and indirect costs. Our findings in relation to ethnicity go against the standard public rhetoric and provide support for shifting the apportioning of blame for child injury from individuals to wider environmental exposures for which public health and societal solutions are required.
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Maternal depressive symptoms (MDS) in the postnatal period may impact children's later development through poorer quality parent-child interactions. The current study tested a specific pathway from MDS (child age 9 months) to child receptive vocabulary (4 ½ years) through both self-reported and observed parent-child verbal interactions (at both 2 and 4 ½ years). Participants (n = 4,432) were part of a large, diverse, contemporary pre-birth national cohort study: Growing Up in New Zealand. Results indicated a direct association between greater MDS at 9 months and poorer receptive vocabulary at age 4 ½ years. There was support for an indirect pathway through self-reported parent-child verbal interactions at 2 years and through observed parent-child verbal interactions at 4 ½ years. A moderated mediation effect was also found: the indirect effect of MDS on child vocabulary through observed verbal interaction was supported for families living in areas of greater socioeconomic deprivation. Overall, findings support the potential role of parent-child verbal interactions as a mechanism for the influence of MDS on later child language development. This pathway may be particularly important for families experiencing socioeconomic adversity, suggesting that effective and appropriate supportive parenting interventions be preferentially targeted to reduce inequities in child language outcomes.
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The way that mothers talk about the past (reminisce) with young children is linked to key memory, language, and socioemotional outcomes. The present research explored the role of a range of child, maternal, socioeconomic, and cultural factors that predict maternal reminiscing style, with a particular focus on maternal personality and child temperament. A total of 1,404 mother-child dyads from the prebirth longitudinal cohort study Growing Up in New Zealand (https://www.growingup.co.nz) participated in a reminiscing task about a negative event when children were 8 years old. This broader cohort is broadly representative of the New Zealand population in terms of maternal ethnicity and socioeconomic status. Conversations were scored using a revised version of the Elaborative Reminiscing Scale. Child temperament during infancy, but not childhood, uniquely predicted maternal reminiscing style. Maternal extraversion also predicted a more elaborative reminiscing style. Other maternal factors, including education, ethnicity, and age, were also identified as unique predictors of maternal reminiscing style. These findings fit well with an ecological systems view of maternal reminiscing as a function of child, maternal, and cultural factors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Memória Episódica , Relações Mãe-Filho , Criança , Feminino , Humanos , Pré-Escolar , Relações Mãe-Filho/psicologia , Temperamento , Estudos de Coortes , Estudos Longitudinais , Nova Zelândia , Mães/psicologia , PersonalidadeRESUMO
OBJECTIVE: To identify antenatal and early childhood exposures of unintentional injury among infants in New Zealand (NZ). METHOD: The theoretical life-course framework of child injury prevention domains was utilised to analyse data from a prospective longitudinal NZ birth cohort (Growing Up in NZ). Risk and protective factors for injury were identified using Robust Poisson regression models. RESULT: Among children included for the analysis(n=6304), 52% were male, 55% were born to European mothers, and 37% lived in a household with high levels of deprivation. Mothers reported that 6% of infants (n=406) had sustained at least one injury by 9 months. Multivariate analysis showed injury risk among single mothers with antenatal depression were more than twice that (IRR=2.20) of children of mothers with partners and without depression. CONCLUSION: Understanding antenatal risk and protective factors for infant injury will assist in implementing injury prevention programmes or modifying the existing policies that affect these vulnerable age groups.
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Coorte de Nascimento , Mães , Criança , Lactente , Humanos , Masculino , Pré-Escolar , Feminino , Gravidez , Nova Zelândia/epidemiologia , Estudos Prospectivos , Características da FamíliaRESUMO
There is growing interest in child socio-emotional competence from parents, educators, employers and policy makers, with emphasis on developing it as early as possible. The aim of the present study was to examine contextual and proximal factors that influence socio-emotional competence development across the first five years of a child's life. We used data from 3200 mothers and their children drawn mostly from four major data collection waves (antenatal, 9 months, 2 years and 4.5 years) of the population-based longitudinal study, Growing Up in New Zealand. Regression analyses were carried out to identify the predictors of socio-emotional competence after controlling for demographics and prior score(s) of socio-emotional competence. We found that specific maternal behaviours, such as playing games and playing with toys with children, singing songs or telling stories to them, reading books with them, having rules around viewing TV, DVDs and videos, and praising children have a positive effect on socio-emotional competence. Parental relationship warmth and less family stress at 9 months also made positive contributions to socio-emotional competence at 9 months and 2 years. In contrast, attending childcare and having more siblings at home negatively predicted socio-emotional competence at 9 months. Mother's unemployment, living in neighbourhoods perceived as negative and being in contact with family and social services were negatively associated with concurrent socio-emotional competence at 2 years. Overall, more and/or stronger contemporaneous effects were found suggesting that negative effects of contextual factors may not have lasting impact on socio-emotional competence. In addition, the results showed that maternal behaviours need to be practised regularly to have positive impact on child's socio-emotional development.
