Surveying social adversity in pregnancy: The antenatal risk burden experienced by Australian women

Goldfeld, Sharon; D'Abaco, Elise; Bryson, Hannah; Mensah, Fiona; Price, Anna

doi:10.1111/jpc.13860

Cited by 28 publications

(27 citation statements)

References 18 publications

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“…The larger cohort was representative of women seeking maternity care through Australian publicly funded hospitals (~70% of Australian births19) on factors including mode of birth, gestation and birth weight. The proportion of participants at socioeconomic disadvantage was similar to that of another community based study (15.6% vs 17.5%, respectively9), suggesting that socioeconomic disadvantage was appropriately represented in the larger cohort. Social and obstetric characteristics of the sample are reported in table 1.…”

Section: Resultssupporting

confidence: 77%

“…At 3 months postpartum, mothers completed items relating to their infant’s gender, length of gestation, birth weight and admittance to a neonatal intensive care unit/special care nursery. In line with prior research,9 mothers were categorised as being at socioeconomic disadvantage if they reported two or more of the following factors during pregnancy: not living with a partner, not working or studying, incomplete schooling (<12 years) or smoking during pregnancy. When their child turned 12 months old, mothers completed the Edinburgh Postnatal Depression Scale (EPDS), a 10-item self-report scale, with higher scores indicating more depressive symptoms (scores range from 0 to 30).…”

Section: Methodsmentioning

confidence: 99%

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Infant sleep and child mental health: a longitudinal investigation

et al. 2020

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ObjectiveTo determine whether infants with severe persistent sleep problems are at increased risk of (1) meeting diagnostic criteria for a psychiatric disorder (age 10 years), and (2) having elevated symptoms of mental health difficulties (ages 4 and 10 years), in comparison with infants with settled sleep.Design and settingProspective longitudinal community cohort study—the Maternal Health Study. Mothers completed questionnaires/interviews at 15 weeks' gestation; 3, 6, 9 and 12 months post partum; and when their child turned 4 and 10 years old. Measures included parental report of infant night waking and sleep problems and child mental health (Strengths and Difficulties Questionnaire; Spence Children’s Anxiety Scale; Development and Well-being Assessment).Participants1460 mother-infant dyads.Results283 (19.4%) infants had persistent severe sleep problems, 817 (56.0%) had moderate/fluctuating sleep problems and 360 (24.7%) infants were settled. Infants with persistent severe sleep problems were more likely to report emotional symptoms at age 4 (adjusted odds ratio (AOR)=2.70, 95% CI 1.21 to 6.05, p=0.02), and meet diagnostic criteria for an emotional disorder at age 10 (AOR=2.37, 95% CI 1.05 to 5.36, p=0.04). Infants with persistent severe sleep problems also had elevated symptoms of separation anxiety (AOR=2.44, 95% CI 1.35 to 4.41, p<0.01), fear of physical injury (AOR=2.14, 95% CI 1.09 to 4.18, p=0.03) and overall elevated anxiety (AOR=2.20, 95% CI 1.13 to 4.29, p=0.02) at age 10.ConclusionsInfants with persistent severe sleep problems during the first postnatal year have an increased risk of anxiety problems and emotional disorders at age 10.

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Section: Resultssupporting

confidence: 77%

Section: Methodsmentioning

confidence: 99%

Infant sleep and child mental health: a longitudinal investigation

et al. 2020

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“…18 We used a brief risk factor survey of 10 broad-ranging psychosocial and socioeconomic risk factors for poorer child outcomes developed and piloted for the study, which showed that 2 (17%) or more adverse risk factors identified 61% of women who reported other more sensitive risk factors (eg, alcohol and drug use and domestic violence) in the standard clinical appointment. 32 Eligible women (1) had due dates before October 1, 2014; (2) were <37 weeks' gestation; (3) had sufficient English to complete interviews; (4) had ≥2 of 10 risk factors identified at screening (Supplemental Table 4) 29,32 ; and (5) had home addresses within travel boundaries specified by participating areas. Women were excluded if they (1) were enrolled in an existing Tasmanian NHV program for 15-to 19-year-olds, (2) did not comprehend the recruitment invitation (eg, intellectual disability or insufficient English), (3) had no mechanism for contact (telephone number or e-mail address), or (4) experienced a critical event (eg, termination of pregnancy, stillbirth, or child death).…”

