The Employment of Mothers and the Outcomes of their Pregnancies: An Australian Study

One of the more dramatic structural changes in a number of western industrial societies has involved the increased participation of women in the paid labour force. Little is known about the health consequences of this change. This paper reports the findings of a prospective longitudinal study of 8,556 pregnant women who were interviewed on three occasions; early in their pregnancy, shortly after the birth of the baby and some six months later. Additional data were derived from the medical record of the delivery. The findings suggest that employed women and housewives differ in their health behaviour (e.g. number of missed appointments, attendance at antenatal classes, smoking) and emotional health in pregnancy, but that there are no significant differences between employed women and housewives in their physical health or pregnancy outcomes. Although none of the differences was statistically significant, virtually all of the indices of outcome were slightly more favourable for the housewives than for the employed women

Information ontrol and the exercise of power in the obstetrical encounter

Interactions between doctor and patient involve participants with unequal power and possibly different interests. While a number of studies have focused upon the doctor/patient relationship, few have examined the utility of the concept of power and its capacity to help us understand the outcome of these interactions. The information sought by pregnant women from their obstetricians is used to provide a case study of one conceptualization and test of the utility of the concept of power. Pregnant women and their obstetricians are found to have different perceptions of the information that should be exchanged during their interactions. Women generally fail to obtain the information they want. Lower social class patients desire more and obtain less information than their higher status counterparts

Religious Values, Practices and Pregnancy Outcomes: A Comparison of the Impact of Sect and Mainstream Christian Affiliation

In this report 6566 women enrolled in the Mater-University of Queensland Study of Pregnancy (MUSP) were separated into three groups; members of religious sects, Christians who attend church frequently and Christians who are infrequent attenders. These three groups, respectively labelled Christian sects, Christian attenders and lukewarm Christians were compared on a number of social background, lifestyle and pregnancy outcome variables. The sect members appeared to have the most favourable health, lifestyles and healthy babies at delivery, though this latter finding appears attributable to specific characteristics of the mother and her lifestyle. On most measures the children of lukewarm Christians appear to manifest the worst health while Christian attenders form a group whose children's health is between that of sect members and lukewarm Christians

Child developmental delay and socio-economic disadvantage in Australia: A longitudinal study

Socio-economic inequalities in adult and child health in Australia have been an issue of national concern. While a large body of data has discussed adult health, there have been relatively few Australian reports of socioeconomic inequalities in child health. This occurs in a context where there have been increases in the proportion of Australian children living in poverty and where there has been an increased interest in child developmental delay as an indicator of child health status. This paper reports the result of a longitudinal study of pregnancy outcomes and one indicator of child health, namely child developmental delay. Three indicators of socio-economic status (chronic socio-economic disadvantage, mother's education, family income) were used to predict child developmental delays observed some 5: years after the study commenced. Mothers who had the lowest socio-economic status (using any of the indicators) had substantially higher rates of children manifesting developmental delays

Socioeconomic Disadvantage and Child Morbidity: An Australian Longitudinal Study

While an extensive body of literature has demonstrated an association between socioeconomic status and child mortality, there have been relatively few papers which discuss the impact of socioeconomic inequality on child morbidity. This absence of data is partly attributable to methodological problems (need for large samples, the difficulty of assessing morbidity) and partly to the absence of relevant official health statistics. This paper reports results from the Mater-University of Queensland Study of Pregnancy (MUSP) and its outcomes. The sample comprises 8556 consecutive pregnancies, of which over 90% were followed up to birth. Of those mothers giving birth, approx. 70% of children were successfully given a health assessment five years after the birth (mothers report of the child's health using a set of standard indicators). The results indicate a consistent pattern with the children of the most socioeconomically disadvantaged mothers manifesting the worst health. Thus children living in socioeconomic disadvantage have a higher rate of health service utilisation, more chronic health problems and poorer dental health. The paper discusses some social policies for redressing these inequalities

