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  • 1.
    Butler, Eadaoin M.
    et al.
    Better Start Natl Sci Challenge, Auckland, New Zealand.;Univ Auckland, Liggins Inst, Private Bag 92019, Auckland, New Zealand..
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Better Start Natl Sci Challenge, Auckland, New Zealand.; Univ Auckland, Liggins Inst, Auckland, New Zealand..
    Taylor, Rachael W.
    Better Start Natl Sci Challenge, Dunedin, New Zealand.;Univ Otago, Dunedin Sch Med, Dunedin, New Zealand..
    Cutfield, Wayne S.
    Better Start Natl Sci Challenge, Auckland, New Zealand.;Univ Auckland, Liggins Inst, Private Bag 92019, Auckland, New Zealand..
    Childhood obesity: how long should we wait to predict weight?2018In: Journal of Pediatric Endocrinology & Metabolism (JPEM), ISSN 0334-018X, E-ISSN 2191-0251, Vol. 31, no 5, p. 497-501Article, review/survey (Refereed)
    Abstract [en]

    Obesity is highly prevalent in children under the age of 5 years, although its identification in infants under 2 years remains difficult. Several clinical prediction models have been developed for obesity risk in early childhood, using a number of different predictors. The predictive capacity (sensitivity and specificity) of these models varies greatly, and there is no agreed risk threshold for the prediction of early childhood obesity. Of the existing models, only two have been practically utilized, but neither have been particularly successful. This commentary suggests how future research may successfully utilize existing early childhood obesity prediction models for intervention. We also consider the need for such models, and how targeted obesity intervention may be more effective than population-based intervention.

  • 2.
    Butler, Eadaoin M.
    et al.
    Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Liggins Inst, Private Bag 92019,Victoria St West, Auckland 1142, New Zealand.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Liggins Inst, Private Bag 92019,Victoria St West, Auckland 1142, New Zealand.
    Taylor, Rachael W.
    Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Otago, Dept Med, Dunedin, New Zealand.
    Cutfield, Wayne S.
    Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Liggins Inst, Private Bag 92019,Victoria St West, Auckland 1142, New Zealand.
    Prediction Models for Early Childhood Obesity: Applicability and Existing Issues2018In: Hormone Research in Paediatrics, ISSN 1663-2818, E-ISSN 1663-2826, Vol. 90, no 6, p. 358-367Article, review/survey (Refereed)
    Abstract [en]

    Statistical models have been developed for the prediction or diagnosis of a wide range of outcomes. However, to our knowledge, only 7 published studies have reported models to specifically predict overweight and/or obesity in early childhood. These models were developed using known risk factors and vary greatly in terms of their discrimination and predictive capacities. There are currently no established guidelines on what constitutes an acceptable level of risk (i.e., risk threshold) for childhood obesity prediction models, but these should be set following consideration of the consequences of false-positive and false-negative predictions, as well as any relevant clinical guidelines. To date, no studies have examined the impact of using early childhood obesity prediction models as intervention tools. While these are potentially valuable to inform targeted interventions, the heterogeneity of the existing models and the lack of consensus on adequate thresholds limit their usefulness in practice. 

  • 3.
    Butler, Eadaoin M.
    et al.
    Univ Auckland, Liggins Inst, Private Bag 92019, Auckland 1142, New Zealand;Better Start Natl Sci Challenge, Auckland, New Zealand.
    Suhag, Alisha
    Univ Auckland, Liggins Inst, Private Bag 92019, Auckland 1142, New Zealand;Univ Bristol, Dept Expt Psychol, Bristol, Avon, England.
    Hong, Ye
    Zhejiang Univ, Childrens Hosp, Dept Endocrinol, Sch Med, 57 Zhugan Ave, Hangzhou 310003, Zhejiang, Peoples R China.
    Liang, Li
    Zhejiang Univ, Sch Med, Affiliated Hosp 1, Hangzhou, Zhejiang, Peoples R China.
    Gong, Chunxiu
    Capital Med Univ, Beijing Childrens Hosp, Beijing, Peoples R China.
    Xiong, Feng
    Chongqing Med Univ, Childrens Hosp, Chongqing, Peoples R China.
    Luo, Feihong
    Fudan Univ, Childrens Hosp Shanghai, Dept Endocrinol, Shanghai, Peoples R China.
    Liu, Geli
    Tianjin Med Univ, Gen Hosp, Tianjin, Peoples R China.
    Chen, Shaoke
    Maternal & Children Hlth Hosp Guangxi Zhuang Auto, Nanning, Peoples R China.
    Taylor, Rachael W.
    Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Otago, Dept Med, Dunedin, New Zealand.
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Private Bag 92019, Auckland 1142, New Zealand;Better Start Natl Sci Challenge, Auckland, New Zealand.
    Fu, JunFen
    Zhejiang Univ, Childrens Hosp, Dept Endocrinol, Sch Med, 57 Zhugan Ave, Hangzhou 310003, Zhejiang, Peoples R China.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Zhejiang Univ, Childrens Hosp, Dept Endocrinol, Sch Med, 57 Zhugan Ave, Hangzhou 310003, Zhejiang, Peoples R China;Univ Auckland, Liggins Inst, Private Bag 92019, Auckland 1142, New Zealand;Better Start Natl Sci Challenge, Auckland, New Zealand.
    Parental Perceptions of Obesity in School Children and Subsequent Action2019In: CHILDHOOD OBESITY, ISSN 2153-2168, Vol. 15, no 7, p. 459-467Article in journal (Refereed)
    Abstract [en]

    Background: Despite perceiving their child as being above a healthy weight, many parents do not intervene. Little is known about the factors influencing parental action. We assessed parental perception of child's weight status, the prevalence of mitigating parental action, and the underlying factors.

    Methods: We studied 20,242 children and adolescents from 6 centers across China. Anthropometry was measured by research nurses. Parents answered questionnaires, including their perception of their child's weight status, and any subsequent weight treatment.

    Results: A total of 3254 children had obesity (16.1%), with 63.0% correctly perceived as overweight by their parents. These children were more likely to be older (>= 8 years; p < 0.0001), have severe obesity [adjusted relative risk (aRR) 1.41; p < 0.0001], and have mothers with overweight/obesity (aRR 1.15; p < 0.0001). In particular, parents of children aged <8 years were over five times more likely to perceive their child with overweight/obesity as "thin" than parents of teenagers. Conversely, girls, older children/adolescents, and urban youth were more likely to be wrongly perceived by parents as having an overweight issue. Only one in four children (27.8%) with available information received treatment for their perceived weight problem. Children with severe obesity were more likely to be treated (aRR 1.34; p < 0.0001), as were children of mothers with overweight/obesity (aRR 1.18; p = 0.002).

    Conclusions: Only one in four Chinese children perceived as overweight by their parents received treatment for their weight problem. Given that overweight/obesity in childhood tracks into adulthood and many parents did not intervene despite perceiving an overweight problem in their child, interventions for childhood obesity need to extend beyond parental perception of children's weight status.

