Sarnia Carter

Intimate partner violence and unplanned pregnancy in the Pacific Islands Families Study

To examine the association between maternal intimate partner violence (IPV) victimization and unplanned pregnancy.

Maternal mental health and child behaviour problems at 2 years: findings from the Pacific Islands Families Study.

Objective: The present study investigated associations between the timing and persistence of maternal psychological disorder and child behaviour problems in a cohort of Pacific 2-year-old children in New Zealand. Method: Mothers of a cohort of 1398 Pacific infants born in South Auckland, New Zealand were interviewed when their children were 6 weeks, 12 and 24 months of age. Within the context of a wider interview, data regarding maternal mental health were obtained at these times and maternal reports of child behaviour were gathered when the children were 2 years old. Results: Prevalence rates for internalizing problems were significantly higher in children of mothers who had self-reported symptoms of psychological disorder (11.9% in no symptoms, 27.8% in early symptoms of postnatal depression, 21.1% in late symptoms of psychological disorder and 42.9% in persistent or recurrent symptoms). The adjusted odds ratio (OR) of a child having internalizing problems was 1.38 (95% confidence interval (CI): 0.79–2.43) in those of mothers reporting early symptoms of postnatal depression, 1.45 (95%CI: 0.85–2.49) in late symptoms of psychological disorder, and 2.93 (95%CI: 1.54–5.57) in persistent or recurrent symptoms relative to the no symptoms group. For externalizing problems, the effects of maternal psychological disorder were not significant. Conclusions: Maternal persistent or recurrent symptoms of psychological disorder may contribute to the behaviour problems of children as young as 2 years old. However, the timing of disorder, whether it is infant or toddler exposure, does not appear to be as crucial. Improved understanding of the associations between maternal psychological disorder and early child behaviour problems may help maternal and child health professionals design appropriate and effective screening and intervention programs to help Pacific mothers and children.

Risk factors for preterm and small-for-gestational-age babies: a cohort from the Pacific Islands Families Study.

Aim:  To explore risk factors that are associated with preterm birth and full‐term small‐for‐gestational‐age (SGA) birth for a Pacific population.

Impact of current and past intimate partner violence on maternal mental health and behaviour at 2 years after childbirth: evidence from the Pacific Islands Families Study

Objective: The present study examined the association between maternal intimate partner violence (IPV) at 6 weeks and 24 months postpartum and maternal health problems in a cohort of Pacific families with 2-year-old children in New Zealand. Methods: Data were gathered from the Pacific Islands Families Study. Mothers of a cohort of Pacific infants born in Auckland, New Zealand during 2000 were interviewed when the children were 6 weeks and 24 months of age. There were 828 mothers cohabiting in married or de facto partnerships who completed measures of IPV, mental health, and health-related behaviour such as smoking and high-risk alcohol use at both data points. The main statistical method used was logistic regression analysis. Results: Compared to mothers who did not experience physical violence at either data point, the odds of reporting psychological distress were 2.42 (95% confidence interval (CI) = 1.07–5.44) for those experiencing physical violence at 6 weeks only, 3.47 (95%CI = 1.75–6.86) for those experiencing physical violence at 24 months only, and 3.84 (95%CI = 1.78–8.30) for those experiencing physical violence at both data points after controlling for sociodemographic factors. Mothers experiencing verbal aggression or physical violence at both data points were more likely to report smoking or high-risk alcohol use at 24 months than those who did not, but the associations were no longer significant after controlling for sociodemographic factors. Conclusion: Being a victim of intimate partner physical violence at any time (past, recent and repeated) may contribute to an increase in maternal psychological distress. Health-related behaviours such as smoking and high-risk alcohol use at 24 months postpartum may to some degree be attributable to repeated victimization of physical violence and verbal aggression, but the relationships are not convincing and deserve further research in longitudinal studies.

Maternal intimate partner violence and behavioural problems among Pacific children living in New Zealand.

AIMS To examine (1) the association between maternal intimate partner violence (IPV) perpetration and victimisation and behavioural problems among two- and four-year-old Pacific children, and (2) the socio-demographic and parenting factors that may impact on this association. DESIGN Mothers of the Pacific Islands Families (PIF) cohort of Pacific infants born in New Zealand during 2000 were interviewed when the children were two and four years of age. This data set was based on mothers who were cohabiting in married or de-facto partnerships (N = 920) and who completed measures of IPV at the two-year assessment point and the Child Behaviour Checklist (CBCL) at the two-or four-year assessment points. Of these, 709 mothers completed the CBCL at both assessment points. RESULTS There were no significant associations between IPV and the prevalence rates of clinically relevant cases of behavioural problems in the two-year-old child cohort. However, the prevalence rates of clinically relevant internalising, externalising and total problem cases were significantly higher among four-year-old children of mothers who reported severe perpetration of IPV. The odds of being in clinical range of internalising were 2.16 times higher for children of mothers who were perpetrators of severe physical violence than for those children of mothers who were not, and for externalising and total problems they were 2.38 and 2.36 times higher respectively. Socio-demographic and parenting factors did not significantly influence the association between IPV and child behaviour problems. CONCLUSION These findings contribute to the complex picture of the consequences that exposure to parental violence may have on the behaviour of young children. The effectiveness of preventative strategies may be maximised if implemented in these early years before such problems become entrenched and lead on to future behavioural problems and impaired family relationships.

