The Longitudinal Study of Australian Children
Annual statistical report 2010

11 Children's pre- and perinatal health experiences

Brigit Maguire, Australian Institute of Family Studies

Children's health is important for, and interrelates with, all aspects of their lives, including their ongoing development and long-term outcomes (Zubrick, Silburn, & Prior, 2005). Because the influence of health on children's ongoing wellbeing begins soon after conception (Currie, Stabile, Manivong, & Roos, 2010), this chapter focuses on children's early pre- and perinatal health experiences. Just as children's early health experiences form a foundation for their later outcomes, this chapter is a foundation for future reports and their examination of children's ongoing development, health and wellbeing.

This chapter examines how these early health experiences vary for Australian children from different subpopulation groups. Previous research has shown that health outcomes vary for different subpopulations (e.g., Kramer, Seguin, Lydon, & Goulet, 2000), and previous analysis of data from Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC) has examined the health experiences of the study sample as a whole.1 Wake et al. (2008) describe the prevalence of prenatal, perinatal and postnatal health issues for Australian infants. This chapter expands on this work to look at how these experiences differ for subpopulations of children. The subpopulation characteristics examined in this chapter are:

  • maternal age at birth;
  • family socio-economic position (SEP); and
  • whether the family lives in a metropolitan or regional area. (See Chapter 2 for details about these groups.)

Chi-square analyses were used to compare groups. Percentages for these subpopulation groups were compared independently (e.g., without examining the relationships between maternal age and family socio-economic position) and without adjusting for potential confounders, so the findings presented in this chapter form a foundation for future analyses that may further examine the effects of adverse early health experiences on children's development and later outcomes, for these and other subpopulation groups.

This chapter focuses on particular aspects of pregnancy and birth that may be indicators of risks to children's health, and for which data were collected in the first wave of LSAC. The chapter looks at whether children in the different subpopulation groups differ on their experiences of:

  • mothers' care providers during pregnancy
  • maternal conditions and medications taken during the pregnancy;
  • risky health behaviours by mothers during pregnancy, particularly drinking alcohol and smoking cigarettes; and
  • pre-term birth and low birth weight.

The majority of questions about children's early health experiences were asked of the B cohort only, so most of the results presented in this chapter are limited to that group of children. However, where comparable questions were also asked of the K cohort, comparisons are made between the two cohorts. Interpretations of these comparisons must be made in the context of the differences between the two cohorts.2 Because of the nature of the questions being explored, references to the "respondent" or the child's "mother" in this section refer to the child's biological mother only.

While many of the details discussed in this chapter were collected retrospectively in the study (that is, parents were asked to recall details that had occurred in the past), and may be subject to particular biases in their reporting, they provide a useful indication of the prevalence of certain behaviours and experiences. It is important to note also that membership of particular subpopulation groups is defined at the time of the first home visit in Wave 1, whereas experiences being compared are based on retrospective recall (e.g., during pregnancy). For example, the family's socio-economic position is defined at Wave 1, but the mother's antenatal care use occurred before this, while she was pregnant with the study child. However, it is assumed that few families would have moved between groups within this time period and that, on a population level, the pattern of differences remains consistent.

11.1 Who provides mothers with medical care during their pregnancy?

The majority (70%) of women in the study made ten or more visits to their medical care provider during the course of their pregnancy with the study child. Australian women have a number of choices about who provides them with medical care during their pregnancy. The main care providers are a general practitioner (GP), an obstetrician, a midwife, or a formal "shared care" arrangement (e.g., between their GP and a hospital). These medical care providers play a role in reducing health risks to both the mother and child. Knowledge of which medical care providers are most likely to have access to different subpopulation groups (e.g., younger mothers) means that information, services and interventions can be directed and targeted to particular health care settings to minimise the risks experienced by particular subpopulation groups.