Section: Design and Participantsmentioning

confidence: 99%

Nurse Home Visiting for Families Experiencing Adversity: A Randomized Trial

Goldfeld

Price

Smith³

et al. 2019

Pediatrics

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103

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Nurse home visiting (NHV) may redress inequities in children's health and development evident by school entry. We tested the effectiveness of an Australian NHV program (right@home), offered to pregnant women experiencing adversity, hypothesizing improvements in (1) parent care, (2) responsivity, and (3) the home learning environment at child age 2 years. METHODS: A randomized controlled trial of NHV delivered via universal child and family health services was conducted. Pregnant women experiencing adversity (≥2 of 10 risk factors) with sufficient English proficiency were recruited from antenatal clinics at 10 hospitals across 2 states. The intervention comprised 25 nurse visits to child age 2 years. Researchers blinded to randomization assessed 13 primary outcomes, including Home Observation of the Environment (HOME) Inventory (6 subscales) and 25 secondary outcomes. RESULTS: Of 1427 eligible women, 722 (50.6%) were randomly assigned; 306 of 363 (84%) women in the intervention and 290 of 359 (81%) women in the control group provided 2-year data. Compared with women in the control group, those in the intervention reported more regular child bedtimes (adjusted odds ratio 1.76; 95% confidence interval [CI] 1.25 to 2.48), increased safety (adjusted mean difference [AMD] 0.22; 95% CI 0.07 to 0.37), increased warm parenting (AMD 0.09; 95% CI 0.02 to 0.16), less hostile parenting (reverse scored; AMD 0.29; 95% CI 0.16 to 0.41), increased HOME parental involvement (AMD 0.26; 95% CI 0.14 to 0.38), and increased HOME variety in experience (AMD 0.20; 95% CI 0.07 to 0.34). CONCLUSIONS: The right@home program improved parenting and home environment determinants of children's health and development. With replicability possible at scale, it could be integrated into Australian child and family health services or trialed in countries with similar child health services.

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“…Indicators of adversity often cluster; whereby children living in families experiencing one type of adversity are more likely to experience others (Goldfeld, D'Abaco, Bryson, Mensah, & Price, 2018;Sabates & Dex, 2015). This cumulative burden is associated with increasingly poor lifelong health outcomes (Chartier, Walker, & Naimark, 2010;Sabates & Dex, 2015).…”

Section: Introductionmentioning

confidence: 99%

Hair cortisol as a measure of the stress response to social adversity in young children

Bryson

Goldfeld

Price

et al. 2019

Developmental Psychobiology

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Hair cortisol has the potential to provide insight into young children's long-term stress response to social adversity. This study investigated associations between children's exposure to adversity from pregnancy to 2 years of age and their hair cortisol at 2 years, using a longitudinal cohort of children enriched for adversity risk, whose mothers were recruited during pregnancy through the "right@home" trial. Exposures were 18 maternal socioeconomic and psychosocial indicators of adversity, examined as concurrent, cumulative, and longitudinal exposure from pregnancy to 2 years. Hair samples were analyzed from 319/603 (53%) children participating at 2 years.Multivariable regression analyses for concurrent exposure showed three indicators of adversity were associated with higher hair cortisol (housing tenure of public rental, paying board or living rent free; not living in a safe place; higher maternal stress symptoms), one with lower hair cortisol (housing problems), and 14 indicators with no evidence of association. There was no evidence of association for the cumulative adversity count. Longitudinal exposure showed "intermittent" and "persistent" high maternal stress symptoms were associated with higher hair cortisol. The small number of associations identified suggests that hair cortisol is limited as a measure of stress response to social adversity in children at 2 years. K E Y W O R D Sadverse childhood experiences, child, hair cortisol, social adversity, stress

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Surveying social adversity in pregnancy: The antenatal risk burden experienced by Australian women

Cited by 28 publications

References 18 publications

Infant sleep and child mental health: a longitudinal investigation

Infant sleep and child mental health: a longitudinal investigation

Nurse Home Visiting for Families Experiencing Adversity: A Randomized Trial

Hair cortisol as a measure of the stress response to social adversity in young children

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