  • 4.
    Chiavaroli, Valentina
    et al.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Pescara Publ Hosp, Neonatal Intens Care Unit, Pescara, Italy.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand.
    Jalaludin, Muhammad Y.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Malaya, Fac Med, Kuala Lumpur, Malaysia.
    Albert, Benjamin B.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Auckland Dist Hlth Board, Starship Childrens Hlth, Auckland, New Zealand.
    Ramkumar, Selvarajan
    Apollo Hosp, Dept Endocrinol, Chennai, Tamil Nadu, India;Madras Med Coll & Govt Gen Hosp, Dept Endocrinol, Chennai, Tamil Nadu, India.
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand;Auckland Dist Hlth Board, Starship Childrens Hlth, Auckland, New Zealand.
    Hofman, Paul L.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Auckland Dist Hlth Board, Starship Childrens Hlth, Auckland, New Zealand.
    Jefferies, Craig A.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Auckland Dist Hlth Board, Starship Childrens Hlth, Auckland, New Zealand.
    Partial remission in type 1 diabetes and associated factors: Analysis based on the insulin dose-adjusted hemoglobin A1c in children and adolescents from a regional diabetes center, Auckland, New Zealand2019In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 20, no 7, p. 892-900Article in journal (Refereed)
    Abstract [en]

    Background Partial remission (PREM) by the insulin dose-adjusted HbA1c (IDAA1c) method has not been evaluated for the combined associations of ethnicity and socioeconomic status in children and adolescents with type 1 diabetes (T1D). Objective To investigate prevalence and predictors of PREM defined by IDAA1c. Methods Six hundred fourteen of 678 children (aged <15 years) with new-onset T1D (2000-2013) from a regional pediatric diabetes service (Auckland, New Zealand). Results Overall rate of PREM at 3 months was 42.4%, and lower in Maori/Pacific children (28.6%; P = .006) and those of other ethnicities (28.8%; P = .030) compared with New Zealand Europeans (50.4%). Comparing the most and least deprived socioeconomic quintiles, the odds of PREM were lower among the most deprived (adjusted odds ratio [aOR] 0.44; P = .019). Lower rates of PREM were seen in children aged 0 to 4.9 years (23.8%) and 10 to 14 years (40.9%) than in children aged 5 to 9.9 years (57.4%; P < .05). Further predictors of lower rates of PREM were ketoacidosis at diagnosis (aOR 0.54 with DKA; P = .002) and diabetes duration (aOR 0.84 per month; P < .0001). Patient's sex, body mass index standard deviation score, or autoantibodies were not associated with PREM. PREM at 3 months was associated with lower HbA1c over 18 months compared with children not in PREM (65.0 vs 71.3 mmol/mol; P < .0001), independent of ketoacidosis. Conclusions This study on a regional cohort of youth with T1D showed social and ethnic disparities in rates of PREM defined by IDAA1c. Further research into reducing ketoacidosis rates at diagnosis and addressing factors associated with lower rates of PREM in non-European children are important health priorities.

  • 5.
    Chiavaroli, Valentina
    et al.
    Pescara Publ Hosp, Neonatal Intens Care Unit, Pescara, Italy.
    Gibbins, John D.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand;Zhejiang Univ, Sch Med, Childrens Hosp, Dept Endocrinol, Hangzhou, Zhejiang, Peoples R China.
    Derraik, Jose G. B.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand;Zhejiang Univ, Sch Med, Childrens Hosp, Dept Endocrinol, Hangzhou, Zhejiang, Peoples R China;Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden.
    Childhood obesity in New Zealand2019In: World Journal of Pediatrics, ISSN 1708-8569, E-ISSN 1867-0687, Vol. 15, no 4, p. 322-331Article, review/survey (Refereed)
    Abstract [en]

    Background: Paediatric obesity has reached epidemic proportions globally, resulting in significant adverse effects on health and wellbeing. Early life events, including those that happen before, during, and after pregnancy can predispose children to later obesity. The purpose of this review is to examine the magnitude of obesity among New Zealand children and adolescents, and to determine their underlying risk factors and associated comorbidities.

    Data sources: PubMed, Web of Science, and Google Scholar searches were performed using the key terms "obesity", "overweight", "children", "adolescents", and "New Zealand".

    Results: Obesity is a major public health concern in New Zealand, with more than 33% of children and adolescents aged 2-14 years being overweight or obese. Obesity disproportionately affects Maori (New Zealand's indigenous population) and Pacific children and adolescents, as well as those of lower socioeconomic status. New Zealand's obesity epidemic is associated with numerous health issues, including cardiometabolic, gastrointestinal, and psychological problems, which also disproportionately affect Maori and Pacific children and adolescents. Notably, a number of factors may be useful to identify those at increased risk (such as demographic and anthropometric characteristics) and inform possible interventions.

    Conclusions: The prevalence of overweight and obese children and adolescents in New Zealand is markedly high, with a greater impact on particular ethnicities and those of lower socioeconomic status. Alleviating the current burden of pediatric obesity should be a key priority for New Zealand, for the benefit of both current and subsequent generations. Future strategies should focus on obesity prevention, particularly starting at a young age and targeting those at greatest risk.

  • 6.
    Chiavaroli, Valentina
    et al.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Hopkins, Sarah A.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand.
    Biggs, Janene B.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Rodrigues, Raquel O.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Brennan, Christine H.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Seneviratne, Sumudu N.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Colombo, Dept Paediat, Fac Med, Colombo, Sri Lanka.
    Higgins, Chelsea
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Baldi, James C.
    Univ Otago, Dunedin Sch Med, Dept Med, Dunedin, New Zealand.
    McCowan, Lesley M. E.
    Univ Auckland, Dept Obstet & Gynaecol, Fac Med & Hlth Sci, Auckland, New Zealand.
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand.
    Hofman, Paul L.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Exercise in pregnancy: 1-year and 7-year follow-ups of mothers and offspring after a randomized controlled trial2018In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 8, article id 12915Article in journal (Refereed)
    Abstract [en]

    There are limited data on long-term outcomes of mothers or their offspring following exercise interventions during pregnancy. We assessed long-term effects of an exercise intervention (home-based stationary cycling) between 20-36 weeks of gestation on anthropometry and body composition in mothers and offspring after 1 and 7 years. 84 women were randomised to intervention or usual activity, with follow-up data available for 61 mother-child pairs (38 exercisers) at 1 year and 57 (33 exercisers) at 7 years. At 1 year, there were no observed differences in measured outcomes between mothers and offspring in the two groups. At the 7-year follow-up, mothers were mostly similar, except that exercisers had lower systolic blood pressure (-6.2 mmHg; p = 0.049). However, offspring of mothers who exercised during pregnancy had increased total body fat (+3.2%; p = 0.034) and greater abdominal (+4.1% android fat; p = 0.040) and gynoid (+3.5% gynoid fat; p = 0.042) adiposity compared with controls. Exercise interventions beginning during pregnancy may be beneficial to long-term maternal health. However, the initiation of exercise during pregnancy amongst sedentary mothers may be associated with adverse effects in the offspring during childhood. Larger follow-up studies are required to investigate long-term effects of exercise in pregnancy.

  • 7.
    Derraik, Jose G. B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. A Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Albert, Benjamin B.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    de Bock, Martin
    Univ Otago, Dept Paediat, Christchurch, New Zealand;Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Butler, Eadaoin M.
    A Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Hofman, Paul L.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Cutfield, Wayne S.
    A Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Socioeconomic status is not associated with health-related quality of life in a group of overweight middle-aged men2018In: PeerJ, ISSN 2167-8359, E-ISSN 2167-8359, Vol. 6, article id e5193Article in journal (Refereed)
    Abstract [en]

    Socioeconomic status is a known determinant of health. In secondary data analyses, we assessed whether socioeconomic status affected health-related quality of life in a group of overweight (body mass index 25-30 kg/m(2)) middle-aged (45.9 +/- 5.4 years) men, recruited in Auckland (New Zealand). Health-related quality of life was assessed with SF-36v2 three times: at baseline, and 12 and 30 weeks later. Socioeconomic status was determined by geo-coded deprivation scores derived from current address using the New Zealand Index of Deprivation 2006 (NZDep2006), as well as capital value of residence. Univariable and multivariable analyses showed no associations between measures of socioeconomic status and any mental or physical health domains. Our findings may reflect the fact that these men are not currently experiencing comorbidities associated with overweight.

