Zealand European Children Research Articles

Children talking about their sleep: a cross-sectional survey of differences by ethnicity and socioeconomic status in Aotearoa New Zealand primary schools.

This study examined differences by ethnicity and socioeconomic status in attitudes to sleep and bedtime routine, as self-reported by children aged 7-9 years. Four groups of parent-child dyads were recruited: Māori participants from low- (n = 18) and high- (n = 17) decile schools and New Zealand European participants from low- (n = 18) and high- (n = 17) decile schools. Children completed a questionnaire about their sleep, a self-report of anxiety symptoms, and a semistructured interview. Most (77%) children reported liking to go to sleep (Māori, 88% vs New Zealand European, 65%; P = .053) and 28% reported trouble sleeping. Māori children were less likely to report fear of the dark and fighting about going to bed. Liking going to sleep was associated with less fear of the dark and of sleeping alone. Children from low-decile schools more often reported waking with pain and feeling sleepy (P = .022) and taking naps (P = .018) during the day. They also had more symptoms of anxiety. New Zealand European children more frequently reported using "screen time" (P = .02) or "reading a book" (P = .05). Children attending high-decile schools were more likely to read at bedtime (P = .01), whereas children attending low-decile schools were more likely to have "play time" (P = .02). Children were able to articulate what was a good night and bad night sleep. These findings suggest that more adverse differences in sleep habits and attitudes in children are most likely to be related to socioeconomic status than to ethnicity. Elder D, Miller J, Douglas B, Stanley J, McDowall P, Campbell A. Children talking about their sleep: a cross-sectional survey of differences by ethnicity and socioeconomic status in Aotearoa New Zealand primary schools. J Clin Sleep Med. 2023;19(1):119-133.

Moe Kitenga: a qualitative study of perceptions of infant and child sleep practices among Māori whānau

Insufficient sleep is a strong risk factor for unhealthy weight gain in children. Māori (the indigenous population of Aotearoa (New Zealand)) children have an increased risk of unhealthy weight gain compared to New Zealand European children. Interventions around sleep could provide an avenue for improving health and limiting excessive weight gain with other meaningful benefits for whānau (extended family) well-being. However, current messages promoting good sleep may not be realistic for many Māori whānau. Using qualitative methods, the Moe Kitenga project explored the diverse realities of sleep in 14 Māori whānau. We conclude that for infant sleep interventions to prevent obesity and improve health outcomes for Māori children, they must take into account the often pressing social circumstances of many Māori whānau that are a barrier to adopting infant sleep recommendations, otherwise sleep interventions could create yet another oppressive standard that whānau fail to live up to.

Sleep patterns in children differ by ethnicity: cross-sectional and longitudinal analyses using actigraphy

ObjectivesTo determine whether sleep patterns (duration, timing, efficiency) differ by ethnicity. DesignLongitudinal study. SettingDunedin, New Zealand. ParticipantsA total of 939 children (48% male) aged 4-12 years (572 European, 181 Māori, 111 Pacific, 75 Asian). MeasurementsAll measurements were obtained at months 0, 12, and 24. Anthropometry was obtained using standard techniques, and parents completed questionnaires assessing demographics, dietary intake, and television habits of children. Sleep and physical activity were measured using Actigraph accelerometers over 1 week. Differences in sleep outcomes according to ethnicity were adjusted for demographics, weight status, and behavioral variables using mixed models. ResultsPacific children had greater body mass index and were more likely to live in deprived areas than children from other ethnic groups (all P<.001), but few differences were observed in behavioral variables. Pacific Island children slept 16 (95% confidence interval, 7-25) minutes less per night than New Zealand European children, predominantly as a result of later bedtimes (29; 20-38 minutes). By contrast, sleep efficiency did not differ by ethnicity or over time (all P≥.118). Māori children did not show the same relative deficits in sleep, displaying similar results to European children. Sleep duration decreased by 8 minutes (95% confidence interval, 6-10) a night each year over 2 years, and change over time did not differ by ethnicity (all P≥.165). ConclusionsFrom a young age, Pacific children had poorer sleep patterns than European children, and these patterns were maintained over 2 years.

