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Objectives: To determine the prevalence of eczema among children in New Zealand. Methods: Population‐based retrospective observational study utilising national pharmaceutical dispensing records for topical corticosteroids and emollients for all New Zealand children aged 0–14 years from 1st January 2006 to 31st December 2019. Data are reported using descriptive statistics, with comparisons between ethnicities and socioeconomic quintiles undertaken with rate ratios. Results: Based on dispensing data, the prevalence of eczema for New Zealand children aged 0–14 years in 2018 was 14.0% (95% CI 14.0%–14.1%), with prevalence decreasing in older age groups (children aged <1 year 26.0% (25.6%–26.4%); children aged 10–14 years 8.8% (8.7%–8.9%)). Prevalence was higher in Pacific children (23.6% (23.3%–24.0%)), but slightly lower in Māori children (13.2% (13.0%–13.3%)). Conclusion: Eczema is a common condition affecting a considerable proportion of children in New Zealand. This study provides nationwide paediatric prevalence data for New Zealand, and highlights the increased burden of eczema in Pacific children. Inequity in dispensing of topical corticosteroids is postulated to explain the reduced rates found for Māori children compared to previous studies. These results support the need for further research to determine factors contributing to differing eczema prevalence rates in New Zealand. [ABSTRACT FROM AUTHOR]

Objective: To investigate associations of the Fetal Pillow® with maternal and neonatal morbidity. Design: Retrospective cohort. Setting: Two tertiary maternity units, New Zealand. Population or Sample: Full dilatation singleton, term, cephalic caesarean section, with three comparisons: at Unit A (1) before versus after introduction of the Fetal Pillow® (1 Jaunary 2016–31 October 2021); (2) with versus without the Fetal Pillow® after introduction (27 July 2017–31 October 2021); and (3) between Unit A and Unit B during the same time period (1 January 2019–31 October 2021). The Fetal Pillow® is unavailable at Unit B. Methods: Cases were ascertained and clinical data were extracted from electronic clinical databases and records. Outcome data were adjusted and presented as adjusted odds ratios (aOR) with 95% CI. Main Outcome Measures: Primary outcome "any" uterine incision extension; secondary outcomes included major extension (into adjacent structures), and a composite neonatal outcome. Results: In all, 1703 caesareans were included; 375 with the device and 1328 without. Uterine incision extension rates were: at Unit A before versus after introduction: 26.8% versus 24.8% (aOR 0.88, 95% CI 0.65–1.19); at Unit A with the Fetal Pillow® versus without: 26.1% versus 23.8% (aOR 1.14, 95% CI 0.83–1.57); and at Unit A versus Unit B: 24.2% versus 29.2% (aOR 0.73, 95% CI 0.54–0.99). No differences were found in major extensions, or neonatal composite outcome. Conclusions: Despite the relatively large size of this study, it could not rule out either a positive or a negative association between use of the Fetal Pillow® and uterine extensions, major uterine incision extensions, and neonatal morbidity. Randomised controlled trial evidence is required to assess efficacy. [ABSTRACT FROM AUTHOR]

Objective: We examined whether the risk of stillbirth was related to ambient air pollution in a UK population. Design: Prospective case–control study. Setting: Forty‐one maternity units in the UK. Population: Women who had a stillbirth ≥28 weeks' gestation (n = 238) and women with an ongoing pregnancy at the time of interview (n = 597). Methods: Secondary analysis of data from the Midlands and North of England Stillbirth case–control study only including participants domiciled within 20 km of fixed air pollution monitoring stations. Pollution exposure was calculated using pollution climate modelling data for NO2, NOx and PM2.5. The association between air pollution exposure and stillbirth risk was assessed using multivariable logistic regression adjusting for household income, maternal body mass index (BMI), maternal smoking, Index of Multiple Deprivation quintile and household smoking and parity. Main Outcome Measure: Stillbirth. Results: There was no association with whole pregnancy ambient air pollution exposure and stillbirth risk, but there was an association with preconceptual NO2 exposure (adjusted odds ratio [aOR] 1.06, 95% CI 1.01–1.08 per microg/m3). Risk of stillbirth was associated with maternal smoking (aOR 2.54, 95% CI 1.38–4.71), nulliparity (aOR 2.16, 95% CI 1.55–3.00), maternal BMI (aOR 1.05, 95% CI 1.01–1.08) and placental abnormalities (aOR 4.07, 95% CI 2.57–6.43). Conclusions: Levels of ambient air pollution exposure during pregnancy in the UK, all of were beneath recommended thresholds, are not associated with an increased risk of stillbirth. Periconceptual exposure to NO2 may be associated with increased risk but further work is required to investigate this association. [ABSTRACT FROM AUTHOR]

