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Biomedical subjects

E A Mitchell

Publications and source records attributed to E A Mitchell.

At least 109 records · Page 6Linked to original sources
PubMed1995

Infant feeding patterns in Canterbury.

AIM: To examine infant feeding patterns during the first 6 months of life in Canterbury. METHODS: A random sample of 10% of all births over a 12 month period in Canterbury was taken from birth notifications (n = 520). Information on the type of feeding was recorded prospectively at three time periods and extracted from available Plunket nursing notes. The participation rate was 81%. Data from nonparticipants on the method of feeding at discharge was obtained from obstetric records. RESULTS: Overall, 90.7% were breastfed at discharge. There was no difference between breastfeeding rates of the participants (91%) compared to the nonparticipants. For participants, 88% were exclusively breastfed at discharge which steadily declined to 36% at 24 weeks. However, some breastmilk was still being given to 70% at 24 weeks. CONCLUSION: Breastfeeding rates are good in comparison to other nations. However, there is room for improvement particularly maintaining exclusive breastfeeding to at least four months. This could be stimulated by the Baby Friendly Hospital Initiative and the fostering of a baby friendly environment to further support and promote breastfeeding in the community.

Adolescent↗
PubMed1995

Factors associated with the age of introduction of solids into the diet of New Zealand infants. New Zealand Cot Death Study Group.

OBJECTIVE: To describe the current timing of the introduction of solids in infancy and the factors influencing the decision to introduce solids. METHODOLOGY: Eighteen hundred infants were selected randomly as part of the New Zealand Cot Death Study. Of these, 88% of the parent/caregivers were interviewed when their infant was aged between 1 and 12 months. They were asked when solids were first introduced into the diet. RESULTS: By 12 weeks of age more than 20% of infants had been given solids; by 16 weeks and by 6 months 50 and 90% of babies, respectively, had been given solids. Maternal smoking, low educational achievement and not being breast-fed exclusively to 4 weeks of age were factors which were strongly associated with the early introduction of solids. CONCLUSION: Half of New Zealand infants are being started on solids earlier than is presently recommended. More education is needed to promote the later introduction of solid foods into the diet.

Age Factors↗
PubMed1995

Antenatal and intrapartum factors associated with sudden infant death syndrome in the New Zealand Cot Death Study.

OBJECTIVE: To describe the relationship between antenatal and intrapartum factors and sudden infant death syndrome (SIDS). METHODOLOGY: The New Zealand Cot Death Study was a 3 year case-control study, with 485 infants who died from SIDS in the postneonatal period and 1800 randomly selected control infants. Data were obtained from obstetric records, parental interview and community nursing records. RESULTS: This study confirms many of the antenatal and intrapartum risk factors for SIDS noted in studies from both the southern and northern hemispheres. After controlling for potential confounders, such as occupational group and marital status, significant inverse effects were noted for interpregnancy interval, birthweight and gestation. Other factors that retained a significantly increased risk of SIDS were: increasing parity, bacteriological evidence of urinary tract infection (UTI) (adjusted odds ratio 1.73, 95% CI 1.10-2.73); smoking antenatally (AdjOR 2.14, 95% CI 1.61-2.84); less than six antenatal checks attended (AdjOR 1.84, 95% CI 1.19-2.84); second stage of labour less than 16 min (AdjOR 2.06, 95% CI 1.35-3.14) and multiple birth (AdjOR 3.23, 95% CI 1.70-6.02). No interaction was observed between maternal haemoglobin and antenatal smoking. Interactions were tested for and not found between antenatal smoking and three antenatal risk factors (UTI, short second stage of labour and number of antenatal appointments). The only significant interaction between these three factors and three modifiable postnatal risk factors (prone sleeping, bed sharing and bottle feeding) was between bed sharing and fewer antenatal appointments. The risk of SIDS associated with bed sharing was greater among those whose mothers had fewer antenatal appointments. CONCLUSIONS: Although many of the previously identified antenatal and intrapartum risk factors for SIDS are confirmed, the risks of SIDS associated with obstetric factors are in general considerably lower than the risks associated with the four modifiable postnatal risk factors.

Case-Control Studies↗
PubMed1995

Are nappy sterilisers associated with SIDS? New Zealand Cot Death Study Group.

Chemicals used to clean nappies have been suggested as a cause of sudden infant death syndrome (SIDS). Parents of 393 cases and 1592 controls were questioned about nappy cleaning procedures. Soaking in sterilisers followed by rinsing in water had a relative risk of 0.91 compared with other cleaning procedures. Nappy cleaning methods are not related to SIDS.