Study respondents were asked to identify their primary care provider during the pregnancy with the study child. Obstetricians were the most common providers of antenatal care (42% of mothers), while 29% of mothers used GPs as their main source of medical care during the pregnancy. Twenty per cent used a midwife, 7% used a formal "shared care" arrangement, and 2% used another source of care.

Table 11.1 shows that the use of different medical care providers varied between different subpopulation groups - among women of different ages, between mothers from different SEPs, and between mothers living in metropolitan and regional areas. There were statistically significant variations between groups for all three comparisons.

Table 11.1 Use of antenatal care providers by maternal age at birth, by family SEP and by residence in metropolitan/regional area, B cohort, Wave 1
  GP % Obstetrician % Midwife % Formal "shared care" % Other % Nobody % Total % No. of observations
Mother's age at birth of child
Under 25 years 42.5 19.9 28.5 6.0 2.7 0.3 100.0 806
25-29 years 32.6 34.5 24.1 6.9 1.6 0.1 100.0 1,345
30-34 years 23.6 52.3 16.5 6.5 1.1 0.0 100.0 1,890
35-39 years 26.1 50.5 13.9 6.8 2.5 0.0 100.0 845
40 years or older 17.8 54.2 15.9 7.3 4.0 0.8 100.0 195
Family socio-economic position
Lowest 25% 43.7 20.8 24.9 7.3 3.0 0.2 100.0 1,268
Middle 50% 27.9 43.1 20.7 6.6 1.6 0.1 100.0 2,541
Highest 25% 14.2 67.1 12.2 5.5 0.9 0.0 100.0 1,272
Metropolitan/regional areas
Metropolitan 22.5 47.1 21.4 7.0 1.7 0.1 100.0 3,188
Regional 43.0 31.6 17.2 5.7 2.2 0.1 100.0 1,907

Note: Mother's age at birth of child: χ2(20, n = 5,081) = 379.8, p < .001; Family socio-economic position: χ2(10, n = 5,081) = 593.7, p < .001; Metropolitan/regional areas: χ2(5, n = 5,095) = 244.2, p < .001. Percentages may not total 100% due to rounding.

When compared to older mothers, younger mothers (less than 25 years) were less likely to receive care from an obstetrician and more likely to receive care from a GP or a midwife. For example, mothers who were younger than 25 years old when their child was born were more than twice as likely as mothers 40 years or older to use a GP as their primary source of care (43% versus 18%).

Mothers from families in the lowest 25% of SEP were three times more likely to use a GP as their primary source of antenatal care, twice as likely to use a midwife, and one third as likely to use an obstetrician, compared to mothers from families in the highest 25% of SEP.

Compared to women in metropolitan areas, women in regional areas were almost twice as likely to use a GP as their primary source of care during their pregnancy (43% of women in regional areas did so, compared to 23% of women in metropolitan areas). Conversely, women in regional areas were less likely to use an obstetrician or midwife (32% used an obstetrician and 17% used a midwife) compared to women in metropolitan areas (47% used an obstetrician and 21% used a midwife).

There was little difference between the groups in terms of those who used formal "shared care" or other arrangements for medical care during their pregnancy.

It is likely that differences between the age groups and levels of socio-economic position relate in part to differences in income and/or membership of private health insurance providers. Similarly, differences between mothers living in metropolitan and regional areas are expected to be related to differences in access to different forms of health care, as GPs are more likely than specialists such as obstetricians and midwives to be based in regional areas. However, these results show that all subpopulation groups used all care providers to some extent, so it is essential that all care providers are aware of any risks that may be specific to particular subpopulation groups.

11.2 What medications do mothers take during pregnancy?

The use of prescription and over-the-counter medications during pregnancy is an important issue, as medications may be beneficial or harmful to the pregnancy and the child (e.g., Kulaga, Zagarzadeh, & Berard, 2009; Lyerly, Little, & Faden, 2009). Other than those medications that pose a risk during pregnancy, the medications that women report taking during pregnancy may also provide some indication of the health problems they experienced, which may then have an impact on the child's health.

