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Infants are increasingly cared for by adults other than their parents. Here we describe non-parental infant care within a diverse cohort; and investigate the relationship between parents' antenatal intentions and actual infant care. 6822 New Zealand women were recruited during pregnancy and asked about their intentions for childcare. Non-parental care was assessed when infants were nine months old: 1717 (25%) of the 6853 cohort children were receiving more than 8 h per week of regular non-parental care. In comparison with infants of European mothers, infants of Asian or Pacific mothers were more likely to be cared for by extended family; and infants of Maori mothers were more likely to receive centre-based care. Infants from families with lower household incomes, living in more deprived areas were more likely to be cared for by family. When their infants were nine months old, mothers from low- to medium-income households were less likely to be using the type of non-parental care they had intended antenatally, and the same was true when their children were aged 2 years.

Participants were 5,831 women in their third trimester of pregnancy, part of a large, longitudinal, pre-birth national cohort study. Women reported on their experience of pushing and shoving, throwing or breaking objects within their relationship over the past month. Univariable regression models examined the association of a large number of potential risk and protective factors. Those significant at the univariable level were carried forward into final multivariable analyses, stratified by New Zealand's four main ethnic groups: European, Māori, Pacific, and Asian peoples. Relationship commitment, reduced family cohesion, and perceived stress were associated with increased risk across ethnic groups. [ABSTRACT FROM AUTHOR]

Background: Acute rheumatic fever (ARF) rates have declined to near zero in nearly all developed countries. However, in New Zealand rates have not declined since the 1980s. Further, ARF diagnoses in New Zealand are inequitably distributed-occurring almost exclusively in Māori (the indigenous population) and Pacific children-with very low rates in the majority New Zealand European population. With ARF diagnosis, secondary prophylaxis is key to prevent recurrence. The purpose of this study was to identify the perceived enablers and barriers to secondary recurrence prophylaxis following ARF for Māori patients aged 14-21. Methods: This study took a systems approach, was informed by patient voice and used a framework method to explore potential barriers and enablers to ongoing adherence with monthly antibiotic injections for secondary prophylaxis. Qualitative interviews were conducted with 19 Māori ARF patients receiving recurrence prophylaxis in the Waikato District Health Board region. Participants included those fully adherent to treatment, those with intermittent adherence or those who had been "lost to follow-up." Results: Barriers and enablers were presented around three factors: system (including access/resources), relational and individual. Access and resources included district nurses coming to patients as an enabler and lack of income and time off work as barriers. Relational characteristics included support from family and friends as enablers and district nurse communication as predominantly a positive although not enabling factor. Individual characteristics included understanding, personal responsibility and fear/pain of injections. Conclusion: This detailed exploration of barriers and enablers for ongoing secondary prophylaxis provides important new information for the prevention of recurrent ARF. Among other considerations, a national register, innovative engagement with youth and their families and a comprehensive pain management programme are likely to improve adherence to ongoing secondary prophylaxis and reduce the burden of RHD for New Zealand individuals, families and health system. [ABSTRACT FROM AUTHOR]

The Infant Behavior Questionnaire Revised–Very Short Form (IBQ–R VSF; Putnam, Helbig, Gartstein, Rothbart, & Leerkes, 2014) is a new publicly available measure of infant temperament measuring positive affectivity/surgency (PAS), negative emotionality (NEG), and orienting and regulatory capacity (ORC). Although the initial psychometric properties of the 3-factor model appear promising, it has not been administered to a large and diverse sample and its predictive validity has not been established. This study administered the IBQ–R VSF to a diverse sample of 5,639 mothers of infants aged between 23 and 52 weeks. Confirmatory factor analysis found that the 3-factor solution did not meet the requirement for satisfactory model fit. Exploratory factor analysis found that a 5-factor solution (PAS, NEG, Orienting Capacity, Affiliation/Regulation, and Fear) was statistically and conceptually the most parsimonious. All 5 temperament dimensions were found to relate to both mother- and partner-reported infant closeness, parenting confidence, and parenting satisfaction, and four of the dimensions (PAS, Orienting Capacity, NEG, and Fear) related to the infants' communication development. Some parental differences were also found. Together these findings suggest that the 5-factor IBQ–R VSF is a promising measure of infant temperament and is related to parenting perceptions and child language development. [ABSTRACT FROM PUBLISHER]

Objective To examine prospectively multiple indicators of pregnancy health and associations with adverse birth outcomes within a large, diverse sample of contemporary women. Design A cohort of pregnant women who gave birth during 2009-10. Population We enrolled a sample of 6822 pregnant New Zealand ( NZ) women: 11% of all births in NZ during the recruitment period. Methods We analysed a number of maternal health indicators and behaviours during pregnancy in relation to birth outcomes using multivariable logistic regression. Associations were described using adjusted odds ratios and 95% confidence intervals. Main outcome measures Three birth outcomes, low birth weight ( LBW), pre-term birth ( PTB) and delivery type, were measured via linkage with maternity hospital perinatal databases. Small for gestational age ( SGA) was then defined as below the 10th percentile by week of gestation. Results Modelling of birth outcomes after adjusting for confounders indicated patterns of increased risk of LBW and PTB for women who smoke, have elevated pre-pregnancy body mass index ( BMI), or with insufficient pregnancy weight gain. SGA was associated with maternal smoking, alcohol use, insufficient weight gain and nausea and vomiting during pregnancy. Risk of caesarean section was associated with having a diagnosed illness before pregnancy, elevated BMI, greater pregnancy weight gain and less pregnancy exercise. Number of risk factor variables were then used to model birth outcomes. Women with multiple risk factors were at increased risk compared with those who had no risk factors. Conclusions Women with multiple health risks are at particular risk of adverse birth outcomes. [ABSTRACT FROM AUTHOR]

Exploration of dietary pattern associations within a multi-ethnic society context has been limited. We aimed to describe dietary patterns of 5664 pregnant women from the Growing Up in New Zealand study, and investigate associations between these patterns and maternal socio-demographic, place of birth, health and lifestyle factors. Participants completed a food frequency questionnaire prior to the birth of their child. Principal components analysis was used to extract dietary patterns and multivariable analyses used to determine associations. Four dietary components were extracted. Higher scores on, ‘Junk’ and ‘Traditional/White bread’, were associated with decreasing age, lower educational levels, being of Pacific or M ̄aori ethnicity and smoking. Higher scores on, ‘Health conscious’ and ‘Fusion/Protein’, were associated with increasing age, better self-rated health, lower pre-pregnancy body mass index (BMI) and not smoking. Higher scores on ‘Junk’ and ‘Health conscious’ were associated with being born in New Zealand (NZ), whereas higher scores on ‘Fusion/Protein’ was associated with being born outside NZ and being of non-European ethnicity, particularly Asian. High scores on the ‘Health conscious’ dietary pattern showed the highest odds of adherence to the pregnancy dietary guidelines. In this cohort of pregnant women different dietary patterns were associated with migration, ethnicity, socio-demographic characteristics, health behaviors and adherence to dietary guidelines. [ABSTRACT FROM AUTHOR]