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The determinants of talking delay alone or its comorbidity with behavioural difficulties was examined in 5768 two-year-old members of the Growing Up in New Zealand longitudinal study. Using the MacArthur-Bates Communicative Development inventories and the total difficulties score from the preschool Strengths and Difficulties Questionnaire, a composite measure was created so that children were categorised as showing no language or behavioural concerns (72.5%), behavioural only difficulties (6.1%), language only difficulties (18.1%), and comorbid language and behavioural difficulties (3.3%). Analyses revealed that antenatal factors such as maternal perceived stress, inadequate folate intake, vitamin intake, alcohol consumption during the first trimester and maternal smoking all had a significant effect on child outcomes. In particular, low multivitamin intake and perceived stress during pregnancy were associated with coexisting language and behavioural difficulties. These findings support international research in showing that maternal factors during pregnancy are associated with developmental outcomes in the early childhood period, and demonstrate these associations within a NZ context. Interventions which address maternal stress management and health behaviours during pregnancy could be beneficial to offspring development.

INTRODUCTION: Pacific women in New Zealand (NZ) have higher rates of antenatal depression than women from other ethnic groups. AIM: To identify factors that are significantly associated with depression symptoms in pregnant Pacific women living in NZ. METHODS: Data were collected from 5657 pregnant women, 727 of whom identified their ethnicity as Pacific Island. Antenatal depression symptoms were measured using the Edinburgh Depression Scale with scores above 12 indicating elevated antenatal depression symptoms (ADS). RESULTS: Pacific women had significantly higher rates of ADS than non-Pacific women, with 23% of pregnant Pacific women experiencing ADS. Factors associated with ADS for Pacific women included age <25 >years, moderate to severe nausea during pregnancy, perceived stress, family stress and relationship conflict. Not seeing the importance of maintaining one's Pacific culture and traditions and negative feelings towards NZ culture were also significantly associated with ADS in Pacific women. One in three Pacific women aged (GP) before their pregnancy were 4.5-fold more likely to experience ADS than non-Pacific women with a regular GP. DISCUSSION: Further attention is required to providing appropriate primary health care for Pacific women of child-bearing age in NZ. Better screening processes and a greater understanding of effective antenatal support for Pacific women is recommended to respond to the multiple risk factors for antenatal depression among Pacific women.

Now we are Four gives us a comprehensive look at how kiwi kids from the Growing Up in New Zealand study are faring. In particular, we can see how the situation of mothers changes when children pass from infancy to early childhood. The biggest shift for most children is that they now attend early childhood education, and most are reported to be generally happy and healthy and spending time getting to know their peers. This means that we also see greater employment of mothers, leading to improved economic circumstances for these households. Nearly half of this generation of mothers live in private rental accommodation and experience multiple changes of address. The effect of this on access to services needs further exploration. Pacific households appear to bear the most significant effects of overcrowding, as seen in the reporting by Pacific mothers that half of their four-year-olds sleep in a room with adults. We also see: •Families moving homes frequently, with half of the children experiencing one or more residential moves since the age of two. One question this raises relates to what impact this has on continuous health care and early childhood education services, and ensuring places are available in local schools? •The increasing number of children living with a single parent as the cohort gets older. This has implications for agencies developing services and systems to support sole parents and their children. •A greater proportion of Māori children living in single-parent households compared to other ethnic groups. Previous research by Superu identified that these families tend to face greater financial stress which impacts their ability to function well. There is a clear need to address this. •One in five mothers experience depressive symptoms during or since pregnancy. This suggests a need to understand how our mental health services can better serve the mothers who aren’t currently getting the support they need. •By the age of four, 97 percent of children spe

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 Māori 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.