Study respondents were asked to report whether they had taken a range of prescription and over-the-counter medications during pregnancy. Thirty-one per cent of mothers in the study reported that they had taken some sort of prescription medicine during the pregnancy with the study child. Figure 11.1 shows the percentage of women who took each of a range of medications during the pregnancy. The most commonly taken prescription medication was antibiotics/penicillin (10% of mothers).

Figure 11.1 Mothers who reported taking prescription medications during pregnancy (n = 5,097), B cohort, Wave 1

Figure 11.1 Mothers who reported taking prescription medications during pregnancy (n = 5,097), B cohort, Wave 1 - as described in text

A higher proportion of women reported taking over-the-counter medications compared to prescription medication. Eighty-four per cent of women reported taking some sort of over-the-counter medication during their pregnancy with the study child. Figure 11.2 shows the percentage that took each of a range of medications. This list of medications includes both those that are recommended during pregnancy, such as folic acid or folate, and those that are not recommended during pregnancy (e.g., some cold and flu tablets). It is a government recommendation that all women take folic acid or folate before and during the first three months of pregnancy3 to prevent neural tube defects in the baby, and 59% of mothers in the study reported taking a folic acid or folate supplement during pregnancy.

Figure 11.2 Mothers who reported taking over-the-counter medications during pregnancy (n = 5,102), B cohort, Wave 1

Figure 11.2 Mothers who reported taking over-the-counter medications during pregnancy (n = 5,102), B cohort, Wave 1 - as described in text

Table 11.2 shows that the mother's age was significantly related to whether she took over-the-counter medications during pregnancy, but not to whether she took prescription medications. Mothers who were younger than 25 years or were 40 years or older when their child was born were most likely than other age groups to report taking prescription medicines during pregnancy. These two groups of women were also the least likely of all five groups to report taking over-the-counter medicines during pregnancy.

Table 11.2 Use of prescription and over-the-counter medications during pregnancy, by maternal age at birth and by family socio-economic position, B cohort, Wave 1
  Prescription medications taken during pregnancy Over-the-counter medications taken during pregnancy Use of folic acid/folate during pregnancy
% No. of observations % No. of observations % No. of observations
Mother's age at birth of child
Under 25 years 33.5 269 76.9 625 46.5 387
25-29 years 29.6 398 83.7 1,144 59.6 829
30-34 years 29.9 554 87.4 1,663 63.4 1240
35-39 years 29.5 249 85.3 724 61.0 534
40 years or older 32.2 61 82.7 163 58.9 118
Family socio-economic position
Lowest 25% 35.1 446 74.2 944 41.0 536
Middle 50% 28.8 721 86.3 2,204 62.4 1,616
Highest 25% 28.2 365 92.7 1,173 74.6 959
Metropolitan/regional areas
Metropolitan 30.4 967 85.3 2,745 60.6 2,015
Regional 30.8 570 81.8 1,581 55.4 1,097

Notes: Mother's age at birth of child - Prescription medications: χ2(4, n = 5,081) = 5.1, p = .35; Over-the-counter medications: χ2(4, n = 5,077) = 50.1, p < .001; Folic acid: χ2(4, n = 5,082) = 72.5, p < .001. Family socio-economic position - Prescription medications: χ2(2, n = 5,080) = 20.5, p < .001; Over-the-counter medications: χ2(2, n = 5,073) = 179.7, p < .001; Folic acid: χ2(2, n = 5,087) = 321.0, p < .001. Metropolitan/regional areas - Prescription medicines: χ2(1, n = 5,094) = 0.1, p = .80; Over-the-counter medications: χ2(1, n = 5,087) = 10.2, p = .02; Folic acid: χ2(1, n = 5,102) = 13.1, p = .02.