  • 8.
    Derraik, Jose G. B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Private Bag 92019, Auckland 1142, New Zealand;A Better Start Natl Sci Challenge, Auckland, New Zealand.
    Butler, Eadaoin M.
    Univ Auckland, Liggins Inst, Private Bag 92019, Auckland 1142, New Zealand;A Better Start Natl Sci Challenge, Auckland, New Zealand.
    Rerkasem, Kittipan
    Chiang Mai Univ, Chiang Mai, Thailand.
    Publishing Without Perishing: A Guide to the Successful Reporting of Clinical Data2019In: International Journal of Lower Extremity Wounds, ISSN 1534-7346, E-ISSN 1552-6941, Vol. 18, no 3, p. 219-227, article id UNSP 1534734619865860Article, review/survey (Refereed)
    Abstract [en]

    Many researchers find writing a scientific manuscript a highly discouraging task. This problem may be partly responsible for the fact that approximately half of completed clinical studies worldwide remain unreported or unpublished. Therefore, we aimed to create a user-friendly guide with helpful recommendations, which are complementary to the many existing reporting guidelines for quantitative clinical data. This article has been prepared with clearly defined subheadings, to facilitate quick identification of any specific sections/topics. We encourage the use of the IMRaD model (ie, Introduction, Methods, Results, and Discussion), providing guidance on the key information required, as well as the dos and don'ts. We also comment briefly on feedback and rejection, proposing the I AM approach (Ignore, Address, and Move on).

  • 9.
    Derraik, Jose G. B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand.
    Chiavaroli, Valentina
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Hopkins, Sarah A.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Biggs, Janene B.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Rodrigues, Raquel O.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Seneviratne, Sumudu N.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Colombo, Dept Paediat, Fac Med, Colombo, Sri Lanka.
    McCowan, Lesley M. E.
    Univ Auckland, Dept Obstet & Gynaecol, Fac Med & Hlth Sci, Auckland, New Zealand.
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand.
    Hofman, Paul L.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Greater Maternal BMI Early in Pregnancy and Excessive Gestational Weight Gain Are Independently Associated with Adverse Health Outcomes in the Offspring at Age 7 Years2018In: Hormone Research in Paediatrics, ISSN 1663-2818, E-ISSN 1663-2826, Vol. 90, p. 296-296Article in journal (Other academic)
  • 10.
    Derraik, Jose G. B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Private Bag 92019, Auckland 1023, New Zealand.;Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand..
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Private Bag 92019, Auckland 1023, New Zealand.;Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand.;Auckland Dist Hlth Board, Starship Childrens Hlth, Auckland, New Zealand..
    Maessen, Sarah E.
    Univ Auckland, Liggins Inst, Private Bag 92019, Auckland 1023, New Zealand..
    Hofman, Paul L.
    Univ Auckland, Liggins Inst, Private Bag 92019, Auckland 1023, New Zealand.;Auckland Dist Hlth Board, Starship Childrens Hlth, Auckland, New Zealand..
    Kenealy, Timothy
    Univ Auckland, Liggins Inst, Private Bag 92019, Auckland 1023, New Zealand.;Univ Auckland, Sch Med, Fac Med & Hlth Sci, Auckland, New Zealand..
    Gunn, Alistair J.
    Auckland Dist Hlth Board, Starship Childrens Hlth, Auckland, New Zealand.;Univ Auckland, Dept Physiol, Auckland, New Zealand..
    Jefferies, Craig A.
    Univ Auckland, Liggins Inst, Private Bag 92019, Auckland 1023, New Zealand.;Auckland Dist Hlth Board, Starship Childrens Hlth, Auckland, New Zealand..
    A brief campaign to prevent diabetic ketoacidosis in children newly diagnosed with type 1 diabetes mellitus: The NO-DKA Study2018In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 19, no 7, p. 1257-1262Article in journal (Refereed)
    Abstract [en]

    Objective New-onset diabetic ketoacidosis (NO-DKA) is entirely preventable with early recognition of the symptoms of type 1 diabetes mellitus (T1D). In this study, we aimed to assess whether a simple and easily delivered educational campaign could reduce the risk of DKA. Methods A poster highlighting key features of new-onset T1D was delivered once a year over 2 years to mailboxes of over 460000 individual residential households in the Auckland region (New Zealand). In the first year, the campaign poster was also delivered to all general practices in the region. Families of all newly diagnosed cases of T1D in children answered a brief questionnaire to ascertain whether the campaign reached them. Results Over the 24-month period covered by this study, 132 new cases of T1D were diagnosed in children and adolescents in Auckland. There were 38 cases (28.8%) of DKA, which is similar to the average over the previous 5-year period (27.0%). The caregivers of three children reported both seeing the campaign poster and seeking medical attention as a result. None of these three children were in DKA at diagnosis; they were aged 6.3 to 9.7 years, and of New Zealand European ethnicity. Conclusions A non-targeted campaign to raise awareness of diabetes symptoms in youth led only a few caregivers to seek timely medical attention. Overall, this once-yearly untargeted campaign to raise awareness of diabetes symptoms in youth had limited impact. More effective strategies are required, possibly involving sustained targeted education of medical practitioners.

  • 11.
    Derraik, Jose G. B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand.
    Miles, Harriet L.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Chiavaroli, Valentina
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Hofman, Paul L.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand.
    Idiopathic short stature and growth hormone sensitivity in prepubertal children2019In: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 91, no 1, p. 110-117Article in journal (Refereed)
    Abstract [en]

    Objective: We compared growth hormone sensitivity to an insulin-like growth factor I (IGF-I) generation test in children with idiopathic short stature (ISS) and of normal stature (NS) across the birthweight range.

    Methods: Forty-six prepubertal children (~7.1 years) born at term were studied: ISS (n = 23; 74% boys) and NS (n = 23; 57% boys). Children underwent a modified IGF-I generation test with recombinant human growth hormone (rhGH; 0.05 mg/kg/d) over four consecutive days. Hormonal concentrations were measured at baseline and day 5.

    Results: Children with idiopathic short stature were 1.90 SDS lighter (P < 0.0001) but had 4.5% more body fat (P = 0.0007) than NS children. Overall, decreasing birthweight SDS across the normal range (-1.9 to +1.5 SDS) was associated with lower percentage IGF-I response to rhGH stimulation in univariable (r = 0.45; P = 0.002) and multivariable models (β = 24.6; P = 0.006). Plasma IGF-I concentrations rose in both groups with rhGH stimulation (P < 0.0001). GHBP levels (P = 0.002) were suppressed in ISS children (-19%; P = 0.029) but increased among NS children (+18%; P = 0.028), with contrasting responses also observed for leptin and IGFBP-1. Further, the increase in insulin concentrations in response to rhGH stimulation was ~3-fold greater in NS children (142% vs 50%; P = 0.006).

    Conclusions: A progressive decrease in birthweight SDS was associated with a reduction in GH sensitivity in both NS and ISS children. Thus, the lower IGF-I response to rhGH stimulation in association with decreasing birthweight indicates that the ISS children at the lower end of the birthweight spectrum may have partial GH resistance, which may contribute to their poorer growth.