Objectives o determine whether maternal exposure to green space during pregnancy is associated with birth weight and gestational age, and whether these associations are modified by demographic and residential factors. Methods Data describing 5091 mother-newborn pairs with residential address during pregnancy linked to data describing their green space exposure. Independent associations determined using linear mixed effects models. Results Maternal exposure to green space during pregnancy was not associated with birth weight and gestational age for the entire cohort. For pregnant women who have not acquired secondary school education, increased exposure to green space was associated with increased gestational age. Conclusion The provision of green space might prove to be beneficial in terms of increasing gestational age for pregnant women who have not acquired secondary school education qualifications.

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.

Background: Exposure to green space has been associated with increased physical activity. However, it is not clear whether this association is because active people preferentially live in greener areas. Relationships between exposure to green space and physical activity during pregnancy are not well defined. Our objective was to determine whether exposure to green space was associated with physical activity in pregnant women. Methods: The current study was completed within the Growing Up in New Zealand cohort study of 6772 pregnant women. The proportion of green space in each census area unit was determined and geocoded to residential address. The association between exposure to green space and physical activity was determined using logistic regression analyses after controlling for confounding variables. Results: Exposure to green space was not associated with participation in physical activity during first trimester and the remainder of pregnancy once preference for living in greener neighborhoods was taken into account. Conclusions: The lack of association between green space and physical activity found in this study does not necessarily mean that living in green space will not translate into better pregnancy health. Preference for living in greener neighborhoods should be considered when investigating relationships between green space and physical activity.

Longitudinal cohort studies have significant potential to inform policy across a range of child and family areas, including early childhood education and care. Here we describe the relationship between policy-makers and New Zealand’s contemporary pre-birth cohort study. We outline a model for policy interaction that highlights the relationship between Growing Up and policy across study design, implementation and analysis. We then describe key policy-relevant questions in the early childhood education and care area that Growing Up has addressed when children were age 2. We used parent-report data for 6242 children to consider: whether socio-economic factors and ethnicity are related to the type, amount and quality of care children receive, and changes in this care across the early years; whether families are intending to utilise ‘20 Hours ECE’ when their children reach age 3, and if not, why not; and whether differences in intentions to use ‘20 Hours ECE’ are based on socio-economic factors, ethnicity and the type of childcare children are receiving at age 2. Results indicated clear differences in non-parental care at age 2 as a function of maternal ethnicity, income, area deprivation and household structure. Several child care proxy quality indicators were lower for children of Māori, Pacific and Asian mothers compared with children of European mothers, and for children living in higher deprivation areas. While 88 % of mothers were intending to utilise the Government’s ‘20 Hours ECE’ funding, Asian and Pacific mothers and mothers whose children were cared for by family members were less likely. These findings highlight the importance of continued policy efforts to reduce socio-economic and ethnic disparities in education and care during the preschool years.

Differences in parent-child interactions have implications for a range of developmental outcomes, yet it has traditionally been difficult for large cohort studies that traverse multiple domains to include such detailed behavioural observations. We describe a new method for observing parent-child interactions specifically designed to be a component of a more comprehensive collection of data about child health and development. Participants were mothers and their two-year-old children who were part of the Growing Up in New Zealand study. During a series of brief, structured parent-child conversation tasks, observers were trained to rate mothers’ warmth, use of open-ended questions, talk about emotions and ‘linking’ talk, children’s emotional expression and mothers’ overall use of discipline. Reliability was established before and reviewed mid-way through the one-year data collection wave. We observed differences in parent-child interaction construct ratings as a function of socio-demographic variables, ethnicity and child gender that were in agreement with published research. Inter-scale correlations and correlations between observer ratings and maternal self-report measures provide preliminary evidence of convergent and discriminant validity. Specifically, higher maternal self-reported affiliation and more frequent book reading were significantly correlated with observer ratings of maternal warmth, maternal language style and children’s emotional expression, and negatively correlated with observer ratings of maternal discipline. Higher maternal self-reported parenting hostility was negatively correlated with observed maternal warmth and language and positively correlated with observed maternal discipline. This observational method is a potentially useful technique for obtaining independent measures of parent-child interactions during the preschool years within large cohort studies.