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BACKGROUND: Antenatal exposure to both antidepressants and maternal depression has been associated with child behavioural difficulties. However, previous research has not adequately distinguished between the effects of the antidepressants and the underlying maternal depression. METHODS: Child behavioural difficulties were assessed using the Strengths and Difficulties Questionnaire at 2-, 4.5-, and 8-years of age by mothers in the Growing Up in New Zealand study (N = 6233 at 2-years; N = 6066 at 4.5-years; N = 4632 at 8-years). Mothers were classified as either on antidepressants, unmedicated depression, or neither based on self-reported antidepressant intake during pregnancy and the Edinburgh Postnatal Depression Scale. Hierarchical multiple logistic regressions were used to examine whether antenatal exposure to antidepressants and unmedicated depression had a differential association with child behavioural outcomes relative to no exposure. RESULTS: When later life depression in the mother and a range of birth and sociodemographic variables were accounted for, neither antenatal exposure to unmedicated depression or antidepressants remained associated with an increased risk of behavioural difficulties at the ages investigated. However, maternal later life depression was associated with behavioural difficulties in the fully adjusted analyses at all three ages investigated. LIMITATIONS: The current study relied on mother-report of child behaviour which may be susceptible to bias due to maternal mental health problems. CONCLUSIONS: Adjusted results did not show an adverse association between antenatal antidepressant exposure or unmedicated depression in relation to child behaviour. Findings also suggest that efforts to improve child behaviour need to include more family-based approaches that support maternal wellbeing.
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Depressão , Complicações na Gravidez , Criança , Feminino , Humanos , Gravidez , Pré-Escolar , Depressão/psicologia , Antidepressivos/efeitos adversos , Mães/psicologia , Comportamento Infantil , Parto , Complicações na Gravidez/tratamento farmacológico , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/induzido quimicamenteRESUMO
BACKGROUND: Linking self-reported data collected from longitudinal studies with administrative health records is timely and cost-effective, provides the opportunity to augment information contained in each and can offset some of the limitations of both data sources. The aim of this study was to compare maternal-reported child injury data with administrative injury records and assess the level of agreement. METHODS: A deterministic linkage was undertaken to link injury-related data from the Growing up in New Zealand (GUiNZ) study to routinely collected injury records from New Zealand's Accident Compensation Corporation (ACC) for preschool children. The analyses compared: (i) the characteristics of mothers with linked data vs. those without, (ii) injury incidences from maternal recall with those recorded in ACC injury claims, and (iii) the demographic characteristics of concordant and discordant injury reports, including the validity and reliability of injury records from both data sources. RESULTS: Of all mothers who responded to the injury questions in the GUiNZ study (n = 5836), more than 95% (n = 5637) agreed to have their child's record linked to routine administrative health records. The overall discordance in injury reports showed an increasing trend as children grew older (9% at 9 M to 29% at 54 M). The mothers of children with discordance between maternal injury reports and ACC records were more likely to be younger, of Pacific ethnicity, with lower educational attainment, and live in areas of high deprivation (p < 0.001). The level of agreement between maternal injury recall and ACC injury record decreased (κ = 0.83 to κ = 0.42) as the cohort moved through their preschool years. CONCLUSIONS: In general, the findings of this study identified that there was underreporting and discordance of the maternal injury recall, which varied by the demographic characteristics of mothers and their child's age. Therefore, linking the routinely gathered injury data with maternal self-report child injury data has the potential to augment longitudinal birth cohort study data to investigate risk or protective factors associated with childhood injury.