The use of medications during pregnancy was also related to the family's socio-economic position, with significant variation occurring between the three groups for both prescription and over-the-counter medications. As a family's socio-economic position increased, so did the likelihood of the mother taking over-the-counter medications during pregnancy. Mothers in the lowest 25% of socio-economic position were more likely to take prescription medicines during pregnancy compared to other mothers.

There was no significant difference between women living in metropolitan and regional areas, though women living in metropolitan areas were slightly more likely to report taking over-the-counter medications during pregnancy.

The third column of Table 11.2 shows how use of folic acid or folate supplements during pregnancy varied among different women. There was significant variation between women of different ages, with mothers who were younger than 25 years when the child was born being the least likely group to report taking folic acid during pregnancy. There was also a significant relationship with the family socio-economic position, as consumption of folic acid or folate increased with the family's socio-economic position. This is likely to reflect the importance of education for health behaviours during pregnancy (Kramer et al., 2000). Women in metropolitan areas were more likely to report taking folic acid during pregnancy compared to women living in regional areas, but this difference was not significant.

11.3 What medical conditions do mothers experience during pregnancy?

The conditions experienced by mothers during pregnancy provide an insight into the health risks faced by the mother and child. For example, the Avon Longitudinal Study of Parents and Children (ALSPAC) has found that maternal anxiety during pregnancy is related to the development of asthma in the child (Golding, 2010). Biological mothers were asked if they had experienced a range of health problems during their pregnancy with the study child.

In both the B and K cohorts, 6% of mothers reported having diabetes during pregnancy and 8% reported having high blood pressure needing treatment (admission to hospital or medication). B cohort mothers were also asked about other physical health problems (20% reported having these) and problems with stress, anxiety or depression (19% reported problems).

For the B cohort, the rates of maternal conditions during pregnancy varied with the mother's age and with the family's socio-economic position (though not all were significant). There was a significant relationship between the mother's age and the incidence of diabetes only. Table 11.3 shows that diabetes was more likely in older mothers, with mothers 40 years or older four times more likely to have diabetes than mothers younger than 25 years.4

Table 11.3 shows that the rates of maternal conditions during pregnancy also varied with family socio-economic position, though this variation was significant for high blood pressure and stress, anxiety or depression only. Mothers from a poorer socio-economic background were more likely to have high blood pressure or to experience stress, anxiety or depression during pregnancy.

Table 11.3 Medical conditions experienced during pregnancy, by maternal age at birth and by family socio-economic position, B cohort, Wave 1
  Diabetes High blood pressure Other physical health problems Stress, anxiety or depression
% No. of observations % No. of observations % No. of observations % No. of observations
Mother's age at birth of child
Under 25 years 3.5 20 10.7 60 18.8 105 23.4 131
25-29 years 5.8 58 8.6 94 18.0 207 17.5 192
30-34 years 4.8 80 7.2 113 19.9 328 17.4 281
35-39 years 8.2 55 7.4 47 23.6 171 19.8 139
40 years or older 15.6 26 11.8 18 27.7 44 22.6 40
Family socio-economic position
Lowest 25% 7.6 65 10.4 93 20.5 192 22.8 208
Middle 50% 5.6 119 8.8 179 20.1 427 18.6 394
Highest 25% 4.8 54 5.1 59 20.7 237 16.0 181

Notes: Mother's age at birth of child - Diabetes: χ2(4, n = 4,221) = 47.5, p < .001; High blood pressure: χ2(4, n = 4,236) = 11.3, p = .05; Other health problems: χ2(4, n = 4,227) = 15.7, p = .01; Stress, anxiety or depression: χ2(4, n = 4,224) = 13.8, p = .01. Family socio-economic position - Diabetes: χ2(2, n = 4,214) = 8.4, p = .03; High blood pressure: χ2(2, n = 4,229) = 20.8, p < .001; Other health problems: χ2(2, n = 4,220) = 0.2, p = .92; Stress, anxiety or depression: χ2(2, n = 4,217) = 16.5, p < .001.