  • 12.
    Derraik, Jose G. B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research. Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand.
    Pasupathy, D.
    Kings Coll London, Sch Life Course Sci, Dept Women & Childrens Hlth, London, England.
    McCowan, L. M. E.
    Univ Auckland, Dept Obstet & Gynaecol, Auckland, New Zealand;Natl Womens Hosp, Auckland Dist Hlth Board, Auckland, New Zealand.
    Poston, L.
    Kings Coll London, Sch Life Course Sci, Dept Women & Childrens Hlth, London, England.
    Taylor, R. S.
    Univ Auckland, Dept Obstet & Gynaecol, Auckland, New Zealand.
    Simpson, N. A. B.
    Univ Leeds, Leeds Inst Biomed & Clin Sci, Sect Obstet & Gynaecol, Leeds, W Yorkshire, England.
    Dekker, G. A.
    Univ Adelaide, Adelaide Med Sch, Robinson Res Inst, Discipline Obstet & Gynaecol, Adelaide, SA, Australia.
    Myers, J.
    Univ Manchester, Maternal & Fetal Heath Res Ctr, Manchester, Lancs, England.
    Vieira, M. C.
    Kings Coll London, Sch Life Course Sci, Dept Women & Childrens Hlth, London, England.
    Cutfield, W. S.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand.
    Ahlsson, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research.
    Paternal contributions to large-for-gestational-age term babies: findings from a multicenter prospective cohort study2019In: Journal of Developmental Origins of Health and Disease, ISSN 2040-1744, E-ISSN 2040-1752, Vol. 10, no 5, p. 529-535, article id PII S2040174419000035Article in journal (Refereed)
    Abstract [en]

    We assessed whether paternal demographic, anthropometric and clinical factors influence the risk of an infant being born large-for-gestational-age (LGA). We examined the data on 3659 fathers of term offspring (including 662 LGA infants) born to primiparous women from Screening for Pregnancy Endpoints (SCOPE). LGA was defined as birth weight >90th centile as per INTERGROWTH 21st standards, with reference group being infants <= 90th centile. Associations between paternal factors and likelihood of an LGA infant were examined using univariable and multivariable models. Men who fathered LGA babies were 180 g heavier at birth (P<0.001) and were more likely to have been born macrosomic (P<0.001) than those whose infants were not LGA. Fathers of LGA infants were 2.1 cm taller (P<0.001), 2.8 kg heavier (P<0.001) and had similar body mass index (BMI). In multivariable models, increasing paternal birth weight and height were independently associated with greater odds of having an LGA infant, irrespective of maternal factors. One unit increase in paternal BMI was associated with 2.9% greater odds of having an LGA boy but not girl; however, this association disappeared after adjustment for maternal BMI. There were no associations between paternal demographic factors or clinical history and infant LGA. In conclusion, fathers who were heavier at birth and were taller were more likely to have an LGA infant, but maternal BMI had a dominant influence on LGA.

  • 13.
    Glover, Marewa
    et al.
    A Better Start Natl Sci Challenge, Auckland 1142, New Zealand;Massey Univ, Sch Hlth Sci, Coll Hlth, Auckland 0632, New Zealand.
    Wong, Sally F.
    Massey Univ, Sch Hlth Sci, Coll Hlth, Auckland 0632, New Zealand.
    Fa'alili-Fidow, Jacinta
    A Better Start Natl Sci Challenge, Auckland 1142, New Zealand;Univ Auckland, TAHA Well Pacific Mother & Infant Serv, Auckland 1142, New Zealand.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. A Better Start Natl Sci Challenge, Auckland 1142, New Zealand;Univ Auckland, Liggins Inst, Auckland 1142, New Zealand.
    Taylor, Rachael W.
    A Better Start Natl Sci Challenge, Auckland 1142, New Zealand;Univ Otago, Dunedin Sch Med, Dunedin 9054, New Zealand.
    Morton, Susan M. B.
    A Better Start Natl Sci Challenge, Auckland 1142, New Zealand;Univ Auckland, Sch Populat Hlth, Ctr Longitudinal Res He Ara Ki Mua, Auckland 1743, New Zealand.
    Tautolo, El Shadan
    Auckland Univ Technol, Ctr Pacific Hlth & Dev Res, Auckland 1142, New Zealand.
    Cutfield, Wayne S.
    A Better Start Natl Sci Challenge, Auckland 1142, New Zealand;Univ Auckland, Liggins Inst, Auckland 1142, New Zealand.
    Ranked Importance of Childhood Obesity Determinants: Parents' Views across Ethnicities in New Zealand2019In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 11, no 9, article id 2145Article in journal (Refereed)
    Abstract [en]

    Maori, Pacific, Indian, and New Zealand European pre-school children's caregivers' views on determinants of childhood obesity are needed to inform strategies that will reduce disparities in prevalence. Nineteen focus groups were conducted to explore the relative influence of factors contributing to body weight in children. Predetermined and participant-suggested factors were ranked. Discussion data were inductively analysed. The cost of healthy foods was the highest ranked factor across all groups. Ranked similarly were ease of access to takeaways and lack of time for food preparation. Cultural factors followed by screen time induced sedentariness in children and lack of time to ensure children exercised was next. Participant-raised factors included lack of familial, social, and health promotion support, and others' behaviour and attitudes negatively impacting what children ate. All groups rejected stereotyping that blamed culture for higher obesity rates. Compared to the Maori and NZ European groups, the Pacific Island and Indian participants spoke of losing culture, missing extended family support, and not having access to culturally appropriate nutrition education or social support and services. Public health policies need to mitigate the negative effects of economic deprivation on food insecurity. Complementary interventions that increase access to healthier meal choices more often are needed.

  • 14.
    Glover, Marewa
    et al.
    Massey Univ, Coll Hlth, Sch Hlth Sci, Auckland 0632, New Zealand.
    Wong, Sally F.
    Massey Univ, Coll Hlth, Sch Hlth Sci, Auckland 0632, New Zealand.
    Taylor, Rachael W.
    Univ Otago, Dunedin Sch Med, Dunedin 9054, New Zealand.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Auckland 1142, New Zealand.
    Fa'alili-Fidow, Jacinta
    Univ Auckland, Sch Populat Hlth, Auckland 1142, New Zealand.
    Morton, Susan M.
    Univ Auckland, Sch Populat Hlth, Auckland 1142, New Zealand;Univ Auckland, Ctr Longitudinal Res He Ara Ki Mua, Auckland 1142, New Zealand.
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Auckland 1142, New Zealand.
    The Complexity of Food Provisioning Decisions by Mori Caregivers to Ensure the Happiness and Health of Their Children2019In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 11, no 5, article id 994Article in journal (Refereed)
    Abstract [en]

    Obesity in children is a global health concern. In New Zealand, one in three school entrant children are overweight or obese. Mori, the indigenous people, are disproportionately represented among the lowest economic group and have a disproportionately high incidence of obesity. This study explored Mori parents' and caregivers' views of the relative importance of weight to health, and the facilitators and barriers to a healthy weight in children aged 6 months to 5 years. Using a grounded qualitative method, in-depth information was collected in focus groups with mostly urban parents and other caregivers. A general inductive thematic analysis (content driven) was used. Insufficient money was an overriding food provisioning factor, but cost interacted with the lack of time, the number of people to feed, their appetites, and allergies. Other factors included ideologies about healthy food, cultural values relating to food selection, serving, and eating, nutrition literacy, availability of food, cooking skills, and lack of help. Childhood obesity was not a priority concern for participants, though they supported interventions providing education on how to grow vegetables, how to plan and cook cheaper meals. Holistic interventions to reduce the negative effects of the economic and social determinants on child health more broadly were recommended.

  • 15.
    Goffin, Sarah M.
    et al.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Auckland, New Zealand; Univ Auckland, Better Start Natl Sci Challenge A, Auckland, New Zealand.
    Groom, Katie M.
    Univ Auckland, Dept Obstet & Gynaecol, Auckland, New Zealand; Auckland City Hosp, Natl Womens Hlth, Auckland, New Zealand.
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Auckland, New Zealand; Univ Auckland, Better Start Natl Sci Challenge A, Auckland, New Zealand.
    Maternal pre-eclampsia and long-term offspring health: Is there a shadow cast?2018In: Pregnancy Hypertension, ISSN 2210-7789, E-ISSN 2210-7797, Vol. 12, p. 11-15Article, review/survey (Refereed)
    Abstract [en]

    Pre-eclampsia is a common pregnancy disorder with important short-term complications for mother and baby. Evidence suggests pre-eclampsia also has implications for the mother beyond pregnancy, as well as long-term effects on offspring health. Limited research has linked pre-eclampsia with changes in offspring blood pressure, BMI, and stroke risk. Underpinning mechanisms are poorly understood, but developmental programming may be involved. Research in this area has been hindered by difficulties in defining pre-eclampsia and problems with study design. Further targeted evaluation through to adulthood is required to determine the long-term impact of pre-eclampsia on offspring disease risk and how this develops.

