ORCID Profile
0000-0003-1458-2147
Current Organisations
The University of Auckland
,
University of Auckland Faculty of Arts
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Springer Science and Business Media LLC
Date: 16-04-2016
DOI: 10.1007/S00737-016-0629-1
Abstract: Antenatal depression is a known risk factor for postnatal depression both are common disorders associated with negative impacts on child development. Few studies have followed up women from pregnancy and through the postnatal period to explore how rates of depression change. This review evaluates recent evidence on depression during pregnancy and after childbirth. A search of Embase, PsychINFO, MEDLINE and Cochrane Reviews was carried out to identify longitudinal studies on antenatal and postnatal depression. Studies that measured depression during pregnancy and up to 1 year after childbirth were evaluated against a set of criteria (e.g. less than 50 % attrition). Of the initial 523 studies identified, 16 studies met the final inclusion criteria with a total of 35,419 women. The average rate of antenatal depression across these studies was 17 and 13 % postnatal depression. The longitudinal nature of the studies revealed that on average 39 % of those who experienced antenatal depression went on to have postnatal depression. Similarly, on average, 47 % of those with postnatal depression had also experienced antenatal depression. On average, almost 7 % of women reported significant depressive symptoms in pregnancy that persisted after childbirth. The review provided evidence that rates of depression tend to be higher during pregnancy than in the first year following childbirth. Furthermore, the longitudinal data show that there is much movement between the groups categorised as depressed or not depressed. There is evidence that postnatal depression is often a continuation of existing antenatal depression.
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.INFBEH.2019.101388
Abstract: The determinants of talking delay alone or its comorbidity with behavioural difficulties was examined in 5768 two-year-old members of the Growing Up in New Zealand longitudinal study. Using the MacArthur-Bates Communicative Development inventories and the total difficulties score from the preschool Strengths and Difficulties Questionnaire, a composite measure was created so that children were categorised as showing no language or behavioural concerns (72.5%), behavioural only difficulties (6.1%), language only difficulties (18.1%), and comorbid language and behavioural difficulties (3.3%). Analyses revealed that antenatal factors such as maternal perceived stress, inadequate folate intake, vitamin intake, alcohol consumption during the first trimester and maternal smoking all had a significant effect on child outcomes. In particular, low multivitamin intake and perceived stress during pregnancy were associated with coexisting language and behavioural difficulties. These findings support international research in showing that maternal factors during pregnancy are associated with developmental outcomes in the early childhood period, and demonstrate these associations within a NZ context. Interventions which address maternal stress management and health behaviours during pregnancy could be beneficial to offspring development.
Publisher: Springer Science and Business Media LLC
Date: 20-01-2020
Publisher: Elsevier BV
Date: 11-2015
DOI: 10.1016/J.JAD.2015.06.009
Abstract: Depression during pregnancy has significant implications for pregnancy outcomes and maternal and child health. There is a need to identify which family, physical and mental health factors are associated with depression during pregnancy. An ethnically and socioeconomically erse s le of 5664 pregnant women living in New Zealand completed a face-to-face interview during the third trimester. Antenatal depression (AD) symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Maternal demographic, physical and mental health, and family and relationship characteristics were measured. The association between symptoms of AD and maternal characteristics was determined using multiple logistic regression. 11.9% of the participating women had EPDS scores (13+) that indicated probable AD. When considering sociodemographic predictors of AD symptoms, we found that women from non-European ethnicities, specifically Pacific Islander, Asian and other, were more likely to suffer from AD symptoms. Greater perceived stress during pregnancy and a diagnosis of anxiety both before and during pregnancy were also associated with greater odds of having AD according to the EPDS. The women were in their third trimester of pregnancy at the interview. Therefore, we cannot discount the possibility of recall bias for questions relating to pre-pregnancy status or early-pregnancy behaviours. AD is prevalent amongst New Zealand women. Ethnicity, perceived stress and anxiety are particularly associated with a greater likelihood of depression during pregnancy. Further attention to supporting maternal mental health status in the antenatal period is required.
Publisher: Bristol University Press
Date: 04-2020
DOI: 10.1332/175795919X15746664055477
Abstract: Inhibitory control is central to developmental trajectories of cognitive, emotional and social functioning in children. Here, inhibitory control was measured using the Luria hand clap task (an adapted version of the Luria pencil tap task). A s le of 5,448 children age 4½ years and their mothers from a longitudinal, population-based New Zealand cohort were included in this study. Antenatal maternal health indictors, child characteristics and performance on the Luria hand clap task were assessed using multivariate ordinal logistic regression. Seven covariates, including mother’s ethnicity and education, and child’s gender, age and birthweight were included. Based on Luria task performance scores that approximated the 25th and 50th percentiles, children were categorised into three groups (low, intermediate, high). High Luria task performance was associated with maternal relationship status, maternal education, first trimester folate supplementation, maternal BMI and smoking before pregnancy. In addition, children born heavier, and female, and older children were more likely to be in the top Luria score category relative to children born smaller, male and younger. A number of potentially modifiable maternal factors significantly predict Luria task performance in children age 4½ years. Identifying socio-demographic, child characteristics and maternal factors that are associated with inhibitory control is a crucial first step for identifying children at risk of atypical inhibition development and informing behavioural intervention strategies.
