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Background/objectives: Two compartment (2 C) models of body composition, including Air Displacement Plethysmography (ADP) and Deuterium Dilution (DD), assume constant composition of fat-free mass (FFM), while 3-compartment (3 C) model overcomes some of these assumptions; studies are limited in infants. The objective of the present study is to compare 3 C estimates of body composition in 6-mo. old infants from Australia, India, and South Africa, including FFM density and hydration, compare with published literature and to evaluate agreement of body composition estimates from ADP and DD., Methods: Body volume and water were measured in 176 healthy infants using ADP and DD. 3C-model estimates of fat mass (FM), FFM and its composition were calculated, compared between countries (age and sex adjusted) and with published literature. Agreement between estimates from ADP and DD were compared by Bland-Altman and correlation analyses., Results: South African infants had significantly higher % FM (11.5%) and density of FFM compared to Australian infants. Australian infants had significantly higher % FFM (74.7 ± 4.4%) compared to South African infants (71.4 ± 5.0) and higher FFMI (12.7 ± 0.8 kg/m 2 ) compared to South African (12.3 ± 1.2 kg/m 2 ) and Indian infants (11.9 ± 1.0 kg/m 2 ). FFM composition of present study differed significantly from literature. Pooled three country estimates of FM and FFM were comparable between ADP and DD; mean difference of -0.05 (95% CI: -0.64, +0.55) kg and +0.05 (95% CI: -0.55, +0.64) kg., Conclusions: 3C-model estimates of body composition in infants differed between countries; future studies are needed to confirm these findings and investigate causes for the differences., (© 2023. The Author(s).)

Objective: To examine the incidence of adverse perinatal outcomes and the risk of adverse perinatal outcomes for Indian-born mothers compared to other mothers living and giving birth in Australia. Design, setting and participants: This retrospective cohort study was designed to investigate all births in Australia in 2012 and those in the Monash Health Birthing Outcomes System (BOS) 2014 to Indian-born mothers in Australia. Data sets were analysed involving descriptive statistics using Statistical Package for Social Sciences (SPSS vs. 23). Results: Indian-born mothers in Australia are at increased risk of induced labour, emergency caesarean section, very preterm birth (20–27 weeks), babies with low to very low birth weight, and low Apgar score (0–2) at 5 min, gestational diabetes, hypothyroidism, iron deficiency anaemia and vitamin B12 deficiencies compared to other mothers giving birth in Australia. This is despite a range of protective factors (25–34 years, married, nonsmokers, and a BMI < 30) that would normally be expected to reduce the risk of adverse perinatal outcomes for mothers giving birth in a developed country. Conclusion: In the absence of many of the recognized maternal risk factors, Indian-born mothers continue to face increased risk of adverse perinatal outcomes, despite access to high quality maternity care in Australia. Recommendations arising from this study include the need for an intervention study to identify maternal risk factors for Indian-born mothers in mid to late pregnancy that contribute to the risk for very preterm birth and low birth weight. [ABSTRACT FROM AUTHOR]

Background: Reports from around the world suggest that rates of preterm birth decreased during COVID‐19 lockdown measures. Aims: To compare the prevalence of preterm birth and stillbirth rates during COVID‐19 restriction measures with infants born at the same maternity centre during the same weeks in 2013–2019. Materials and Methods: Deidentified data were extracted from the Mater Mothers' healthcare records database. This is a supra‐regional tertiary perinatal centre. Logistic regressions were used to examine singleton live preterm birth rates during the beginning of COVID‐19 restrictions (16 March‐17 April; 'early'; 6955 births) and during the strictest part of COVID‐19 restrictions (30 March‐1 May; 'late'; 6953 births), according to gestational age subgroups and birth onset (planned or spontaneous). We adjusted for multiple covariates, including maternal age, body mass index, ethnicity, parity, socioeconomic status, maternal asthma, diabetes mellitus and/or hypertensive disorder. Singleton stillbirth rates were also examined between 16 March–1 May. Results: Planned moderate/late preterm births declined by more than half during early COVID‐19 restrictions compared with the previous seven years (29 vs an average of 64 per 1000 births; adjusted odds ratio 0.39, 95% CI 0.22–0.71). There was no effect on extremely or very preterm infants, spontaneous preterm births, or stillbirth rates. Rolling averages from January to June revealed a two‐week non‐significant spike in spontaneous preterm births from late April to early May, 2020. Conclusions: Together with evidence from other nations, the pandemic provides a unique opportunity to identify causal and preventative factors for preterm birth. [ABSTRACT FROM AUTHOR]