11.4 How many mothers report drinking alcohol or smoking cigarettes during pregnancy?

Risky health behaviours by the mother during pregnancy, particularly drinking alcohol (National Health and Medical Research Council NHMRC, 2009) and smoking cigarettes (Australian Institute of Health and Welfare AIHW, 2009), increase the risk of harm to the child. Smoking during pregnancy has been associated with a range of health and developmental problems for the child during the perinatal and postnatal periods, and also for their long-term health and developmental outcomes. These health and developmental problems include risk of spontaneous abortion, ectopic pregnancy, low birth weight, birth defects, respiratory problems, poor cognitive development and psychological problems (AIHW, 2009). While high levels of alcohol consumption during pregnancy have been shown to be associated with severe outcomes for the baby (including miscarriage, stillbirth, birth defects, and neurological and cognitive problems) (AIHW, 2009), there has generally been less consensus on whether low to moderate alcohol consumption is dangerous during pregnancy (Henderson, Gray, & Brocklehurst, 2007). However, the Australian Government has recently released new guidelines that recommend that women do not drink any alcohol during pregnancy (NHMRC, 2009). Analyses of LSAC data (Waves 1 and 2) has shown that close to a quarter of parents (mothers and fathers) of study children smoke cigarettes, and persistence of smoking was more likely among younger, less educated parents, and those with problematic alcohol use and financial problems (Maloney, Hutchinson, Burns, & Mattick, 2010).

Respondents were asked whether they drank alcohol or smoked cigarettes during the pregnancy with the study child and, if so, how much and how often, for each trimester of the pregnancy. This section examines the percentage of mothers who reported drinking alcohol or smoking cigarettes at some stage during the pregnancy. While these are simple measures of risky behaviour during pregnancy (particularly given that these data are probably subject to under-reporting), they provide some indication of the prevalence of these behaviours in the general population, and for different subpopulation groups.

Mothers from both the B and K cohorts were asked to report their alcohol consumption and cigarette use, which means that we can make comparisons between the two cohorts. This is of particular interest given historical changes in the Australian Government's recommendations on alcohol consumption during pregnancy. As described in Powers et al. (2010), the guidelines between 1992 and late 2001 recommended that women not drink alcohol during pregnancy. However, in 2001 the guidelines were revised to suggest it was safe to drink small amounts of alcohol during pregnancy, before being changed again in 2009 to the current guidelines recommending no alcohol consumption during pregnancy.

Table 11.4 shows the percentages of mothers in the two cohorts who reported drinking alcohol and who reported smoking cigarettes during their pregnancy. Notwithstanding the differences between the two groups (see introduction to this chapter), the rates of mothers who reported smoking during pregnancy were relatively stable between the two cohorts, with a slight decline consistent with a continued anti-smoking message. However, the numbers of mothers who reported drinking alcohol at some stage of the pregnancy was about 10 percentage points higher for the B cohort (who were born in 2003-04) compared to the K cohort (who were born in 1999-2000). This suggests that rates of alcohol consumption in pregnancy were higher after the release of the less stringent guidelines; however, further research is needed to disentangle the possible effects of under-reporting. The results obtained here are also lower than the rates of alcohol consumption found by Powers et al.'s (2010) analysis of data from the Australian Longitudinal Study on Women's Health, which warrants further analysis of these data in LSAC.

Table 11.4 Percentage of mothers who reported drinking alcohol/smoking cigarettes during pregnancy, B and K cohorts, Wave 1
  Drank alcohol during pregnancy Smoked cigarettes during pregnancy
% No. of observations % No. of observations
K cohort (born 1999-2000) 27.6 1,186 20.0 740
B cohort (born 2003-04) 37.6 1,633 18.3 709