Examining parent and child agreement in the diagnosis of adolescent depression

Background: The diagnosis of depression in adolescents relies on identifying the presence of specific core and additional symptoms. Symptoms can be identified using structured or unstructured interviews and a range of questionnaire measures, which are completed by the young person and by a parent or carer. The aim of this research was to examine the inter- and intra-rater reliability of parent report and adolescent self-report of depression symptoms. Method: In a sample of parent-child dyads, where young people aged 13-17 were referred to a mental health service for depression, we examined adolescents’ (n = 46) and parents’ (n = 46) independent responses to the Schedule for Affective Disorders and Schizophrenia in School-Age Children (Kaufman et al., 1997) and the Mood and Feelings Questionnaire (Costello & Angold, 1988). Results: In the clinical interview, diagnostic criteria were more often met based on the adolescent’s report, and adolescents endorsed more symptoms of depression than their parents. Tentative results also suggest that parent-child agreement about specific symptoms was low. Comparing different measures of depression revealed that adolescent report on the questionnaire and interview was significantly correlated. However, there was no significant correlation between parent questionnaire and interview report. Conclusion: These results suggest that relying solely on parents to identify depression in their children may result in young people with depression being missed and therefore untreated. Young people themselves should be encouraged and enabled to recognise the symptoms of depression, and have an established pathway to services that offer assessment and treatment

A genome-wide association study of total child psychiatric problems scores

Substantial genetic correlations have been reported across psychiatric disorders and numerous cross-disorder genetic variants have been detected. To identify the genetic variants underlying general psychopathology in childhood, we performed a genome-wide association study using a total psychiatric problem score. We analyzed 6,844,199 common SNPs in 38,418 school-aged children from 20 population-based cohorts participating in the EAGLE consortium. The SNP heritability of total psychiatric problems was 5.4% (SE = 0.01) and two loci reached genome-wide significance: rs10767094 and rs202005905. We also observed an association of SBF2, a gene associated with neuroticism in previous GWAS, with total psychiatric problems. The genetic effects underlying the total score were shared with common psychiatric disorders only (attention-deficit/hyperactivity disorder, anxiety, depression, insomnia) (rG > 0.49), but not with autism or the less common adult disorders (schizophrenia, bipolar disorder, or eating disorders) (rG 0.29). The results suggest that many common genetic variants are associated with childhood psychiatric symptoms and related phenotypes in general instead of with specific symptoms. Further research is needed to establish causality and pleiotropic mechanisms between related traits.</p

Collecting food-related data from low socioeconomic groups: How adequate are our current research designs?

Australian researchers examining the relationship between socioeconomic status and food-related behaviour have often selected their samples from the electoral roll and then collected their data using a mail-survey method. These studies have generally found statistically significant associations between socioeconomic status and behaviour although these relationships are usually only weak-to-moderate in strength. Given the consistent and strong pattern of association between socioeconomic status and mortality, and diet acid mortality, there is a possibility that these studies may have used a research design that underestimates the magnitude of the association, To assess this possibility, results obtained using an electoral-roll sample and mail-survey method were compared with findings obtained by administering the same questionnaire directly to a sample of indigent clients contacted through a welfare agency. The comparison suggests that studies that draw their samples from electoral rails and then collect data using a mail-survey questionnaire may greatly understate the level of socioeconomic inequality in food-related behaviour in the wider community

Behaviour and accidents in young children and adolescents

The Mater-University Study of Pregnancy recruited a cohort of 8,458 Brisbane women during pregnancy. Subsequent follow-ups of mother and child occurred a few days, 6 months, 5 years and 14 years after birth,with the collection of a wide range of biological, sociological and behavioural information as well as measures of mental and physical health. In anticipation of a further cohort follow-up (funded by CARRS-Q) aimed specifically at examining risk-taking behaviour and road crashes in young drivers, the present paper examines the relationship between child and adolescent behaviour and the occurrence of accidents. his indicates that children with behaviour problems, particularly social and attentional disorders at age 5 years are nearly twice as likely to have had an accident in the past three months. While there is some evidence of continuity of accident occurrence (27% of children whose mother's reported an accident at age 5 years also were also reported to have had an accident requiring medical attention in the last year) this association was weak. Behaviour problems, as measured by the Child Services, police or juvenile Aid Bureau at age 14 also predict accident occurrence at age 14. 'Binge drinking' (consumption of seven or more alcoholic drinks at a time), while rare in this sample (2%) was associated with a doubling of accident risk. The next phase of MUSP will involve administering a questionnaire focused on risk taking behaviour to adolescents, followed up by later record linkage to accident reports and medical records to obtain end-points of road crashes and accident morbidity