  • 16.
    Heather, Natasha L.
    et al.
    Auckland Dist Hlth Board, Newborn Metab Screening Programme, LabPlus, Auckland, New Zealand;Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Webster, Dianne
    Auckland Dist Hlth Board, Newborn Metab Screening Programme, LabPlus, Auckland, New Zealand.
    Hofman, Paul L.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Auckland Dist Hlth Board, Starship Childrens Hosp, Auckland, New Zealand.
    The impact of demographic factors on newborn TSH levels and congenital hypothyroidism screening2019In: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 91, no 3, p. 456-463Article in journal (Refereed)
    Abstract [en]

    Context

    Optimal newborn screening thyroid‐stimulating hormone (TSH) cut‐offs are contentious. Analysis of demographic factors that impact screen TSH levels may help explain international variance and provide guidance to screening programmes.

    Objective

    To determine the influence of demographic factors on newborn screening TSH levels and screening performance parameters.

    Design and Setting

    National, retrospective population study using blood spot TSH cards from the New Zealand newborn screening programme in 2010‐2015.

    Patients

    325 685 blood spot cards.

    Main Outcome Measures

    Likelihood of exceeding specific TSH thresholds (TSH ≥5, ≥10 and ≥15 mIU/L) and group‐specific screening performance parameters.

    Results

    The likelihood of high TSH levels differed between ethnic groups. Pacific Island infants were more than twice as likely to have high‐normal TSH levels (≥5 and ≥10 mIU/L) and nearly twice as likely to have a positive screen (≥15 mIU/L) as New Zealand Europeans. Māori or Chinese ethnicity, male sex, younger gestational age and greater socio‐economic deprivation scores were also associated with high‐normal TSH levels. At a TSH threshold ≥15 mIU/L, screening sensitivity was lowest (88.89% vs 95.83% overall) and PPV greatest (88.89% vs 62.84%) amongst Asian infants. Early samples were more than three times as likely to reach the screen‐positive threshold and more likely to yield a false‐positive result (PPV 20.00% vs 68.87%, P = 0.004).

    Conclusions

    Newborn TSH levels are impacted by a number of demographic variables, particularly ethnicity and age at sample collection. Screening performance may be improved through the use of targeted thresholds.

  • 17.
    Hong, Ye
    et al.
    Zhejiang Univ, Sch Med, Childrens Hosp, Endocrinol Dept, Hangzhou, Zhejiang, Peoples R China.
    Maessen, Sarah E.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Dong, Guanping
    Zhejiang Univ, Sch Med, Childrens Hosp, Endocrinol Dept, Hangzhou, Zhejiang, Peoples R China.
    Huang, Ke
    Zhejiang Univ, Sch Med, Childrens Hosp, Endocrinol Dept, Hangzhou, Zhejiang, Peoples R China.
    Wu, Wei
    Zhejiang Univ, Sch Med, Childrens Hosp, Endocrinol Dept, Hangzhou, Zhejiang, Peoples R China.
    Liang, Li
    Zhejiang Univ, Affiliated Hosp 1, Dept Pediat, Sch Med, Hangzhou, Peoples R China.
    Wang, Chun Lin
    Zhejiang Univ, Affiliated Hosp 1, Dept Pediat, Sch Med, Hangzhou, Peoples R China.
    Chen, Xiaochun
    Zhejiang Univ, Sch Med, Childrens Hosp, Endocrinol Dept, Hangzhou, Zhejiang, Peoples R China.
    Gibbins, John D.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Zhejiang Univ, Sch Med, Childrens Hosp, Endocrinol Dept, Hangzhou, Zhejiang, Peoples R China;Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand.
    Fu, JunFen
    Zhejiang Univ, Sch Med, Childrens Hosp, Endocrinol Dept, Hangzhou, Zhejiang, Peoples R China.
    Associations between maternal age at menarche and anthropometric and metabolic parameters in the adolescent offspring2019In: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 90, no 5, p. 702-710Article in journal (Refereed)
    Abstract [en]

    Objective: We examined the associations between maternal age at menarche and anthropometry and metabolism in adolescent offspring.

    Methods: Anthropometric, metabolic and blood pressure data were obtained from 304 girls and 190 boys aged 11-16 years attending school in Hangzhou (China). Age at menarche for both mothers and daughters was self-reported. Fasting blood samples were obtained and all participants underwent clinical examinations. Obesity was defined as BMI >= 95th percentile for age and sex.

    Results: Older maternal age at menarche was associated with older age of their daughters at menarche (r = 0.21; P < 0.001). Mother's age at menarche was not associated with anthropometry or metabolism of daughters. However, younger maternal age at menarche was associated with increased hip and waist circumferences, and BMI SDS of their sons. Boys whose mothers were <= 13 years at menarche had an adjusted relative risk of obesity 3-fold greater than sons of mothers with a later menarcheal onset (2.96; 95% CI 1.49, 5.87). Among daughters, every 1-year increase in their age at menarche was associated with a 0.34 SDS reduction in BMI. Increasing age at menarche was also associated with reduced waist and hip circumferences (-1.5 and -1.8 cm/y, respectively) and waist-to-height ratio (-0.008 per year). Girls in the youngest menarcheal age tertile (8.8-11.6 years) had diastolic blood pressure 2.2 mm Hg higher than other girls (P = 0.029).

    Conclusions: Younger maternal age at menarche is associated with increased obesity risk in their sons, but not daughters. However, girls who experience menarche earlier have a less favourable anthropometric profile.

  • 18.
    Leong, Karen S. W.
    et al.
    Univ Auckland, Liggins Inst, Auckland, New Zealand..
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Auckland, New Zealand.;Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand..
    Hofman, Paul L.
    Univ Auckland, Liggins Inst, Auckland, New Zealand..
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.;Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand..
    Antibiotics, gut microbiome and obesity2018In: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 88, no 2, p. 185-200Article, review/survey (Refereed)
    Abstract [en]

    Antibiotics have been hailed by many as "miracle drugs" that have been effectively treating infectious diseases for over a century, leading to a marked reduction in morbidity and mortality. However, with the increasing use of antibiotics, we are now faced not only with the increasing threat of antibiotic resistance, but also with a rising concern about potential long-term effects of antibiotics on human health, including the development of obesity. The obesity pandemic continues to increase, a problem that affects both adults and children alike. Disruptions to the gut microbiome have been linked to a multitude of adverse conditions, including obesity, type 2 diabetes, inflammatory bowel diseases, anxiety, autism, allergies, and autoimmune diseases. This review focuses on the association between antibiotics and obesity, and the role of the gut microbiome. There is strong evidence supporting the role of antibiotics in the development of obesity in well-controlled animal models. However, evidence for this link in humans is still inconclusive, and we need further well-designed clinical trials to clarify this association.

