Rannveig Nordhagen

Recurrent pain in children, socio-economic factors and accumulation in families.

The aim of this study was to estimate the prevalence of parent-reported pain among children in the Nordic countries in 1996, and to describe the association between recurrent pain in children and parental socio-economic factors. We also wanted to estimate the association between parental pain and childhood pain and co-occurrence of different pain patterns in the same child. Data were obtained from a cross-sectional survey on childrens health and well-being in the Nordic countries in 1996. About 10, 000 children aged 2–17 years of age were selected from population registries. Mean response rate was 68%. We selected the cases ≥7 years where the respondent was the childs biological mother or father, yielding a total of 6230 subjects. The adjusted analyses were performed using logistic regression in SPSS. The total prevalence of headache, abdominal pain and back pain among children 7–17 years of age was 14.9, 8.3 and 4.7%, respectively. The most common pain combination was headache and abdominal pain. Pain was most frequent among girls. The prevalence was slightly higher in low educated or low-income families compared to those of high status. Children living in low educated, low-income, worker families had approximately a 1.4-fold odds of having pain. There was a strong association between the different pain conditions, and between pain and other forms of distress in the same child. A site-specific association between parental and child pain was also shown, but we assume that this might have been mediated through subjective (information) bias.

Overweight and obesity among adolescents in Norway: cultural and socio-economic differences

BACKGROUND The aim of this study was to investigate overweight and obesity among a representative population of 15,966 Norwegian 15-16 year olds and the associations with different socio-economic and cultural risk factors. METHODS Self-reported data were obtained from school-based surveys in six counties during 2000-04. Overweight and obesity were calculated using Coles index. RESULTS The prevalence of overweight and obesity were 11.8% and 2.4%, respectively, higher among boys. Logistic regression analyses revealed that adolescents in Nordland, Troms and Finnmark (the northernmost counties) were 70-90% more likely to be overweight and obese compared with adolescents in Oslo (the capital and southernmost county) (OR for overweight in Finnmark = 1.7, CI = 1.3, 2.3). Lower educational plans and poor family economy were both significantly associated with overweight and obesity. So was physical inactivity (OR = 1.2, CI = 1.1, 1.3 and OR = 1.6, CI = 1.2, 2.1, respectively). Eating breakfast was positively associated with not being overweight/obese. CONCLUSION Overweight and obesity is associated with socio-economic factors and with factors related to food habits and nutrition, suggesting important areas for prevention.

Postpartum depression among Pakistani women in Norway: Prevalence and risk factors

Objective. To assess the prevalence of and risk factors for postpartum depression among Pakistani women in Norway. Methods. A total of 207 pregnant Pakistani women living in Norway participated in a questionnaire study. The author interviewed the women face to face during pregnancy and 6 to 12 weeks after delivery. The Edinburgh postnatal depression scale was used to identify the risk cases. Results. Only 7.6% of the immigrant Pakistani women were depressed postpartum. High scores on the life event scale, a history of prior depression, single marital status, a poor relationship to ones partner and an age of 30 years or more were found to be significant risk factors for postpartum depression. Conclusions. The prevalence of postpartum depression among immigrant Pakistani women seems to be low compared with the prevalence reported in immigrant populations elsewhere, it was however only slightly lower than the study of ethnic Norwegians (8.9%). The risk factors were similar to results from international reports; moreover, there were few cultural differences in risk factors between ethnic Norwegian and Pakistani immigrants.

Intrauterine exposure to caffeine and inattention/overactivity in children

Aim:  To determine the association between intrauterine exposure to timing and sources of caffeine and inattention/overactivity, suggesting ADHD in the child.

Children in the environment: Forest day-care centers: Modern day care with historical antecedents

Some features of early child care are more prominent in Norway than in other countries, such as emphasis on the outdoor environment. Of general relevance and interest is the form of day care provided by forest day-care centers. Three ideas form the development of these centers placed in wild areas. First, throughout history, Norwegians have had a close attachment to nature and some parents want to provide their children with outdoor experiences at an early age. Second, urging children to play outdoors characterizes the image many parents have of a happy, healthy childhood. Third, provision of day care for children has always been restricted in western countries, forcing parents to invent types of service that can become part of an ecological system that promotes healthy development. The forest day-care centers developed recently represent a supplement to the wide typology of child care in the 21st century. The article outlines the connections between these ideas in general European and western history and Norwegian history and presents debate and decisions about a question dating from the last half of the 1980s. It concludes that the forest day-care centers are perhaps only a modern form of the original kindergarten concept, which started in Europe and America as gardens for children not gardens of children.