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Cuidadores , Mães , Feminino , Humanos , Pré-Escolar , Estudos de Coortes , Reprodutibilidade dos Testes , Estudos LongitudinaisRESUMO
A nationally generalisable cohort (n 5770) was used to determine the prevalence of non-timely (early/late) introduction of complementary food and core food groups and associations with maternal sociodemographic and health behaviours in New Zealand (NZ). Variables describing maternal characteristics and infant food introduction were sourced, respectively, from interviews completed antenatally and during late infancy. The NZ Infant Feeding Guidelines were used to define early (≤ 4 months) and late (≥ 7 months) introduction. Associations were examined using multivariable multinomial regression, presented as adjusted relative risk ratios and 95 % confidence intervals (RRR; 95% CI). Complementary food introduction was early for 40·2 % and late for 3·2 %. The prevalence of early food group introduction were fruit/vegetables (23·8 %), breads/cereals (36·3 %), iron-rich foods (34·1 %) and of late were meat/meat alternatives (45·9 %), dairy products (46·2 %) and fruits/vegetables (9·9 %). Compared with infants with timely food introduction, risk of early food introduction was increased for infants: breastfed < 6months (2·52; 2·19-2·90), whose mothers were < 30 years old (1·69; 1·46-1·94), had a diploma/trade certificate v. tertiary education (1·39; 1·1-1·70), of Maori v. European ethnicity (1·40; 1·12-1·75) or smoked during pregnancy (1·88; 1·44-2·46). Risk of late food introduction decreased for infants breastfed < 6 months (0·47; 0.27-0·80) and increased for infants whose mothers had secondary v. tertiary education (2·04; 1·16-3·60) were of Asian v. European ethnicity (2·22; 1·35, 3·63) or did not attend childbirth preparation classes (2·23; 1·24-4·01). Non-timely food introduction, specifically early food introduction, is prevalent in NZ. Interventions to improve food introduction timeliness should be ethnic-specific and support longer breast-feeding.
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Aleitamento Materno , Alimentos Infantis , Lactente , Feminino , Gravidez , Humanos , Adulto , Estudos de Coortes , Nova Zelândia/epidemiologia , Prevalência , Fenômenos Fisiológicos da Nutrição do LactenteRESUMO
We investigated the association between persistence and change in behavioral difficulties during early to middle childhood and several cognitive outcomes. We observed 3904 8-year-olds enrolled in the longitudinal study Growing Up in New Zealand (50% male/female; 23% Maori, 9% Pacific Peoples, 13% Asian, 2% Middle Eastern/Latin American/African, 9% Other, 43% European). The NIH Toolbox Cognition Battery was used to assess cognitive functioning at 8 years and the Strengths and Difficulties Questionnaire for behavioral difficulties at 4.5 and 8 years. Multivariate logistic regression analyses were conducted, controlling for well-known sociodemographic confounders. Children with persistent or later onset of behavioral difficulties were at higher risk for poorer vocabulary, reading, inhibitory control/attention, episodic memory, working memory and processing speed at age 8 compared to children with no or improved difficulties. Our study supports the importance of addressing both cognitive and behavioral aspects when planning educational programmes and interventions in early and middle childhood.
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New Zealand (NZ) lacks nationally representative or generalisable information on the dietary intakes of pre-schoolers. We used Growing Up in New Zealand cohort data to i) develop child feeding indexes (CFIs) based on National Food and Nutrition Guidelines for 2- and 4.5-year-olds; ii) describe the cohort adherence to the guidelines at 2 (n = 6046) and 4.5 years (n = 5889) and; iii) assess the CFIs' convergent construct validity, by exploring associations with maternal sociodemographic and health behaviours and with child body mass index for age (BMI/age) and the waist-to-height ratio at 4.5 years. The CFIs scores ranged from 0 to 11, with 11 representing full adherence to the guidelines. Associations were tested using multiple linear regressions and Poisson regressions with robust variance (risk ratios [RR], 95% confidence intervals, 95% CI). The CFIs mean scores (SD) at 2 and 4.5 years were, respectively, 6.13 (1.21) and 6.22 (1.26) points. Maternal characteristics explained, respectively, 27.2% and 31.9% of the variation in the CFIs scores at 2 and 4.5 years. In the adjusted model at the 4.5-year interview, in relation to girls ranked in the 5th quintile, those in the 2nd (RR, 95% CI: 1.48; 1.03; 1.24) and 4th (1.53; 1.05; 2.23) quintiles of the CFI were more likely to have BMI/age > +2z (World Health Organization growth standards) at 4.5 years. At 2 and 4.5 years, most children fell short of meeting national guidelines. The associations between the CFIs scores at both time points with maternal characteristics and with children's body size at 4.5 years were in the expected directions, confirming the CFIs' convergent construct validity among NZ pre-schoolers.
