The association between maternal and partner experienced racial discrimination and prenatal perceived stress, prenatal and postnatal depression: findings from the growing up in New Zealand cohort study

Background A growing number of studies document the association between maternal experiences of racial discrimination and adverse children’s outcomes, but our understanding of how experiences of racial discrimination are associated with pre- and post-natal maternal mental health, is limited. In addition, existent literature rarely takes into consideration racial discrimination experienced by the partner. Methods We analysed data from the Growing Up in New Zealand study to examine the burden of lifetime and past year experiences of racial discrimination on prenatal and postnatal mental health among Māori, Pacific, and Asian women in New Zealand (NZ), and to study the individual and joint contribution of mother’s and partner’s experiences of lifetime and past year racial discrimination to women’s prenatal and postnatal mental health. Results Our findings show strong associations between lifetime and past year experiences of ethnically-motivated interpersonal attacks and unfair treatment on mother’s mental health. Māori, Pacific, and Asian women who had experienced unfair treatment by a health professional in their lifetime were 66 % more likely to suffer from postnatal depression, compared to women who did not report these experiences. We found a cumulative effect of lifetime experiences of ethnically-motivated personal attacks on poor maternal mental health if both the mother and the partner had experienced a racist attack. Conclusions Experiences of racial discrimination have severe direct consequences for the mother’s mental health. Given the importance of mother’s mental health for the basic human needs of a healthy child, racism and racial discrimination should be addressed

Ethnic disparities in infectious disease hospitalisations in the first year of life in New Zealand.

Aim Infectious disease (ID) hospitalisation rates are increasing in New Zealand (NZ), especially in pre-school children, and Māori and Pacific people. We aimed to identify risk factors for ID hospitalisation in infancy within a birth cohort of NZ children, and to identify differences in risk factors between ethnic groups. Methods We investigated an established cohort of 6846 NZ children, born in 2009–2010, with linkage to a national data set of hospitalisations. We used multivariable logistic regression to obtain odds ratios (OR) for factors associated with ID hospitalisation in the first year of life, firstly for all children, and then separately for Māori or Pacific children. Results In the whole cohort, factors associated with ID hospitalisation were Māori (OR: 1.49, 95% CI: 1.17–1.89) or Pacific (2.51; 2.00–3.15) versus European maternal ethnicity, male gender (1.32; 1.13–1.55), low birthweight (1.94, 1.39–2.66), exclusive breastfeeding for Factors associated with ID hospitalisation for Māori infants were high household deprivation (2.16, 1.06–5.02) and maternal smoking (1.48, 1.02–2.14); and for Pacific infants were delayed immunisation (1.72, 1.23–2.38), maternal experience of health-care racism (2.20, 1.29–3.70) and maternal smoking (1.59, 1.10–2.29). Conclusions Māori and Pacific children in NZ experience a high burden of ID hospitalisation. Some risk factors, for example maternal smoking, are shared, while others are ethnic-specific. Interventions aimed at preventing ID hospitalisations should address both shared and ethnic-specific factors.</p

Ethnic disparities in infectious disease hospitalisations in the first year of life in New Zealand.

Aim Infectious disease (ID) hospitalisation rates are increasing in New Zealand (NZ), especially in pre-school children, and Māori and Pacific people. We aimed to identify risk factors for ID hospitalisation in infancy within a birth cohort of NZ children, and to identify differences in risk factors between ethnic groups. Methods We investigated an established cohort of 6846 NZ children, born in 2009–2010, with linkage to a national data set of hospitalisations. We used multivariable logistic regression to obtain odds ratios (OR) for factors associated with ID hospitalisation in the first year of life, firstly for all children, and then separately for Māori or Pacific children. Results In the whole cohort, factors associated with ID hospitalisation were Māori (OR: 1.49, 95% CI: 1.17–1.89) or Pacific (2.51; 2.00–3.15) versus European maternal ethnicity, male gender (1.32; 1.13–1.55), low birthweight (1.94, 1.39–2.66), exclusive breastfeeding for &lt;4 months (1.22, 1.04–1.43), maternal experience of health-care racism (1.60, 1.19–2.12), household deprivation (most vs. least deprived quintile of households (1.50, 1.12–2.02)), day-care attendance (1.43, 1.12–1.81) and maternal smoking (1.55, 1.26–1.91). Factors associated with ID hospitalisation for Māori infants were high household deprivation (2.16, 1.06–5.02) and maternal smoking (1.48, 1.02–2.14); and for Pacific infants were delayed immunisation (1.72, 1.23–2.38), maternal experience of health-care racism (2.20, 1.29–3.70) and maternal smoking (1.59, 1.10–2.29). Conclusions Māori and Pacific children in NZ experience a high burden of ID hospitalisation. Some risk factors, for example maternal smoking, are shared, while others are ethnic-specific. Interventions aimed at preventing ID hospitalisations should address both shared and ethnic-specific factors.</p

Serological Evidence of Immune Priming by Group A Streptococci in Patients with Acute Rheumatic Fever

Acute rheumatic fever (ARF) is an autoimmune response to Group A Streptococcus (GAS) infection. Repeated GAS exposures are proposed to ‘prime’ the immune system for autoimmunity. This notion of immune-priming by multiple GAS infections was first postulated in the 1960s, but direct experimental evidence to support the hypothesis has been lacking. Here we present novel methodology, based on antibody responses to GAS T‑antigens, that enables previous GAS exposures to be mapped in patient sera. T-antigens are surface expressed, type specific antigens and GAS strains fall into 18 major clades or T-types. A panel of recombinant T-antigens was generated and immunoassays were performed in parallel with serum depletion experiments allowing type-specific T‑antigen antibodies to be distinguished from cross-reactive antibodies. At least two distinct GAS exposures were detected in each of the ARF sera tested. Furthermore, no two sera had the same T-antigen reactivity profile suggesting that each patient was exposed to a unique series of GAS T‑types prior to developing ARF. The methods have provided much-needed experimental evidence to substantiate the immune-priming hypothesis, and will facilitate further serological profiling studies that explore the multifaceted interactions between GAS and the host