Exclusive and any breast-feeding rates of Pacific infants in Auckland: data from the Pacific Islands Families First Two Years of Life Study.

OBJECTIVES To present current breast-feeding rates for Pacific infants resident in New Zealand. Reasons for the introduction of complementary liquid foods were also explored. DESIGN A longitudinal study using hospital discharge summary records and maternal home interviews undertaken at 6 weeks, 12 and 24 months postpartum. Turnbulls non-parametric survival analysis was used to model exclusive breast-feeding rates. SETTING Auckland, New Zealand. RESULTS The cohort comprised 1376 infants at 6 weeks, 1223 infants at 12 months and 1142 infants at 24 months. Exclusive breast-feeding rates at hospital discharge, 6 weeks, 3 and 6 months postpartum were 84% (95% confidence interval (CI): 80-88%), 49% (95% CI: 43-55%), 37% (95% CI: 32-42%) and 9% (95% CI: 7-11%), respectively. Significant ethnic difference existed, with Samoan mothers having higher exclusive breast-feeding rates than Tongan mothers (P = 0.002). The percentage of infants receiving any breast milk at hospital discharge, 6 weeks, 12 and 24 months was 96% (95% CI: 94-97%), 95% (95% CI: 94-96%), 31% (95% CI: 28-34%) and 15% (95% CI: 13-17%), respectively. Again ethnic differences emerged. Common reasons cited for discontinuation of exclusive breast-feeding included uncertainty of breast milk supply (56%), problems with breasts (30%) and difficulties breast-feeding in work or educational environments (26%). However, 691 (50%) mothers sought no advice about their breast-feeding concerns within the first six weeks of life. CONCLUSIONS Exclusive breast-feeding rates for Pacific infants are ethnically heterogeneous, have declined since the 1990s and fall short of the World Health Organization recommendations. The principal reasons cited for exclusive breast-feeding discontinuation echo those reported over a decade ago.

Do perceptions of neighbourhood problems contribute to maternal health?: Findings from the Pacific Islands Families study

Research suggests that physical and social aspects of the neighbourhood have a bearing on our well-being. As part of the Pacific Islands Families Study, this study examined maternal perceptions and socio-demographic determinants of neighbourhood problems and their association with mental health. The main problems reported centred on noise, pollution and safety matters. Ethnicity, deprivation and alcohol consumption were the best predictors of greater perceived neighbourhood problems. Adjusted analyses showed that those reporting greater neighbourhood problems were almost twice as likely as those reporting fewer problems to have psychological morbidity. Mothers with high deprivation scores were 7.3 times more likely to have psychological morbidity. Findings suggest that neighbourhood quality and socio-economic position are important contributors to mental health. Negative effects on health are likely to derive from exposure to pollutants and from problem features in the neighbourhood acting as sources of psychosocial stress and barriers to health promoting activities. Improvements to services and regulations may contribute to health gains.

Pacific Islands Families Study: Factors associated with living in extended families one year on from the birth of a child*

Abstract Using data from the “Pacific Islands Families: the first two years of life (PIF) study”, this paper explores the factors associated with the living arrangements of mothers with a one‐year‐old Pacific child. Three living arrangements are considered: (1) those children who live with immediate family members only; (2) children who live with extended family members including at least one of their grandparents; and (3) children who live with extended family members but do not live with any of their grandparents. Findings of interest include: mothers who were born in New Zealand are much more likely to live in an extended family with the childs grandparent(s) compared to those who came to New Zealand as an adult; and mothers with high New Zealand identity and low Pacific identity being more likely to live with extended family members other than the childs grandparent(s) relative to those with low New Zealand and high Pacific identity.

Housing Tenure: Pacific Families in New Zealand

Home ownership has been associated with health, social and economic benefits. However, a decline in ownership has been observed over the past decade in New Zealand. Minority groups, including Pacific people, have been disadvantaged in the housing sector. This study investigated housing tenure and the relationship between tenure and health among mothers of a birth cohort of Pacific children in New Zealand. Findings showed that most families lived in state or private rental accommodation with few (15.4 per cent) owning their own homes. Homeowners were more likely to be older, partnered and have higher incomes. Better mental health was observed for homeowners compared to renters. Findings can inform housing and public health policy for Pacific families.