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Dieta , Comportamento Alimentar , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Humanos , Nova Zelândia , Estado NutricionalRESUMO
Importance: People conceived using assisted reproductive technology (ART) make up an increasing proportion of the world's population. Objective: To investigate the association of ART conception with offspring growth and adiposity from infancy to early adulthood in a large multicohort study. Design, Setting, and Participants: This cohort study used a prespecified coordinated analysis across 26 European, Asia-Pacific, and North American population-based cohort studies that included people born between 1984 and 2018, with mean ages at assessment of growth and adiposity outcomes from 0.6 months to 27.4 years. Data were analyzed between November 2019 and February 2022. Exposures: Conception by ART (mostly in vitro fertilization, intracytoplasmic sperm injection, and embryo transfer) vs natural conception (NC; without any medically assisted reproduction). Main Outcomes and Measures: The main outcomes were length / height, weight, and body mass index (BMI; calculated as weight in kilograms divided by height in meters squared). Each cohort was analyzed separately with adjustment for maternal BMI, age, smoking, education, parity, and ethnicity and offspring sex and age. Results were combined in random effects meta-analysis for 13 age groups. Results: Up to 158â¯066 offspring (4329 conceived by ART) were included in each age-group meta-analysis, with between 47.6% to 60.6% females in each cohort. Compared with offspring who were NC, offspring conceived via ART were shorter, lighter, and thinner from infancy to early adolescence, with differences largest at the youngest ages and attenuating with older child age. For example, adjusted mean differences in offspring weight were -0.27 (95% CI, -0.39 to -0.16) SD units at age younger than 3 months, -0.16 (95% CI, -0.22 to -0.09) SD units at age 17 to 23 months, -0.07 (95% CI, -0.10 to -0.04) SD units at age 6 to 9 years, and -0.02 (95% CI, -0.15 to 0.12) SD units at age 14 to 17 years. Smaller offspring size was limited to individuals conceived by fresh but not frozen embryo transfer compared with those who were NC (eg, difference in weight at age 4 to 5 years was -0.14 [95% CI, -0.20 to -0.07] SD units for fresh embryo transfer vs NC and 0.00 [95% CI, -0.15 to 0.15] SD units for frozen embryo transfer vs NC). More marked differences were seen for body fat measurements, and there was imprecise evidence that offspring conceived by ART developed greater adiposity by early adulthood (eg, ART vs NC difference in fat mass index at age older than 17 years: 0.23 [95% CI, -0.04 to 0.50] SD units). Conclusions and Relevance: These findings suggest that people conceiving or conceived by ART can be reassured that differences in early growth and adiposity are small and no longer evident by late adolescence.
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Adiposidade , Sêmen , Adolescente , Adulto , Criança , Pré-Escolar , Estudos de Coortes , Transferência Embrionária/métodos , Feminino , Humanos , Lactente , Masculino , Obesidade/epidemiologia , Gravidez , Técnicas de Reprodução Assistida/efeitos adversosRESUMO
AIM: Breastfeeding is a fundamental aspect of tikanga Maori (Maori cultural traditions/practices) requiring protection and promotion. This study identifies determinants of exclusive breastfeeding in wahine Maori. METHODS: Wahine Maori enrolled in the Growing Up in New Zealand child cohort study participated (n=1060). Exclusive breastfeeding duration was self-reported. Hierarchical regression analyses were framed by a model of Maori health and wellbeing. RESULTS: Most wahine Maori initiated breastfeeding (96%), with 12% exclusively breastfeeding for six or more months. Wahine Maori had increased odds of exclusively breastfeeding for six or more months if they: thought it best to breastfeed for >6 months (adjusted odds ratio (aOR)=1.94, 95% confidence interval (CI)=1.05-3.78); thought returning to work would not (aOR=2.17, 95% CI=1.17-4.24) or may (aOR=4.25, 95% CI=1.86-9.85) limit breastfeeding; were experienced mothers (aOR=2.55, 95% CI=1.35-5.06); or were undecided about vaccination (aOR=3.16, 95% CI=1.55-6.39). Exclusive breastfeeding for six or more months was less likely if mothers experienced depression during pregnancy (aOR=0.47, 95% CI=0.20-0.99) or viewed cultural traditions/practices as "fairly important" (aOR=0.53, 95% CI=0.27-0.99), compared to "very important". CONCLUSION: Determinants of exclusive breastfeeding in wahine Maori are knowledge of breastfeeding recommendations, return to work, motherhood experience, connection to Te Ao Maori (Maori worldview) and tikanga Maori, antenatal depression and vaccine indecision. Interventions delivered within a Kaupapa Maori framework will best address breastfeeding inequities in Aotearoa New Zealand.