In the B cohort, alcohol consumption and smoking of cigarettes were both significantly related to the age of the mother when the child was born, though in different ways. Table 11.5 shows that older mothers were more likely to report drinking alcohol at some stage during pregnancy: mothers who were 40 years or older when their child was born were more than twice as likely as mothers under 25 years to report drinking (though it is not possible using these data to disentangle the extent to which this is a reporting phenomenon). In contrast, younger mothers were more likely to report smoking during pregnancy: mothers who were younger than 25 years were more than three times as likely to say they smoked, compared to mothers 40 years and older. Recent research has found that the long-term effects of alcohol consumption during pregnancy are related to the mother's age; for example, Chiodo et al. (2010) found that the effect of alcohol consumption on children's performance on measures of attention (e.g., ability to maintain focus on a particular task) at age 7 years was worse for older mothers.

There was a similar (significant) pattern of smoking and alcohol consumption during pregnancy for the three family socio-economic groups. Table 11.5 shows that smoking was less likely and alcohol consumption at some stage during the pregnancy was more likely as a family's socio-economic position increased, with large differences between families in the bottom ranking and the top ranking for both behaviours.

Women living in metropolitan areas were more likely to report drinking alcohol during pregnancy than those in regional areas (though this was not significant). However, women in regional areas were 10 percentage points more likely to report smoking during pregnancy (and this was significant).

Note that these data look only at whether mothers drank alcohol or smoked cigarettes at some stage during their pregnancy. A more detailed analysis could investigate the frequency and amount of alcohol consumption and cigarette smoking.

Table 11.5 Drinking alcohol and cigarette smoking, by maternal age at birth and by family socio-economic position, B cohort, Wave 1
  Drank alcohol during pregnancy Smoked cigarettes during pregnancy
% No. of observations % No. of observations
Mother's age at birth of child
Under 25 years 19.8 116 36.9 202
25-29 years 32.4 373 18.4 195
30-34 years 44.2 738 14.5 209
35-39 years 44.4 335 12.8 88
40 years or older 42.3 70 9.9 14
Family socio-economic position
Lowest 25% 22.9 213 35.8 322
Middle 50% 38.3 829 16.3 336
Highest 25% 51.8 590 4.2 48
Metropolitan/regional areas
Metropolitan 38.9 1,070 15.2 367
Regional 35.0 563 24.6 342

Notes: Mother's age at birth of child - Drank alcohol: χ2(4, n = 4,225) = 142.5, p < .001; Smoked cigarettes: χ2(4, n = 4,237) = 184.0, p < .001. Family socio-economic position - Drank alcohol: χ2(2, n = 4,218) = 186.3, p < .001; Smoked cigarettes: χ2(2, n = 4,230) = 360.1, p < .001. Metropolitan/regional areas - Drank alcohol: χ2(1, n = 4,227) = 6.1, p = .05; Smoked cigarettes: χ2(1, n = 4,239) = 56.0, p < .001.

11.5 Which mothers had a pre-term birth or a child with a low birth weight?

Both pre-term birth (born before 37 weeks of gestation (Laws & Sullivan, 2009)) and low birth weight (less than 2,500 grams5) have been found to be associated with a range of ongoing health effects. Pre-term birth is associated with increased risk of cerebral palsy, sensory disabilities, learning problems and respiratory problems, and problems associated with pre-term birth continue throughout life (Beck et al., 2010). Low birth weight is associated with effects such as neurological and physical disabilities, and the effects of low birth weight also continue through childhood and adolescence into adulthood (AIHW, 2009). Gestational age and low birth weight are associated, as babies can be of low birth weight due to being born early or because of poor growth (Laws & Sullivan, 2009).

Of the children in the B cohort, 5% were born late (42 weeks gestation or later), 89% were born on time (37-41 weeks), 5% were born somewhat early (33-36 weeks), and 2% were born very early (32 weeks or earlier). Of the children in the B cohort, 94% were a normal weight (2,500 g and heavier), and 6% had a low birth weight (less than 2,500 g).

