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Aim: Many, varied, antenatal risk factors can adversely impact children's health, behaviour and cognition. Understanding the antenatal risk factors experienced by women can help identify which families are most likely to benefit from additional early supports; however, there is a dearth of published Australian antenatal risk data. This study aimed to determine the prevalence and co-occurrence of a broad range of risk factors in a community-based sample of pregnant Australian women.Methods: A brief risk factor survey (10 items, including age, social support, health, smoking, stress or anxious mood, education, household income, employment) completed by pregnant women attending the antenatal clinic waiting rooms of 10 public maternity hospitals, which were selected for their provision of care to areas with fewer socio-economic resources in the states of Victoria and Tasmania, between May 2013 and August 2014.Results: A total of 5586 women participated, with an average age of 29.0 years and gestation of 26.9 weeks. The most prevalent antenatal risk factors were poorer global health (38.9%), not finishing high school (33.5%) and smoking (14.9%), all proportions higher than the general population. Most women reported at least one risk factor (68.6%), with 21.5% reporting ≥3. There was a high degree of co-occurrence between risk factors, especially the three most prevalent.Conclusions: This study reveals the considerable and varied risk burden experienced by Australian women during pregnancy. By understanding where need is greatest and tailoring support accordingly, risk factor assessment provides an opportunity to address equity through health care, ultimately optimising the future developmental outcomes of all children. [ABSTRACT FROM AUTHOR]

Aim Glycosylated haemoglobin ( HbA1c), a marker of diabetic glycemic control, is associated with chronic psychosocial stress in non-diabetic adults. This study aimed to determine whether HbA1c also acts as a biomarker of psychosocial stress in healthy 6-year-olds. Methods Design and participants: Eligible participants were 326 children recruited from 6 socio-economically diverse areas in Melbourne, Australia, who took part in an earlier randomised trial for sleep problems at age 7 months. At 6 years, they participated in a follow-up assessment. Outcome : HbA1c collected by finger-prick. Exposures (collected simultaneously) : proxy measures of child stress including: (i) child mental health; (ii) maternal mental health (depression, anxiety, stress), negative life events in the preceding year, life stresses and coping; and (iii) family socioeconomic status and financial stress. Analyses: linear regressions, adjusted for original randomisation status and clustering. Results Sixty percent (134/225) of children retained at 6 years provided HbA1c data, which ranged from 3.9%-5.8% ( SD 0.3%). No child or family variable was associated with HbA1c. Of the maternal variables, only anxiety predicted HbA1c (adjusted difference per point increase: −0.01, 95% CI: −0.003 to 0.02, P = 0.01); this association was in the opposite direction to that hypothesised and clinically insignificant. Conclusion HbA1c was not associated with psychosocial stress in healthy 6-year-olds. This suggests that any link between HbA1c and psychosocial stress emerges after this age, and that HbA1c is unlikely to be a reliable biomarker for stress in early childhood or over the transition to school. [ABSTRACT FROM AUTHOR]

Aim: Australian data on the prevalence and distribution of antenatal risk factors are scarce. This study aimed to investigate (i) the feasibility and acceptability of an antenatal risk factor survey collected in public settings and (ii) whether the survey risk factors co-occur with more sensitive risk factors that are privately asked by clinicians.Methods: Design and setting: study-designed survey linked with clinician-collected risk factors.Participants: pregnant women attending antenatal clinics at two Victorian hospitals.Measures: (i) study-designed survey: young pregnancy, no support, poor/fair/good general health, anxious mood, not finishing high school, no income, long-term illness, living without another adult, not employed, never had a job and proxy poverty measures; (ii) Clinician-collected data: smoking, alcohol/marijuana/drug use, domestic violence, social issues, history of mental health problems and depression symptoms.Analyses: (i) feasibility and acceptability were assessed through survey completion. Each item was assessed for whether they discriminated risk; dichotomised into risk versus no risk; with a total count calculated. (ii) Co-occurrence was assessed by examining how the risk factor count agreed with clinician-collected items.Results: One hundred and sixty-six of 186 (89%) eligible women completed the survey; 139 of 166 (84%) consented to linking clinician-collected data. The high response and zero missing data demonstrated feasibility and acceptability. Of women with linked data, 92 of 139 (66%) had ≥1 survey risk factor and 30 of 139 (22%) had ≥3; 36 of 139 (26%) had at least one co-occurring clinician-collected risk factor.Conclusions: This survey provides a simple, rapid approach to gathering antenatal risk data publicly. It may be a helpful addition to clinicians' standard history collection. [ABSTRACT FROM AUTHOR]