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Aleitamento Materno , Havaiano Nativo ou Outro Ilhéu do Pacífico , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Mães , Nova Zelândia , GravidezRESUMO
The primary objective of this study was to delineate classes of individuals based on depression trajectories from the antenatal period through 54-month postpartum and internal and external resources that are associated with low depression risk. Participants came from the Growing Up in New Zealand (GUiNZ) study (n = 5664), which is a pregnancy cohort study and is nationally representative of the ethnic and socioeconomic diversity of contemporary New Zealand births. Growth curve mixture modeling was used to identify distinct subgroups based on depression scores from the antenatal period through 54-month postpartum. Logistic regression models were run to investigate socioeconomic factors and internal and external resources that were associated with depression class membership. A two-class model, "low risk" and "high risk," resulted in the best model fit. Most of the sample (n = 5110, 90%) fell into the "low-risk" class defined by no-to-mild depression symptoms during pregnancy and decreasing depressive symptoms over time (bintercept = - .05, bslope = - .05). Approximately 10% of the sample fell into the "high-risk" class (n = 554, 10%) defined by mild-to-moderate depressive symptoms during pregnancy and increasing depressive symptomology over time (bintercept = .39, bslope = .57). More positive parenting-related attitudes, better pre-pregnancy self-reported health, informal social supports, and community belonging were significantly associated with greater odds of being in the "low-risk" class, after controlling for socioeconomic factors. These findings suggest that targeting internal and external resources for individuals across the perinatal and early childhood periods is important to mitigating maternal depression.
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Depressão Pós-Parto , Mães , Pré-Escolar , Estudos de Coortes , Depressão/diagnóstico , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/prevenção & controle , Feminino , Humanos , Gravidez , Escalas de Graduação Psiquiátrica , Fatores de RiscoRESUMO
OBJECTIVES: The aim of this study was to assess the association of antenatal maternal dietary patterns (DPs) and other health aspects with infant temperament in a large multiethnic cohort, taking maternal personality and prenatal stress into account. DESIGN AND METHODS: Using data from 3968 children born in 2009/2010 and their mothers from the Growing Up in New Zealand cohort, infant temperament was assessed at 9 months using the Infant Behavior Questionnaire-Revised Very Short Form. Maternal antenatal diet and other health aspects were assessed antenatally. Maternal DPs (n=4) were derived using principal components analysis based on food intake reported on a 44-item food frequency questionnaire. Path analyses investigated factors associated with infant temperament, namely maternal personality, prenatal maternal stress, DPs and other health aspects, including potential inter-relations and mediating effects. RESULTS: Women who scored higher in the fusion DP (standardised beta (ß)=0.05; 95% CI 0.02 to 0.09) and healthy DP (ß=0.05; 95% CI 0.02 to 0.09), who exercised more (ß=0.04; 95% CI 0.01 to 0.07), and who drank less alcohol (ß=-0.05; 95% CI -0.08 to -0.02) were more likely to have infants with an overall less difficult temperament. Sex-specific differences were found in the associations between maternal DP and infant temperament. Maternal personality and prenatal stress were significantly associated with all dimensions of infant temperament. The strongest predictors for a more difficult temperament were prenatal stress (ß=0.12; 95% CI 0.08 to 0.15) and the personality dimensions neuroticism (ß=0.10; 95% CI 0.07 to 0.14) and extraversion (ß=-0.09; 95% CI -0.12 to -0.06). CONCLUSIONS: Associations of antenatal maternal diet and health aspects with infant temperament were statistically significant but small. While they should not be overinterpreted as being deterministic, the findings of this study support the link between maternal modifiable health-related behaviours and infant temperament outcomes.