Case-Control Studies↗
PubMed1995

Immunisation and the sudden infant death syndrome. New Zealand Cot Death Study Group.

AIMS: To examine the relation between immunisation and the risk of sudden infant death syndrome (SIDS). METHODS: A large nationwide case-control study. Parental held records were used to measure immunisation status. RESULTS: Infants were at increased risk of SIDS if they had not received the 6 week, 3 month, and 5 month immunisations. After controlling for potential confounding variables, including those which measured health care use and infant illness, the relative risk of SIDS for infants not being immunised at 6 weeks was 2.1 (95% confidence interval = 1.2, 3.5). Four percent of cases died within four days of immunisation and 7.6% of control infants had been immunised within four days of the nominated date. There was a reduced chance of SIDS in the four days immediately following immunisation (OR = 0.5; 95% CI = 0.2 to 0.9). CONCLUSIONS: Immunisation does not increase the risk of SIDS and may even lower the risk.

Case-Control Studies↗
PubMed1995

Sudden infant death syndrome in New Zealand: are risk scores useful? New Zealand National Cot Death Study Group.

STUDY OBJECTIVE: To evaluate the Christchurch, Invercargill, Dunedin (CID) and Oxford record linkage study (ORLS) risk scores in five regions of New Zealand and examine the effect of risk factors for sudden infant death syndrome (SIDS), such as prone sleeping position, maternal smoking, breast feeding, measures of illness, the use of antenatal classes, community health care, and medical services on a high and low risk group delineated by the CID score. DESIGN: This was a case-control study of infants dying of SIDS. SETTING: Both the cases and controls were born in one of five health districts in New Zealand and their parents were interviewed between 1 November 1987 and 31 October 1990. PARTICIPANTS: The cases were 485 infants who died of SIDS. The controls were a random sample drawn from the same five regions in which the cases were born, chosen so that their age on the day on which they were interviewed was similar to the age at death of the cases. Risk scores were calculated for 387 case and 1579 controls. MEASUREMENTS AND MAIN RESULTS: Using the recommended cut off points the sensitivity and specificity of the CID and ORLS were found to be similar to those described for other samples. The differences among the regions were significant. There was, however, no evidence that the association between SIDS and the risk factors considered was different in the high and low risk groups delineated by the CID score. The relative attributable risk for smoking was 32.3% in the high risk group. The excess risk that could be attributed to a different prevalence of any of the other risk factors in the high risk group was small when compared with the low risk group. CONCLUSIONS: Health care resources should be spent on promoting and evaluating good child care practices for all, rather than identifying and promoting special interventions for those in the high risk category.

Breast Feeding↗
PubMed1995

International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods.

The aetiology of asthma and allergic disease remains poorly understood, despite considerable research. The International Study of Asthma and Allergies in Childhood (ISAAC), was founded to maximize the value of epidemiological research into asthma and allergic disease, by establishing a standardized methodology and facilitating international collaboration. Its specific aims are: 1) to describe the prevalence and severity of asthma, rhinitis and eczema in children living in different centres, and to make comparisons within and between countries; 2) to obtain baseline measures for assessment of future trends in the prevalence and severity of these diseases; and 3) to provide a framework for further aetiological research into genetic, lifestyle, environmental, and medical care factors affecting these diseases. The ISAAC design comprises three phases. Phase 1 uses core questionnaires designed to assess the prevalence and severity of asthma and allergic disease in defined populations. Phase 2 will investigate possible aetiological factors, particularly those suggested by the findings of Phase 1. Phase 3 will be a repetition of Phase 1 to assess trends in prevalence.

Adolescent↗
PubMed1994

Observations on ethnic differences in SIDS mortality in New Zealand.

INTRODUCTION: Within New Zealand the SIDS mortality rate is higher in Maori than in non-Maori, predominantly European. AIMS: This paper addresses two questions (1) How should ethnicity be defined, by biological or cultural criteria? (2) Why is the SIDS rate higher in Maori, because of different risk factors or because of a higher prevalence of common risk factors? METHODS: A nationwide case-control study. RESULTS: The majority of mothers with some Maori blood (as reported on the infants birth registration form) report they are Maori (as recorded in the obstetric records or interview). Risk factors for SIDS are similar in the various ethnic groups in New Zealand. CONCLUSIONS: Using a biological definition underestimates the number of Maori infants compared to the cultural definition. Differences in SIDS mortality appear to be explained by differences in prevalence of known risk factors, the most important of which, prone sleeping position, maternal smoking, lack of breast feeding and bed sharing, are culturally determined rather than biologically.