  • 19.
    Leong, Karen S. W.
    et al.
    Univ Auckland, Liggins Inst, Private Bag 92019, Auckland 1023, New Zealand;Better Start Natl Sci Challenge, Auckland, New Zealand.
    McLay, Jessica
    Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Ctr Methods & Policy Applicat Social Sci, Auckland, New Zealand.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Private Bag 92019, Auckland 1023, New Zealand;Better Start Natl Sci Challenge, Auckland, New Zealand.
    Gibb, Sheree
    Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Otago, Dunedin Sch Med, Dunedin, New Zealand.
    Shackleton, Nichola
    Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Ctr Methods & Policy Applicat Social Sci, Auckland, New Zealand.
    Taylor, Rachael W.
    Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Otago, Dunedin Sch Med, Dunedin, New Zealand.
    Glover, Marewa
    Better Start Natl Sci Challenge, Auckland, New Zealand;Ctr Res Excellence Indigenous Sovereignty & Smoki, Auckland, New Zealand.
    Audas, Rick
    Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Otago, Dunedin Sch Med, Dunedin, New Zealand.
    Taylor, Barry
    Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Otago, Dunedin Sch Med, Dunedin, New Zealand.
    Milne, Barry J.
    Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Ctr Methods & Policy Applicat Social Sci, Auckland, New Zealand.
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Private Bag 92019, Auckland 1023, New Zealand;Better Start Natl Sci Challenge, Auckland, New Zealand.
    Associations of Prenatal and Childhood Antibiotic Exposure With Obesity at Age 4 Years2020In: JAMA NETWORK OPEN, ISSN 2574-3805, Vol. 3, no 1Article in journal (Refereed)
    Abstract [en]

    Importance Although antibiotics are associated with obesity in animal models, the evidence in humans is conflicting. Objective To assess whether antibiotic exposure during pregnancy and/or early childhood is associated with the development of childhood obesity, focusing particularly on siblings and twins. Design, Setting, and Participants This cross-sectional national study included 284 & x202f;211 participants (132 & x202f;852 mothers and 151 & x202f;359 children) in New Zealand. Data analyses were performed for 150 & x202f;699 children for whom data were available, 30 & x202f;696 siblings, and 4188 twins using covariate-adjusted analyses, and for 6249 siblings and 522 twins with discordant outcomes using fixed-effects analyses. Data analysis was performed November 2017 to March 2019. Exposure Exposure to antibiotics during pregnancy and/or early childhood. Main Outcomes and Measures The main outcome is odds of obesity at age 4 years. Anthropometric data from children born between July 2008 and June 2011 were obtained from the B4 School Check, a national health screening program that records the height and weight of 4-year-old children in New Zealand. These data were linked to antibiotics (pharmaceutical records) dispensed to women before conception and during all 3 trimesters of pregnancy and to their children from birth until age 2 years. Results The overall study population consisted of 132 & x202f;852 mothers and 151 & x202f;359 children (77 & x202f;610 [51.3%] boys) who were aged 4 to 5 years when their anthropometrical measurements were assessed. Antibiotic exposure was common, with at least 1 course dispensed to 35.7% of mothers during pregnancy and 82.3% of children during the first 2 years of life. Results from covariate-adjusted analyses showed that both prenatal and early childhood exposures to antibiotics were independently associated with obesity at age 4 years, in a dose-dependent manner. Every additional course of antibiotics dispensed to the mothers yielded an adjusted odds ratio (aOR) of obesity in their children (siblings) of 1.02 (95% CI, 0.99-1.06), which was similar to the odds across pregnancy for the whole population (aOR, 1.06; 95% CI, 1.04-1.07). For the child's exposure, the aOR for the association between antibiotic exposure and obesity was 1.04 (95% CI, 1.03-1.05) among siblings and 1.05 (95% CI, 1.02-1.09) among twins. However, fixed-effects analyses of siblings and twins showed no associations between antibiotic exposure and obesity, with aORs of 0.95 (95% CI, 0.90-1.00) for maternal exposure, 1.02 (95% CI, 0.99-1.04) for child's exposure, and 0.91 (95% CI, 0.81-1.02) for twins' exposure. Conclusions and Relevance Although covariate-adjusted analyses demonstrated an association between antibiotic exposure and odds of obesity, further analyses of siblings and twins with discordant outcomes showed no associations. Thus, these discordant results likely reflect unmeasured confounding factors. Question Is antibiotic exposure during pregnancy and/or during early childhood associated with the development of childhood obesity? Findings This cross-sectional national study of 284 & x202f;211 participants (132 & x202f;852 mothers and 151 & x202f;359 children) in New Zealand found that both prenatal and early childhood exposures to antibiotics were independently associated with obesity at age 4 years in a dose-dependent manner. However, fixed-effects analyses of siblings and twins with discordant outcomes showed no associations between antibiotic exposure and obesity. Meaning Although judicious use of antibiotics is necessary, antibiotics are unlikely to be a major contributor to childhood obesity. This cross-sectional study of mothers and their children in New Zealand assesses whether exposure to antibiotics during pregnancy and/or early childhood is associated with the development of childhood obesity.

  • 20.
    Maessen, Sarah E.
    et al.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Ahlsson, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research.
    Lundgren, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research.
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand.
    Maternal smoking early in pregnancy is associated with increased risk of short stature and obesity in adult daughters2019In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, article id 4290Article in journal (Refereed)
    Abstract [en]

    We assessed anthropometry in 22,421 adult daughters in association with their mothers' tobacco smoking early in pregnancy (at their first antenatal visit) in Sweden, particularly their risk of short stature and obesity. Adult daughters were grouped by maternal smoking levels during pregnancy: Nonsmokers (58.5%), Light smokers (24.1%; smoked 1-9 cigarettes/day), and Heavier smokers (17.4%; smoked >= 10 cigarettes/day). Anthropometry was recorded on the adult daughters at approximately 26.0 years of age. Obesity was defined as BMI >= 30 kg/m(2), and short stature as height more than two standard deviations below the population mean. Daughters whose mothers were Light and Heavier smokers in early pregnancy were 0.8 cm and 1.0cm shorter, 2.3 kg and 2.6 kg heavier, and had BMI 0.84 kg/m(2) and 1.15 kg/m(2) greater, respectively, than daughters of Non-smokers. The adjusted relative risk of short stature was 55% higher in women born to smokers, irrespectively of smoking levels. Maternal smoking had a dose-dependent association with obesity risk, with offspring of Heavier smokers 61% and of Light smokers 37% more likely to be obese than the daughters of Non-smokers. In conclusion, maternal smoking in pregnancy was associated with an increased risk of short stature and obesity in their adult daughters.

  • 21.
    Murali, Mrinal
    et al.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Hofman, Paul L.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Cutfield, Wayne S.
    Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Hornung, Tim
    Starship Childrens Hosp, Dept Paediat Cardiol, Auckland, New Zealand.
    Gusso, Silmara
    Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Exercise capacity and cardiac function in adolescents born post-term2018In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 8, article id 12963Article in journal (Refereed)
    Abstract [en]

    There is some evidence that children born post-term (>= 42 weeks of gestation) have metabolic abnormalities that may be associated with an increased risk of adverse health outcomes in adulthood. However, there are no data as to whether adolescents born post-term display alterations in aerobic capacity or cardiovascular function. We studied 48 adolescents (56% males) in Auckland (New Zealand) with a mean age of 14.3 years (SD = 1.7): 25 born post-term and 23 born at term (37-41 weeks of gestation). Assessments included metabolic markers in blood, whole body DXA scans, 24-hour ambulatory blood pressure monitoring, maximal exercise capacity, as well as cardiac MRI scan at rest and during submaximal exercise. Exercise capacity was lower in the post-term than in control participants (44.5 vs 47.8 ml/kgffm/min; p = 0.04). There were no differences in left ventricular volumes at rest and during exercise between groups. The 24-hour ambulatory blood pressure monitoring also showed no differences between the two groups. Being born post-term was associated with reduced exercise capacity, but with no observed differences in central cardiac function. We speculate that the reduction in exercise capacity may be due to changes in the peripheral vascular system.