Gene-by-Activity Interactions on Obesity Traits of 6-Year-Old New Zealand European Children: A Children of SCOPE Study.

The decline of physical activity in children is considered an important determinant to explain the rising rates of obesity. However, this risk may be augmented in children who are genetically susceptible to increased weight gain. We hypothesized that a sedentary lifestyle and moderate activity will interact with genetic loci, resulting in differential effects in relation to obesity risk. We recruited 643 European children born to participants in the New Zealand-based Screening for Pregnancy Endpoints (SCOPE) study. Seventy gene variants were evaluated by the Sequenom assay. Interaction analyses were performed between the genetic variants and the activity type derived from actigraphy, in relation to percentage body fat. We found a statistically significant association between increased proportions of sedentary activity with increased percentage body fat scores (P = .012). The OLFM4-9568856 (P = .01) and GNPDA2-rs10938397 (P = .044) gene variants showed genotype differences with proportions of sedentary activity. Similarly, the OLFM4-9568856 (P = .021), CLOCK-rs4864548 (P = .029), and LEPR-1045895 (P = .047) showed genotype differences with proportions of moderate activity. We found evidence for unadjusted gene-by-activity interactions of SPACA3/SPRASA-rs16967845, PFKP-rs6602024, and SH2B1-rs7498665 on percentage body fat scores. These findings indicate a differential effect of physical activity in relation to obesity risk, suggesting that children genetically predisposed to increased weight gain may benefit from higher levels of moderate activity.

Gene-by-environment interactions of the CLOCK, PEMT, and GHRELIN loci with average sleep duration in relation to obesity traits using a cohort of 643 New Zealand European children

ObjectivesModern technology may have desensitised the ‘biological clock’ to environmental cues, disrupting the appropriate co-ordination of metabolic processes. Susceptibility to misalignment of circadian rhythms may be partly genetically influenced and effects on sleep quality and duration could predispose to poorer health outcomes. Shorter sleep duration is associated with obesity traits, which are brought on by an increased opportunity to eat and/or a shift of hormonal profile promoting hunger. We hypothesised that increased sleep duration will offset susceptible genetic effects, resulting in reduced obesity risk. MethodsWe recruited 643 (male: 338; female: 305) European children born to participants in the New Zealand centre of the International Screening for Pregnancy Endpoints sleep study. Ten genes directly involved in the circadian rhythm machinery and a further 20 genes hypothesised to be driven by cyclic oscillations were evaluated by Sequenom assay. Multivariable regression was performed to test the interaction between gene variants and average sleep length (derived from actigraphy), in relation to obesity traits (body mass index (BMI) z-scores and percentage body fat (PBF)). ResultsNo association was found between average sleep length and BMI z-scores (p = 0.056) or PBF (p = 0.609). Uncorrected genotype associations were detected between STAT-rs8069645 (p = 0.0052) and ADIPOQ-rs266729 (p = 0.019) with differences in average sleep duration. Evidence for uncorrected gene-by-sleep interactions of the CLOCK-rs4864548 (p = 0.0039), PEMT-936108 (p = 0.016) and GHRELIN-rs696217 (p = 0.046) were found in relation to BMI z-scores but not for PBF. ConclusionOur results indicate that children may have different genetic susceptibility to the effects of sleep duration on obesity. Further confirmatory studies are required in other population cohorts of different age groups.

Analysis of association of gene variants with obesity traits in New Zealand European children at 6 years of age.