Table 11.6 shows that mother's age was not significantly related to gestational age, but older mothers (aged 40 or older) were most likely to have a pre-term birth: 9% did so, compared to 7% of mothers in their 30s. Young mothers (younger than 25 years) and older mothers (40 years or older) were the most likely to have a late birth. The table shows that incidence of low birth weight did not vary significantly between mothers of different ages, though mothers younger than 25 when the child was born were most likely to have a baby with low birth weight.

Table 11.6 Gestational age and low birth weight, by maternal age at birth and by family socio-economic position, B cohort, Wave 1
  Gestational age Low birth weight
Late birth (42 weeks or later) % On time (37-41 weeks) % Somewhat early (33-36 weeks) % Very early (32 weeks or earlier) % Total % No. of observations % No. of observations
Mother's age at birth of child
Under 25 years 5.5 87.2 5.7 1.7 100.0 807 6.7 800
25-29 years 4.3 89.8 4.8 1.1 100.0 1,347 5.9 1,339
30-34 years 4.8 88.3 5.2 1.8 100.0 1,889 5.0 1,881
35-39 years 3.9 89.3 4.8 1.9 100.0 843 5.7 840
40 years or older 5.4 85.3 6.7 2.6 100.0 194 5.9 194
Family socio-economic position
Lowest 25% 4.9 86.1 6.8 2.2 100.0 1,270 7.2 1,251
Middle 50% 4.5 88.7 5.0 1.8 100.0 2,544 6.1 2,538
Highest 25% 4.7 91.1 3.7 0.6 100.0 1,270 3.0 1,269

Note: Mother's age at birth of child - Gestational age: χ2(12, n = 5,080) = 9.9, p = .72; Low birth weight: χ2(4, n = 5,054) = 3.7, p = .51. Family socio-economic position - Gestational age: χ2(6, n = 5,084) = 24.9, p < .01; Low birth weight: χ2(2, n = 5,058) = 23.0, p < .001. Percentages may not total 100% due to rounding.

Table 11.6 also shows that family socio-economic position was significantly related to gestational age. Mothers from families with a low socio-economic position were twice as likely as mothers from families in the top 25% of socio-economic position to have a pre-term birth. Low birth weight was also significantly related to the family's socio-economic position: children were twice as likely to have a low birth weight if they were in the lowest 25% or middle 50% on the ranking of family socio-economic position, compared to those in the top 25%.

11.6 Summary

This chapter has examined particular aspects of children's early health experiences that may be indicators of risks to children's health, and has explored how these early health experiences vary for Australian children from different subpopulation groups.

There was little variation between mothers living in metropolitan or regional areas, though women living in regional areas were more likely to report smoking at some time during pregnancy.

Younger mothers were less likely to take over-the-counter medications, less likely to drink alcohol at some stage during pregnancy, but more likely to smoke. Older mothers were more likely to experience diabetes during their pregnancy, to drink alcohol at some stage during pregnancy, but less likely to smoke.

Mothers from a poorer socio-economic background were more likely to take prescription medicines and less likely to take over-the-counter medications during pregnancy. They were more likely to smoke, have high blood pressure and stress, anxiety or depression during pregnancy, and their children were more likely to be born pre-term, and to have a low birth weight. Mothers from the top 25% of socio-economic position were more likely to report drinking alcohol at some stage during pregnancy compared to other mothers.

It is likely that there are relationships between the comparisons made in this chapter; for example, mother's age is related to family socio-economic position (as younger mothers are more likely to be less educated and to have lower incomes). This chapter has compared subpopulation groups independently, without adjusting for potential confounders or statistically testing differences, and further analyses are warranted to examine the effects of adverse early health experiences on children's development and later outcomes, for these and other subpopulation groups. Nevertheless, the care providers used by different groups of women play an important role in ensuring that health risks specific to particular groups are minimised and that children from all subpopulation groups have a chance to experience a healthy start to life. Future research will be able to use LSAC data to investigate the association between children's early pre- and perinatal health experiences and their later health and developmental outcomes.