  • 22.
    Rerkasem, Kittipan
    et al.
    Chiang Mai Univ, Fac Med, Dept Surg, Chiang Mai, Thailand;Chiang Mai Univ, NCD Ctr, Res Inst Hlth Sci, Chiang Mai, Thailand.
    Wongthanee, Antika
    Chiang Mai Univ, NCD Ctr, Res Inst Hlth Sci, Chiang Mai, Thailand.
    Rerkasem, Amaraporn
    Chiang Mai Univ, NCD Ctr, Res Inst Hlth Sci, Chiang Mai, Thailand.
    Pruenglampoo, Sakda
    Chiang Mai Univ, NCD Ctr, Res Inst Hlth Sci, Chiang Mai, Thailand.
    Mangklabruks, Ampica
    Chiang Mai Univ, Fac Med, Dept Internal Med, Chiang Mai, Thailand.
    Hofman, Paul L.
    Univ Auckland, Liggins Inst, Private Bag 92019, Auckland, New Zealand.
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Private Bag 92019, Auckland, New Zealand;Better Start Natl Sci Challenge, Auckland, New Zealand.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Private Bag 92019, Auckland, New Zealand;Better Start Natl Sci Challenge, Auckland, New Zealand.
    Lower insulin sensitivity in young adults born preterm in Thailand2020In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 21, no 2, p. 210-214Article in journal (Refereed)
    Abstract [en]

    Background: Previous studies reported impaired glucose homeostasis among preterm survivors, but consisted almost exclusively of Caucasians. It is unknown whether Asians born preterm display similar impairments.

    Aim: To assess glucose homeostasis and other cardiometabolic outcomes among young adults born preterm in Thailand.

    Methods: Participants were 575 young adult offspring of mothers from the Chiang Mai Low Birth Weight Study, born in 1989 to 1990 and followed up in 2010: 54.1% females, median age 20.6 years, including 33 individuals (5.7%) born preterm. After an overnight fast, participants underwent clinical assessments, including blood sampling (glucose, insulin, and lipid profile). Insulin sensitivity was assessed using HOMA-IR and insulin secretion estimated using HOMA-beta.

    Results: In unadjusted analyses, young Thai adults born preterm were 3.2 cm shorter (P = .037), 6 kg lighter (P = .016), and had HOMA-beta 34% higher (P = .026) than those born at term. Adjusted analyses accounting for important confounders showed marked impairments in glucose homeostasis among preterm survivors: fasting insulin levels were 32% greater (P = .011), with HOMA-IR and HOMA-beta that were 31% (P = .020) and 43% higher (P = .005), respectively, compared to peers born at term. There were no other contrasting observations between groups, with anthropometric differences disappearing after adjustment for confounders.

    Discussion: Young adults in Thailand born preterm were more insulin resistant than peers born at term. The observed impairments in glucose metabolism among young Thai adults born preterm corroborate findings reported mostly on Caucasians. The challenge for general practitioners and public health professionals is to encourage those born preterm to make healthier lifestyle choices early on.

  • 23.
    Seneviratne, Sumudu N.
    et al.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.;Univ Colombo, Fac Med, Dept Paediat, Colombo, Sri Lanka..
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Auckland, New Zealand.;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand..
    Jiang, Yannan
    Univ Auckland, Dept Stat, Auckland, New Zealand..
    McCowan, Lesley M. E.
    Univ Auckland, Dept Obstet & Gynaecol, Auckland, New Zealand..
    Gusso, Silmara
    Univ Auckland, Liggins Inst, Auckland, New Zealand..
    Biggs, Janene B.
    Univ Auckland, Liggins Inst, Auckland, New Zealand..
    Parry, Graham K.
    Univ Auckland, Dept Stat, Auckland, New Zealand..
    Chiavaroli, Valentina
    Univ Auckland, Liggins Inst, Auckland, New Zealand..
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Auckland, New Zealand.;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand..
    Hofman, Paul L.
    Univ Auckland, Liggins Inst, Auckland, New Zealand..
    Nulliparity is associated with subtle adverse metabolic outcomes in overweight/obese mothers and their offspring2017In: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 87, no 5, p. 545-551Article in journal (Refereed)
    Abstract [en]

    Background: We aimed to evaluate metabolic outcomes in overweight/obese nulliparous and multiparous women and their offspring.

    Study design: Seventy-two overweight and obese women who participated in a randomized controlled trial of exercise in pregnancy were included in the study, comparing 18 nulliparous and 54 multiparous women and their singleton offspring. Women were assessed at 19 and 36 weeks of gestation. Fetal growth was measured using standard obstetric ultrasound techniques. Cord blood was collected at birth. Maternal and offspring body composition was assessed using DXA similar to 2 weeks after delivery.

    Results: Nulliparous women had higher HbA1c in the third trimester of pregnancy than multiparous women (5.48% vs 5.29%; P=.002) and were more insulin-resistant based on the surrogate marker sex hormone-binding globulin (354 vs 408 nmol/L; P=.047). Nulliparous women also had higher levels of the inflammatory marker tumour necrosis factor-alpha (4.74 vs 3.62 pg/mL; P=.025). At birth, the offspring of nulliparous women were on average 340 g (P=.013) and 0.69 standard deviation scores (P=.026) lighter than those born of multiparous women. Cord blood data showed lower insulin-like growth factor-II (P=.026) and higher IGF binding protein-1 (P=.002) levels in the offspring of nulliparous women. In addition, a less favourable metabolic profile was observed in the offspring of nulliparous women, as indicated by higher triglyceride (P<.001) and interleukin-6 (P=.039) concentrations.

    Conclusions: Infants born of nulliparous overweight and obese women appear to be exposed to a less favourable metabolic environment in utero, with evidence of subtle adverse metabolic outcomes at birth compared to infants of overweight/obese multiparous women.

  • 24.
    Shackleton, N.
    et al.
    Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Ctr Methods & Policy Applicat Social Sci, Auckland, New Zealand.
    Milne, B. J.
    Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Ctr Methods & Policy Applicat Social Sci, Auckland, New Zealand.
    Audas, R.
    Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Otago, Dunedin Sch Med, Dunedin, New Zealand.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Zhu, T.
    Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Ctr Methods & Policy Applicat Social Sci, Auckland, New Zealand.
    Taylor, R. W.
    Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Otago, Dunedin Sch Med, Dunedin, New Zealand.
    Morton, S. M. B.
    Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Ctr Longitudinal Res He Ara Ki Mua, Auckland, New Zealand;Univ Auckland, Sch Populat Hlth, Auckland, New Zealand.
    Glover, M.
    Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand;Massey Univ, Sch Publ Hlth, Coll Hlth, Auckland, New Zealand.
    Cutfield, W. S.
    Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Taylor, B.
    Univ Auckland, Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Otago, Dunedin Sch Med, Dunedin, New Zealand.
    Improving rates of overweight, obesity and extreme obesity in New Zealand 4-year-old children in 2010-20162018In: Pediatric Obesity, ISSN 2047-6302, E-ISSN 2047-6310, Vol. 13, no 12, p. 766-777Article in journal (Refereed)
    Abstract [en]

    Background Prevalence of childhood obesity is high in developed countries, and there is a growing concern regarding increasing socio-economic disparities. Objectives To assess trends in the prevalence of overweight, obesity and extreme obesity among New Zealand 4-year olds, and whether these differ by socio-economic and ethnic groupings. Methods A national screening programme, the B4 School Check, collected height and weight data for 75-92% of New Zealand 4-year-old children (n = 317 298) between July 2010 and June 2016. Children at, or above, the 85th, 95th and 99.7th percentile for age and sex adjusted body mass index (according to World Health Organization standards) were classified as overweight, obese and extremely obese, respectively. Prevalence rates across 6 years (2010/11 to 2015/16) were examined by sex, across quintiles of socio-economic deprivation, and by ethnicity. Results The prevalence of overweight, obesity and extreme obesity decreased by 2.2 [95% CI, 1.8-2.5], 2.0 [1.8-2.2] and 0.6 [0.4-0.6] percentage points, respectively, between 2010/2011 and 2015/2016. The downward trends in overweight, obesity and extreme obesity in the population persisted after adjustment for sex, ethnicity, deprivation and urban/rural residence. Downward trends were also observed across sex, ethnicity and deprivation groups. Conclusions The prevalence of obesity appears to be declining in 4-year-old children in New Zealand across all socio-economic and ethnic groups.