Identify predictors of maternal bonding and responsiveness for mothers of very preterm infants (< 32 weeks gestational age) at 6 weeks and 12 months corrected-age (CA). Cross-sectional and longitudinal study containing 39 mothers of very preterm infants. At 6 weeks CA maternal self-efficacy made a significant unique contribution to the variance in self-reported maternal bonding and responsiveness (21% and 26%, respectively). At 12 months CA maternal trauma symptoms, depressive symptoms and self-efficacy made a significant unique contribution to the variance in bonding (14%, 9% and 9%, respectively). Maternal self-efficacy made a significant 31% unique contribution to the variance in responsiveness. The combined effects of maternal trauma symptoms, depressive symptoms and self-efficacy at 6 weeks CA predicted maternal responsiveness at 12 months CA (p = .042). Supporting maternal self-efficacy is key to facilitating bonding and responsiveness up to 12 months CA following a very preterm birth.Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12612000194864., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives: To evaluate the diagnosis and management of reflux and gastro-oesophageal reflux disease (GORD) in infants aged <1 year presenting to general practitioners (GPs).Design, Setting and Participants: A nationally representative, prospective, cross-sectional survey of GP activity in Australia, 2006-2016 (Bettering the Evaluation And Care of Health Study). Annually, a random sample of around 1000 GPs recorded details for 100 consecutive visits with consenting, unidentified patients.Outcome Measures: Diagnoses of reflux and GORD and their management including prescribing of acid-suppressant medicines (proton pump inhibitors (PPIs) and histamine receptor antagonists (H2RAs)) and counselling, advice or education.Results: Of all infants' visits, 512 (2.7%) included a diagnosis of reflux (n=413, 2.2%) or GORD (n=99, 0.5%). From 2006 to 2016, diagnostic rates decreased for reflux and increased for GORD. Prescribing of acid suppressants occurred in 43.6% visits for reflux and 48.5% visits for GORD, similar to rates of counselling, advice or education (reflux: 38.5%, GORD: 43.4% of visits). Prescribing of PPIs increased (statistically significant only for visits for reflux), while prescribing of H2RAs decreased.Conclusions: Overprescribing of acid suppressants to infants may be occurring. In infants, acid-suppressant medicines are no better than placebo and may have significant negative side effects; however, guidelines are inconsistent. Clear, concise and consistent guidance is needed. GPs and parents need to understand what is normal and limitations of medical therapy. We need a greater understanding of the influences on GP prescribing practices, of parents' knowledge and attitudes and of the pressures on parents of infants with these conditions. [ABSTRACT FROM AUTHOR]

Background/Aims: There are only few data on dietary arachidonic acid (ARA) and docosahexaenoic acid (DHA) intake in infants from developing countries, and current global recommendations on intake during early life may not reflect the needs of the world's most vulnerable infants. The aim of the study was to provide estimates of intake of ARA and DHA in infants and young children aged 6-36 months who live in developing countries. Methods: FAO Food Balance Sheets and fatty acid composition data from Australian food composition tables were utilized to generate mean per capita intake estimates for DHA and ARA in developing countries. The median daily intake of DHA and ARA in children age 6-36 months in each country was determined by combining the fatty acid composition of breast milk and complementary foods with the estimated intakes being weighted according to median duration of any breastfeeding. Results: The median daily dietary intake for ARA and DHA across 76 developing countries was 64.0 and 48.9 mg/day, respectively. The lowest complementary food intake of ARA and DHA was present in countries with the lowest gross national income and highest birth rates. Conclusion: Global recommendations on ARA and DHA in early life need to reflect the specific needs of infants and families living in low income countries, and country-specific food policies should address gaps between recommended and achieved intakes. [ABSTRACT FROM AUTHOR]

Aim: This study sought to describe the burden of acute diarrhoeal illness (ADI) in an Australian subtropical urban setting following rotavirus vaccine introduction and to investigate the associations between child/family characteristics and ADI., Methods: Parents of 154 children from the Observational Research in Childhood Infectious Diseases birth cohort provided daily symptom and health-care data until the age of 2 years., Results: The incidence rate of ADI was 1.07 per child-year (95% confidence interval: 0.94-1.21). The median length of episode duration was 3 days (25th-75th percentiles: 1-6). The incidence rate was significantly higher in the first month of life and between 6 and 17 months of age compared with 18-23 months, also for children with siblings and in formal childcare. Overall, 49% of ADI episodes led to health-care visits., Conclusions: Despite a successful rotavirus vaccine programme, ADI still results in a substantial disease burden affecting young Australian children and their families., (© 2020 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)

Aim: The aim of this study was to evaluate the attitudes and practices of Australian general practitioners (GPs) regarding infant gastro-oesophageal reflux disease (GORD) diagnosis and management.Methods: A national cross-sectional survey, involving a random sample of currently practising Australian GPs (n = 2319) was undertaken between July and September 2011. GPs attitudes and management of infant GORD were surveyed via an online and paper-based 41-item questionnaire.Results: In total, 400 responses were analysed (17.24% response rate). The majority of GPs employed empirical trials of acid-suppression medication and/or lifestyle modifications to diagnose infant GORD. GPs frequently recommended dietary modification despite the belief that they were only moderately effective at best. In addition, GPs frequently prescribed acid-suppression medication, despite concerns regarding their safety in the infant population. Other GP concerns included the lack of clinical guidelines and education for GPs about infant GORD, as well as the level of evidence available for the safety and efficacy of diagnostic tests and treatments.Conclusion: Despite the important role Australian GPs play in the diagnosis and management of infant GORD, high-level evidence-based guidelines for GPs are lacking. Consequently, GPs engage in diagnostic and management practices despite their concerns regarding the safety and effectiveness. [ABSTRACT FROM AUTHOR]