Childhood obesity is a public health problem, which is associated with a long-term increased risk of cardiovascular disease and premature mortality. Several gene variants have previously been identified that have provided novel insights into biological factors that contribute to the development of obesity. As obesity tracks through childhood into adulthood, identification of the genetic factors for obesity in early life is important. The objective of this study was to identify putative associations between genetic variants and obesity traits in children at 6 years of age. We recruited 1208 children of mothers from the New Zealand centre of the international Screening for Pregnancy Endpoints (SCOPE) study. Eighty common genetic variants associated with obesity traits were evaluated by the Sequenom assay. Body mass index standardised scores (BMI z-scores) and percentage body fat (PBF; measured by bio-impedance assay (BIA)) were used as anthropometric measures of obesity. A positive correlation was found between BMI z-scores and PBF (p < 0.001, r = 0.756). Two subsets of gene variants were associated with BMI z-scores (HOXB5-rs9299, SH2B1-rs7498665, NPC1-rs1805081 and MSRA-rs545854) and PBF (TMEM18-rs6548238, NPY-rs17149106, ETV-rs7647305, NPY-rs16139, TIMELESS-rs4630333, FTO-rs9939609, UCP2-rs659366, MAP2K5-rs2241423 and FAIM2-rs7138803) in the genotype models. However, there was an absence of overlapping association between any of the gene variants with BMI z-scores and PBF. A further five variants were associated with BMI z-scores (TMEM18-rs6548238, FTO-rs9939609 and MC4R-rs17782313) and PBF (SH2B1-rs7498665 and FTO-rs1421085) once separated by genetic models (additive, recessive and dominant) of inheritance. This study has identified significant associations between numerous gene variants selected on the basis of prior association with obesity and obesity traits in New Zealand European children.

Risk factors for migraine and tension-type headache in 11 year old children

BackgroundThough migraine and tension type headache are both commonly diagnosed in childhood, little is known about their determinants when diagnosed prior to puberty onset. Our aim was to determine psychosocial- and health-related risk factors of migraine and tension-type headache in 11 year old children.Methods871 New Zealand European children were enrolled in a longitudinal study at birth and data were collected at birth, 1, 3.5, 7, and 11 years of age. Primary headache was determined at age 11 years based on the International Headache Society. Perinatal factors assessed were small for gestational age status, sex, maternal smoking during pregnancy, maternal perceived stress, and maternal school leaving age. Childhood factors assessed were sleep duration, percent body fat, television watching, parent and self-reported total problem behaviour, being bullied, and depression.ResultsPrevalence of migraine and tension-type headache was 10.5% and 18.6%, respectively. Both migraine and TTH were significantly associated with self-reported problem behaviour in univariable logistic regression analyses. Additionally, migraine was associated with reduced sleep duration, and both sleep and behaviour problems remained significant after multivariable analyses. TTH was also significantly associated with antenatal maternal smoking, higher body fat, and being bullied. For TTH, problem behaviour measured at ages 3.5 and 11 years both remained significant after multivariable analysis. Being born small for gestational age was not associated with either headache group.ConclusionsAlthough they share some commonality, migraine and tension-type headache are separate entities in childhood with different developmental characteristics. The association between primary headache and problem behaviour requires further investigation.

Epidemiology and outcome of acute kidney injury in New Zealand children

To determine the aetiology, incidence and short-term outcomes of New Zealand children with acute kidney injury (AKI) requiring renal replacement therapy (RRT) over a 6-year period. A retrospective chart review of all children requiring RRT for AKI from January 2001 to December 2006 at Starship Children's Hospital, Auckland, New Zealand was conducted. The primary outcome was survival to discharge. A total of 226 children required RRT for AKI over the 6-year study period. The annual incidence was 4.0 per 100,000 total population under 15 years of age. The commonest causes of AKI were post cardiac surgery (58%), haemolytic uraemic syndrome (17%), sepsis (13%) and glomerulonephritis (4%). The survival rate to hospital discharge was 89%. A total of 40% of all surviving children had one or more abnormalities at the time of discharge suggestive of ongoing renal dysfunction (hypertension, continuing need for antihypertensive medication, reduced estimated glomerular filtration rate or abnormal urinalysis). More Maori and Pacific Island children were treated for AKI than would be expected from population data (P < 0.0001). Sepsis and glomerulonephritis were seen more commonly as causes of AKI in Maori and Pacific Island children compared with New Zealand European children. In our study, 40% of surviving children had evidence of short-term renal dysfunction at discharge following AKI. This suggests that all children should undergo a period of follow-up after any episode of AKI to look for resolution or further development of signs of renal injury.