  • 25.
    Shackleton, Nichola
    et al.
    A Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Ctr Methods & Policy Applicat Social Sci, Auckland, New Zealand.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. A Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Audas, Richard
    A Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Otago, Dunedin Sch Med, Dept Womens & Childrens Hlth, Dunedin, New Zealand.
    Taylor, Rachael W.
    A Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Otago, Dunedin Sch Med, Dept Womens & Childrens Hlth, Dunedin, New Zealand.
    Glover, Marewa
    A Better Start Natl Sci Challenge, Auckland, New Zealand;Massey Univ, Coll Hlth, Sch Hlth Sci, Auckland, New Zealand.
    Morton, Susan M. B.
    A Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Ctr Longitudinal Research He Ara ki Mua, Auckland, New Zealand;Univ Auckland, Sch Populat Hlth, Auckland, New Zealand.
    Tautolo, El-Shadan
    A Better Start Natl Sci Challenge, Auckland, New Zealand;Auckland Univ Technol, Ctr Pacific Hlth & Dev Res, Auckland, New Zealand.
    Kokaua, Jesse
    A Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Otago, Dunedin Sch Med, Dept Womens & Childrens Hlth, Dunedin, New Zealand.
    Taylor, Barry
    A Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Otago, Dunedin Sch Med, Dept Womens & Childrens Hlth, Dunedin, New Zealand.
    Cutfield, Wayne S.
    A Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Liggins Inst, Auckland, New Zealand.
    Milne, Barry J.
    A Better Start Natl Sci Challenge, Auckland, New Zealand;Univ Auckland, Ctr Methods & Policy Applicat Social Sci, Auckland, New Zealand.
    Decomposing ethnic differences in body mass index and obesity rates among New Zealand pre-schoolers2019In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 43, no 10, p. 1951-1960Article in journal (Refereed)
    Abstract [en]

    Objective To determine the extent to which ethnic differences in BMI Z-scores and obesity rates could be explained by the differential distribution of demographic (e.g. age), familial (e.g. family income), area (e.g. area deprivation), parental (e.g. immigration status), and birth (e.g. gestational age) characteristics across ethnic groups. Methods We used data on 4-year-old children born in New Zealand who attended the B4 School Check between the fiscal years of 2010/2011 to 2015/2016, who were resident in the country when the 2013 census was completed (n = 253,260). We implemented an Oaxaca-Blinder decomposition to explain differences in BMI Z-score and obesity between Maori (n = 63,061) and European (n = 139,546) children, and Pacific (n = 21,527) and European children. Results Overall, 15.2% of the children were obese and mean BMI Z-score was 0.66 (SD = 1.04). The Oaxaca-Blinder decomposition demonstrated that the difference in obesity rates between Maori and European children would halve if Maori children experienced the same familial and area level conditions as Europeans. If Pacific children had the same characteristics as European children, differences in obesity rates would reduce by approximately one third, but differences in mean BMI Z-scores would only reduce by 16.1%. Conclusion The differential distribution of familial, parental, area, and birth characteristics across ethnic groups explain a substantial percentage of the ethnic differences in obesity, especially for Maori compared to European children. However, marked disparities remain.

  • 26.
    Skudder-Hill, Loren
    et al.
    Jiangsu Univ, Sch Clin Med, Zhenjiang, Jiangsu, Peoples R China.
    Ahlsson, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research.
    Lundgren, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Perinatal, Neonatal and Pediatric Cardiology Research.
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Private Bag 92019, Auckland, New Zealand;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden;Univ Auckland, Liggins Inst, Private Bag 92019, Auckland, New Zealand;Univ Auckland, A Better Start Natl Sci Challenge, Auckland, New Zealand;Zhejiang Univ, Sch Med, Childrens Hosp, Dept Endocrinol, Hangzhou, Zhejiang, Peoples R China.
    Preterm Birth is Associated With Increased Blood Pressure in Young Adult Women2019In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 8, no 12, article id e012274Article in journal (Refereed)
    Abstract [en]

    Background-While there is some evidence of elevated blood pressure later in life in preterm survivors, data on adult women are still lacking. Thus, we assessed the associations between preterm birth and blood pressure in young adult women. Methods and Results-We studied 5232 young adult women who volunteered for military service in Sweden between 1990 and 2007. Anthropometric and clinic blood pressure data were collected during the medical examination at the time of conscription. There was a progressive decline in systolic and diastolic blood pressures, as well as in mean arterial pressure, with increasing gestational age. Women born preterm had an adjusted increase in systolic blood pressure of 3.8 mm Hg (95% CI, 2.5-5.1; P<0.0001) and mean arterial pressure of 1.9 mm Hg (95% CI, 0.9-2.8; P 0.0001) compared with young women born at term. Rates of systolic hypertension were also considerably higher in young women born preterm (14.0% versus 8.1%, P<0.0001), as were rates of isolated systolic hypertension. The adjusted relative risk of systolic hypertension in women born preterm was 1.72 (95% CI, 1.26-2.34; P<0.001) that of women born at term or post-term, but there was no significant difference in the risk of diastolic hypertension (adjusted relative risk, 1.60; 95% CI, 0.49-5.20). Conclusions-Young adult women born preterm display elevated systolic blood pressure and an increased risk of hypertension compared with peers born at term or post-term.

  • 27.
    Yuan, Jinna
    et al.
    Zhejiang Univ, Childrens Hosp, Endocrinol Dept, Sch Med, Hangzhou, Zhejiang, Peoples R China.
    Derraik, Jose G. B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, Natl Sci Challenge, Auckland, New Zealand.
    Fu, Junfen
    Zhejiang Univ, Childrens Hosp, Endocrinol Dept, Sch Med, Hangzhou, Zhejiang, Peoples R China.
    Dong, Guanping
    Zhejiang Univ, Childrens Hosp, Endocrinol Dept, Sch Med, Hangzhou, Zhejiang, Peoples R China.
    Cutfield, Wayne S.
    Univ Auckland, Liggins Inst, Auckland, New Zealand;Univ Auckland, Natl Sci Challenge, Auckland, New Zealand.
    Wu, Wei
    Zhejiang Univ, Childrens Hosp, Endocrinol Dept, Sch Med, Hangzhou, Zhejiang, Peoples R China.
    Huang, Ke
    Zhejiang Univ, Childrens Hosp, Endocrinol Dept, Sch Med, Hangzhou, Zhejiang, Peoples R China.
    Jiang, Youjun
    Zhejiang Univ, Childrens Hosp, Endocrinol Dept, Sch Med, Hangzhou, Zhejiang, Peoples R China.
    Chen, Xiaochun
    Zhejiang Univ, Childrens Hosp, Endocrinol Dept, Sch Med, Hangzhou, Zhejiang, Peoples R China.
    Beta-Cell Function in Chinese Youngsters with Type 1 Diabetes and Assessment of Surrogate Markers of Severe Insulin Deficiency2018In: Hormone Research in Paediatrics, ISSN 1663-2818, E-ISSN 1663-2826, Vol. 90, p. 644-644Article in journal (Other academic)
1 - 27 of 27
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