Background: Birthweight remains one of the strongest predictors of perinatal mortality and disability. Birthweight percentiles form a reference that allows the detection of neonates at higher risk of neonatal and postneonatal morbidity. The aim of the study is to present updated national birthweight percentiles by gestational age for male and female twins born in Australia.Methods: Population data were extracted from the Australian National Perinatal Data Collection for twins born in Australia between 2001 and 2010. A total of 43,833 women gave birth to 87,666 twins in Australia which were included in the study analysis. Implausible birthweights were excluded using Tukey's methodology based on the interquartile range. Univariate analysis was used to examine the birthweight percentiles for liveborn twins born between 20 and 42 weeks gestation.Results: Birthweight percentiles by gestational age were calculated for 85,925 live births (43,153 males and 42,706 females). Of these infants, 53.6% were born preterm (birth before 37 completed weeks of gestation) while 50.2% were low birthweight (<2500 g) and 8.7% were very low birthweight (<1500 g). The mean birthweight decreased from 2462 g in 2001 to 2440 g in 2010 for male twins, compared with 2485 g in 1991-94. For female twins, the mean birthweight decreased from 2375 g in 2001 to 2338 g in 2010, compared with 2382 g in 1991-94.Conclusions: The birthweight percentiles provide clinicians and researchers with up-to-date population norms of birthweight percentiles for twins in Australia. [ABSTRACT FROM AUTHOR]

STUDY QUESTION What is the standard of birthweight for gestational age for babies following assisted reproductive technology (ART) treatment? SUMMARY ANSWER Birthweight for gestational age percentile charts were developed for singleton births following ART treatment using population-based data. WHAT IS KNOWN ALREADY Small for gestational age (SGA) and large for gestational age (LGA) births are at increased risks of perinatal morbidity and mortality. A birthweight percentile chart allows the detection of neonates at high risk, and can help inform the need for special care if required. STUDY DESIGN, SIZE, DURATION This population study used data from the Australian and New Zealand Assisted Reproduction Database (ANZARD) for 72 694 live born singletons following ART treatment between January 2002 and December 2010 in Australia and New Zealand. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 69 315 births (35 580 males and 33 735 females) following ART treatment were analysed for the birthweight percentile. Exact percentiles of birthweight in grams were calculated for each gestational week between Week 25 and 42 for fresh and thaw cycles by infant sex. Univariate analysis was used to determine the exact birthweight percentile values. Student t-test was used to examine the mean birthweight difference between male and female infants, between single embryo transfer (SET) and double embryo transfer (DET) and between fresh and thaw cycles. MAIN RESULTS AND THE ROLE OF CHANCE Preterm births (birth before 37 completed weeks of gestation) and low birthweight (<2500 g) were reported for 9.7 and 7.0% of live born singletons following ART treatment. The mean birthweight was 3280 g for live born singletons following fresh cycles (3338 g for male infants and 3217 for female infants) and 3413 g for live born singletons following thaw cycles (3475 g for male infants and 3349 for female infants). The proportion of SGA for male ART births following thaw cycles at 35–41 weeks gestation was significantly lower than for the Australian general population, ranging from 3.8% (95% confidence interval (CI): 1.3%, 6.2%) at 35 weeks gestation to 7.9% (95% CI: 6.3%, 9.5%) at 41 weeks gestation. The proportion of LGA for male ART births following thaw cycles was significantly higher than for the Australian general population between 33 weeks (17.1%, 95% CI: 8.9%, 25.2%) and 41 weeks (14.4%, 95% CI: 12.3%, 16.5%). A similar trend was shown for female infants following thaw cycles. The live born singletons following SET were, on average, 45 g heavier than live born singletons following DET (P< 0.001). Overall, SGA was reported for 8.9% (95% CI: 8.6%, 9.1%) of live born singletons following SET and for 9.9% (95% CI: 9.5%, 10.3%) of live born singletons following DET. LIMITATIONS, REASONS FOR CAUTION Birthweight percentile charts do not represent fetal growth standards but only the weight of live born infants at birth. WIDER IMPLICATIONS OF THE FINDINGS The comparison of birthweight percentile charts for ART births and general population births provide evidence that the proportion of SGA births following ART treatment was comparable to the general population for SET fresh cycles and significantly lower for thaw cycles. Both fresh and thaw cycles showed better outcomes for singleton births following SET compared with DET. Policies to promote single embryo transfer should be considered in order to minimize the adverse perinatal outcomes associated with ART treatment. STUDY FUNDING/COMPETING INTEREST(S) No specific funding was obtained. The authors have no conflicts of interest to declare. [ABSTRACT FROM PUBLISHER]