Risk factors for obesity in 7-year-old European children: the Auckland Birthweight Collaborative Study

Objective:To identify risk factors associated with obesity in primary school children, with a particular focus on those which can be modified. To identify critical periods and growth patterns in the...

At-Home Breakfast Consumption among New Zealand Children: Associations with Body Mass Index and Related Nutrition Behaviors

Objective The evidence supporting the relationship between breakfast consumption and body weight is growing, but the mechanisms to explain this relationship are less understood. This study aims to describe the relationship between breakfast consumption and body mass index (BMI) and relevant nutrition behaviors. Design Cross-section design using the New Zealand’s 2002 National Children’s Nutrition Survey. Participants were interviewed about their food habits and physical activity, completed a food frequency questionnaire, and were weighed and measured for height. Subjects/setting A nationally representative sample of 3,275 children aged 5 to 14 years. Main outcome measures Breakfast consumption, BMI, and nutrition behaviors. Statistical analyses performed The demographic characteristics of children by breakfast consumption were generated by cross-tabulations. Regression models were used to examine the relationships between breakfast consumption and BMI and nutrition behaviors. Results Breakfast consumption was most frequent among boys, children aged 5 to 6 years, children aged 7 to 10 years, New Zealand European children, and children from more affluent neighborhoods. Age differences in breakfast consumption increased with socioeconomic deprivation; older children experiencing the most socioeconomic deprivation were the least likely to eat breakfast. Skipping breakfast was associated with a higher BMI ( P=0.002). Children who missed breakfast were significantly less likely to meet recommendations for fruit and vegetable consumption ( P=0.005) and more likely to be frequent consumers of unhealthy snack foods. No relationship was found between breakfast consumption and physical activity. Discussion Results from our study suggest that efforts to increase breakfast consumption should be prioritized for older children from more deprived backgrounds. Increasing at home breakfast consumption may limit the amount of unhealthful snack foods children consume later in the day. Schools also have the potential to make a reasonable nutritional impact by providing healthful and affordable breakfast options for children who do not eat breakfast at home.

Determinants of developmental delay in infants aged 12 months

The aim of this study was to determine which demographic, maternal, obstetric and postnatal variables were associated with achievement of developmental milestones at the age of 12 months in term infants. Mothers and babies were enrolled in the Auckland Birthweight Collaborative Study shortly after birth. All infants were full term (gestation >or= 37 weeks). Approximately half of the sample were small for gestational age (SGA = birthweight <or= 10th percentile), and half were appropriate for gestational age (AGA = birthweight > 10th percentile). A maternal interview was conducted soon after birth. Phase 2 of the study occurred 12 months later when mothers were sent a postal questionnaire requesting information about the child's health and development during the first year of life using the Denver Prescreening Developmental Questionnaire. Seven hundred and forty-four (85.4%) European mothers returned the postal questionnaire. SGA children were not at increased risk of developmental delay at 12 months of age. In a sample representative of New Zealand European children, after adjustment for the effects of potential confounders, maternal smoking during pregnancy (OR = 2.1 [95% CI 1.1, 4.0]), maternal smoking during the first year of life (OR = 1.9 [95% CI 1.0, 3.8]) and low levels of satisfaction with parenting (OR = 2.4 [95% CI 1.1, 5.2]) were associated with significantly increased risk of developmental delay. In the subgroup of SGA children, maternal smoking during pregnancy (OR = 2.9 [95% CI 1.4, 6.2]), high levels of stress associated with parenting (OR = 2.2 [95% CI 1.2, 4.0]), and low levels of satisfaction with parenting (OR = 4.3 [95% CI 1.3, 13.5]) were significantly associated with developmental delay after adjustment for the effects of potential confounders. In conclusion, maternal and postnatal factors were better predictors of developmental delay than demographic variables.