Case-Control Studies↗
PubMed1994

Risk factors for small for gestational age infants: a New Zealand study. New Zealand Cot Death Study Group.

AIM: The aim was to identify risk factors for small for gestational age infants. METHOD: Case-control study. The study population was 1800 infants selected randomly from all babies born over a three year period over 78% of the country. Of these 1800 infants, 85 (4.8%) were classified as preterm (< 37 weeks completed gestation) and were excluded. 157 (8.9%) were classified as small for gestational age (cases) and 1519 (86.3%) were fullterm, nonsmall for gestational age infants (controls). Risk factors were investigated using data collected from obstetric records and parental interviews. RESULTS: Risk factors associated with small for gestational age after controlling for potential confounders included maternal smoking during pregnancy (Odds ratio (OR) 2.61, 95% confidence interval (CI) 1.65, 4.15), primiparity (OR 2.96, 95% CI 1.59, 5.48), lack of antenatal care in the first trimester (OR 1.83, 95% CI 1.13, 2.98) and young age when mother left school (OR 1.56, 95% CI 1.01, 2.41). Use of marijuana in pregnancy significantly increased risk of small for gestational age at the 6% level (OR = 1.86, 95% CI 0.98, 3.52). The population attributable risk for maternal smoking was 31.1% (95% CI 18.2, 41.9). CONCLUSION: Maternal smoking was the most important modifiable risk factor in this dataset for small for gestational age.

Adolescent↗
PubMed1994

Sex specific birthweight percentiles by gestational age for New Zealand.

AIM: To produce sex specific percentiles by gestational age for New Zealand infants. METHODS: Gestational age (completed weeks) and birthweight (10 g multiples) was obtained for all births in New Zealand in 1990 and 1991. Outliers were identified and removed, the data was normalised at each gestational age and percentiles produced. RESULTS: The percentile charts were produced for gestational ages 24 to 44 weeks by sex of infant. There was an approximate difference of 100 g between male and female birthweight at all gestational ages. DISCUSSION: These are the first national birthweight percentile charts for New Zealand. As they may vary over time we recommend they be updated every 5 years.

Biometry↗
PubMed1994

Well health care and the sudden infant death syndrome.

The aim of this study was to examine whether poor attendance at routine antenatal and postnatal 'well child' health services was associated with a higher risk of sudden infant death syndrome (SIDS, or cot death). A nationwide case-control study of SIDS in New Zealand enrolled 485 postneonatal deaths due to SIDS and 1800 control infants who were selected randomly. The risk for SIDS was found to be higher for infants whose mothers attended their first antenatal check later than 3 months into the pregnancy, made fewer antenatal visits, and did not go to antenatal education classes. However, this increased risk was largely explained by high parity, maternal smoking, the mother not being married, mother being < 20 years old at the birth of her first child, and delivery during the winter months. Infants not attending a 6 week postnatal check had an almost three-fold increased risk of SIDS compared with those who did attend (odds ratio [OR] 2.86; 95% confidence interval [CI] 1.93, 4.24). Similarly, infants not attending well child clinics were at increased risk of SIDS (OR 2.75; 95% CI 2.09, 3.62). These differences persisted when adjusted for likely confounders. This study demonstrates that infants who miss child health nurse clinics are those most at risk for SIDS and are those who warrant increased surveillance.

Case-Control Studies↗
PubMed1994

Prevalence, severity and medical management of asthma in European school children in 1985 and 1991.

This present study, conducted in 1991, examined trends in the prevalence, severity and medical management of asthma in European school children by repeating the protocol of a study performed in 1985, using the same schools and questionnaire. One thousand, nine hundred and one children in 1991 were compared with 1084 children in 1985. The prevalence of respiratory symptoms increased significantly by approximately one-third, although the increase in the diagnostic label 'asthma' did not increase significantly. Asthma severity indices (> 12 asthma attacks in the last 12 months and symptoms in the last month) were not significantly increased, except for night cough in the last month (1985 7.0%, 1991 9.9%, P = 0.008). In 1991, children with wheeze in the last 12 months were more likely to be diagnosed as having asthma and treated with bronchodilators and prophylactic drugs than in 1985. We conclude that the prevalence of asthma symptoms has increased from 1985 to 1991, but the two indices of severity of asthma are mostly unchanged. Diagnosis of asthma in children with symptoms has improved but asthma still appears underrecognized. Drug treatment of asthma has increased.

Adolescent↗