11.7 Further reading

  • Baxter, J. (2008). Breastfeeding, employment and leave: An analysis of mothers in Growing Up in Australia. Family Matters, 80, 17-26.
  • Baxter, J., Cooklin, C., & Smith, J. (2009). Which mothers wean their babies prematurely from full breastfeeding? An Australian cohort study. Acta Paediatrica, 98(8), 1274-1277.
  • Baxter, J., & Smith, J. (2009). Breastfeeding and infants' time use (Research Paper No. 43). Melbourne: Australian Institute of Family Studies
  • Cooklin, A. R., Donath, S. M., & Amir, L. H. (2008). Maternal employment and breastfeeding: Results from the Longitudinal Study of Australian Children. Acta Paediatrica, 97(5), 620-623.
  • Donath, S. M., & Amir, L. (2008). Maternal obesity and initiation and duration of breastfeeding: Data from the Longitudinal Study of Australian Children. Maternal and Child Nutrition, 4, 163-170.
  • Nicholson, J. M., & Sanson, A. (2003). A new longitudinal study of the health and wellbeing of Australian children: How will it help. Medical Journal of Australia, 178(6), 282-284.
  • Qu, L., Soriano, G., & Weston, R. (2006) Starting early, starting late: The health and wellbeing of mother and child. Family Matters, 74, 4-11.
  • Wake, M., Sanson, A., Berthelsen, D., Hardy, P., Misson, S., Smith, K., et al. (2008). How well are Australian infants and children aged 4 to 5 years doing? (Social Policy Research Paper No. 36). Canberra: Department of Families, Housing, Community Services and Indigenous Affairs.

11.8 References

  • Australian Institute of Health and Welfare. (2009). A picture of Australia's children 2009. Canberra: AIHW.
  • Beck, S., Wojdyla, D., Say, L., Betran, A. P., Merialdi, M., Requejo, J. H., et al. (2010). The worldwide incidence of preterm birth: A systematic review of maternal mortality and morbidity. Bulletin of the World Health Organization, 88, 31-38.
  • Chiodo, L. M., da Costa, D. E., Hannigan, J. H., Covington, C. Y., Sokol, R. J., Janisse, J., Greenwald, M., Ager, J., & Delaney-Black, V. (2010). The impact of maternal age on the effects of prenatal alcohol exposure on attention. Alcoholism: Clinical Experimental Research, 34(10), 1813-1821.
  • Commonwealth of Australia. (2010). LSAC data users information. Melbourne: Australian Institute of Family Studies. Retrieved from <www.aifs.gov.au/growingup/data/index.html>.
  • Currie, J., Stabile, M., Manivong, P., & Roos, L. L. (2010). Child health and young adult outcomes. Journal of Human Resources, 45(3), 517.
  • Food Standards Australia New Zealand. (2010). Folic acid/folate. Canberra: FSANZ. Retrieved from <www.foodstandards.gov.au/consumerinformation/adviceforpregnantwomen/folicacidfolateandpr4598.cfm>.
  • Golding, J. (2010). Determinants of child health and development: The contribution of ALSPAC. A personal view of the birth cohort study. Archives of Disease in Childhood, 95(5), 319-322.
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Footnote(s)

1 The Australian Institute of Health and Welfare (AIHW) National Perinatal Statistics Unit also reports annually on the pregnancy and childbirth of mothers in Australia (e.g., Laws & Sullivan, 2009).

2 For example, see the LSAC Data Users Guide (Commonwealth of Australia, 2010). K cohort children were 4-5 years old at the first wave of the study, so their mothers were recalling pregnancy and birth details that occurred further in the past, and were more likely than B cohort mothers to have had another pregnancy in the interim.

3 See, for example, Food Standards Australia New Zealand (2010).

4 Note that the questionnaire did not distinguish between different types of diabetes (e.g., gestational diabetes).

5 This is the definition of low birth weight provided by the World Health Organization (2010).

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