Childhood abuse and later worries about the baby's health in pregnancy

Objective. To explore the associations between sexual and/or physical abuse in childhood and worries about the babys health in pregnancy. Design. Cross‐sectional questionnaire study. Setting. Norwegian prospective pregnancy cohort. Sample. An original sample of 58,139 pregnancies (1999–2006) covering about 43% of the pregnant population. Methods. Two self‐reported questionnaires in the 17th and 30th week of gestation were merged with data from the Medical Birth Registry of Norway. Associations between physical and/or sexual childhood abuse and worries about the babys health were assessed with multiple logistic regression analyses. Main outcome measures. Strong worries about the babys health in the 30th week of gestation among women with experience of childhood abuse. Results. Women who reported being exposed to physical or sexual childhood abuse or a combination of the two were at increased risk of strong worries about the babys health compared to women who had not been similarly exposed (adjusted odds ratio (OR) = 1.62, 95% confidence interval (CI) 1.26–2.08; adjusted OR = 1.30, 95% CI 1.03–1.64; adjusted OR = 2.10, 95% CI 1.68–2.62, respectively). Marital status, adult abuse, pelvic pain, quality of antenatal care, self‐efficacy and previous birth experiences were also associated with concern about the babys health. Conclusions. There were significant associations between physical and/or sexual childhood abuse and strong concern about the babys health. Worries about the babys health are complex and associated with many elements of risk.

Chronic illness and aggressive behaviour: A population-based study of 4-year-olds

The objective of this study was to examine the hypothesis that aggressive behaviour is explained by various medical conditions. The current study investigated this hypothesis in a population-based study of families with a 4-year-old child (n = 1915). Maternal reports of child health and development were assessed and a paediatrician examined a subsample (n = 263) with a chronic illness. Twice as many toddlers with a chronic physical disorder displayed aggressive behaviour when compared with toddlers without such disorders. All seven medical diagnostic categories included children with aggressive behaviour, but the highly prevalent condition of asthma contributed to more than a third of the cases with co-occurrence of chronic illness and aggressive behaviour. Neurological, sensory and skin/joint disorders accounted for another third. Subsequent analyses showed that poor language was an additional risk factor while attending day-care centres in groups with 5 – 15 children was a protective factor against aggressive behaviour.

Re-examining the link between prenatal maternal anxiety and child emotional difficulties, using a sibling design.

Background Prenatal exposure to maternal anxiety has been associated with child emotional difficulties in a number of epidemiological studies. One key concern, however, is that this link is vulnerable to confounding by pleiotropic genes or environmental family factors. Methods Data on 82 383 mothers and children from the population-based Mother and Child Cohort Study and data on 21 980 siblings were used in this study. Mothers filled out questionnaires for each unique pregnancy, for infant difficulties at 6 months and for emotional difficulties at 36 months. The link between prenatal maternal anxiety and child difficulties were examined using logistic regression analyses and multiple linear regression analyses for the full study sample and the sibling sample. Results In the conventional full-cohort analyses, prenatal exposure to maternal anxiety was associated with child difficulties at both 6 months [odds ratio (OR) = 2.1 (1.94-2.27)] and 36 months [OR = 2.72 (2.47-2.99)]. The findings were essentially the same whether we examined difficulties at 6 months or at 36 months. However, these associations were no longer present once we controlled for potential social and genetic confounders in the sibling comparison analyses, either at 6 months [OR = 1.32 (0.91-1.90)] or at 36 months [OR = 1.28 (0.63-2.60)]. Findings from multiple regression analyses with continuous measures were essentially the same. Conclusions Our finding lends little support for there being an independent prenatal effect on child emotional difficulties; rather, our findings suggest that the link between prenatal maternal anxiety and child difficulties could be confounded by pleiotropic genes or environmental family factors.