The association between intelligence and diet at 3.5 and 7 years was examined in 591 children of European descent. Approximately half of the children were born small-for-gestational age (birth weight @?10th percentile). The relationship between IQ and diet (measured by food frequency) was investigated using multiple regression analyses. Eating margarine at least daily was associated with significantly lower IQ scores at 3.5 years in the total sample and at 7 years in SGA children. For all children, eating the recommended daily number of breads and cereals was associated with significantly higher IQ scores at 3.5 years, and those who ate fish at least weekly had significantly higher IQ scores at 7 years than those who did not. The consumption of fish, breads and cereals commeasurable with nutritional guidelines may be beneficial to children's cognitive development. In contrast, consuming margarine daily was associated with poorer cognitive functioning. Further research is needed to identify the nutrients that may underlie this association. (Contains 2 tables.)

Dietary pattern analysis is typically based on dimension reduction and summarises the diet with a small number of scores. We assess 'joint and individual variance explained' (JIVE) as a method for extracting dietary patterns from longitudinal data that highlights elements of the diet that are associated over time. The Auckland Birthweight Collaborative Study, in which participants completed an FFQ at ages 3·5 (n 549), 7 (n 591) and 11 (n 617), is used as an example. Data from each time point are projected onto the directions of shared variability produced by JIVE to yield dietary patterns and scores. We assess the ability of the scores to predict future BMI and blood pressure measurements of the participants and make a comparison with principal component analysis (PCA) performed separately at each time point. The diet could be summarised with three JIVE patterns. The patterns were interpretable, with the same interpretation across age groups: a vegetable and whole grain pattern, a sweets and meats pattern and a cereal v. sweet drinks pattern. The first two PCA-derived patterns were similar across age groups and similar to the first two JIVE patterns. The interpretation of the third PCA pattern changed across age groups. Scores produced by the two techniques were similarly effective in predicting future BMI and blood pressure. We conclude that when data from the same participants at multiple ages are available, JIVE provides an advantage over PCA by extracting patterns with a common interpretation across age groups. [ABSTRACT FROM AUTHOR]

Objective: To assess speech outcomes at five and ten years of age in a nationwide study of children with orofacial cleft. Design: Prospective study. Participants: Children born with orofacial cleft and having primary surgery in New Zealand. Speech samples were available for 151 five-year-old, and 163 ten-year-old children. Main outcome measures: Intelligibility, Acceptability, Velopharyngeal function, Hypernasality, Hyponasality, severity of airflow evaluated by perceptual speech assessment (using the standardised Rhinocleft assessment), and overall assessment of requirement for clinical intervention. Results: A large proportion of five-year-old children had speech that was considered to be not completely intelligible, was not acceptable, and had inadequate velopharyngeal function. The noted deficiencies led to a clinical judgement that further speech and/or surgical intervention was required in 85% with cleft lip and palate, 65% with cleft palate and 26% with cleft lip. The proportion of children with poor speech outcomes in the ten-year-old children was lower, though of clinical importance, further intervention required for 25% with CLP, 15% with CP and 3% with CL. The number of sound production errors in both age groups followed the same pattern with fewest in those with CL and most in those with CLP. Conclusions: A significant proportion of children with orofacial cleft were found to have poor speech outcomes requiring further treatment. The outcomes are poor compared to centres reported in the UK and Scandinavia. New Zealand requires a review of the current services for individuals born with cleft to improve speech outcomes and interdisciplinary care. [ABSTRACT FROM AUTHOR]