Publisher: BMJ
Date: 02-2022
DOI: 10.1136/BMJOPEN-2020-046790
Abstract: The aim of this study was to assess the association of antenatal maternal dietary patterns (DPs) and other health aspects with infant temperament in a large multiethnic cohort, taking maternal personality and prenatal stress into account. Using data from 3968 children born in 2009/2010 and their mothers from the Growing Up in New Zealand cohort, infant temperament was assessed at 9 months using the Infant Behavior Questionnaire-Revised Very Short Form. Maternal antenatal diet and other health aspects were assessed antenatally. Maternal DPs (n=4) were derived using principal components analysis based on food intake reported on a 44-item food frequency questionnaire. Path analyses investigated factors associated with infant temperament, namely maternal personality, prenatal maternal stress, DPs and other health aspects, including potential inter-relations and mediating effects. Women who scored higher in the fusion DP (standardised beta (β)=0.05 95% CI 0.02 to 0.09) and healthy DP (β=0.05 95% CI 0.02 to 0.09), who exercised more (β=0.04 95% CI 0.01 to 0.07), and who drank less alcohol (β=−0.05 95% CI −0.08 to –0.02) were more likely to have infants with an overall less difficult temperament. Sex-specific differences were found in the associations between maternal DP and infant temperament. Maternal personality and prenatal stress were significantly associated with all dimensions of infant temperament. The strongest predictors for a more difficult temperament were prenatal stress (β=0.12 95% CI 0.08 to 0.15) and the personality dimensions neuroticism (β=0.10 95% CI 0.07 to 0.14) and extraversion (β=−0.09 95% CI −0.12 to –0.06). Associations of antenatal maternal diet and health aspects with infant temperament were statistically significant but small. While they should not be overinterpreted as being deterministic, the findings of this study support the link between maternal modifiable health-related behaviours and infant temperament outcomes.
Publisher: SAGE Publications
Date: 14-07-2021
DOI: 10.1177/00048674211025699
Abstract: Throughout pregnancy, women are at an increased risk of depression, with prevalence estimates between 6.5% and 18%. Global prevalence of antenatal antidepressant use is considerably lower at 3%. The present study determined the proportion of women taking antidepressants across pregnancy in New Zealand. We investigated whether variation exists across age bands, area-level deprivation and ethnicities, and identified how many women experienced unmedicated depression. Antenatal data ( n = 6822) consisted of primarily third-trimester interviews conducted with mothers participating in Growing Up in New Zealand, a longitudinal study investigating child development. Women were asked about their antidepressant intake during pregnancy and assessed on antenatal depression symptoms using the Edinburgh Postnatal Depression Scale. Antidepressant use data were also compared to population-level data from Statistics New Zealand’s Integrated Data Infrastructure. Antidepressant prevalence across pregnancy was 3.2%, with a 2.7% prevalence in trimester one and 2.6% following the first trimester. There was no significant difference in usage within age bands and area-level deprivation quintiles. Ethnicity-specific data revealed that Pasifika and Asian ethnicities had the lowest antidepressant use, and New Zealand Europeans the highest. The rate of unmedicated depression, where women met the Edinburgh Postnatal Depression Scale criteria for significant depressive symptoms but did not receive antidepressants during pregnancy, was 11.8%, indicating that antenatal depression treatment may be inadequate. Greater rates of unmedicated depression were seen for younger women (⩽24 years), those living in high deprivation areas and mothers of Pasifika, Asian and Māori ethnicities. Antenatal antidepressant use in New Zealand follows global prevalence estimates and highlights possible undertreatment of antenatal depression in New Zealand. Future research including other treatment types (e.g. behavioural therapy) is needed to evaluate whether undertreatment occurs across all treatment options.
Publisher: Informa UK Limited
Date: 30-03-2023
Publisher: Springer Science and Business Media LLC
Date: 18-04-2019
Publisher: Springer Science and Business Media LLC
Date: 06-01-2020
DOI: 10.1007/S10578-019-00953-X
Abstract: The link between behavioural and cognitive difficulties is well established. However, research is limited on whether persistence and change in behavioural difficulties relates to cognitive outcomes, particularly during preschool. We used a large New Zealand birth cohort to investigate how persistence and change in serious behavioural problems from ages 2 to 4.5 years related to measures of cognitive delay at 4.5 years (n = 5885). Using the Strengths and Difficulties total problems score at each time point, children were categorised as showing no difficulties, improved behaviour, concurrent difficulties, and persistent difficulties. Cognitive measures assessed included receptive language, early literacy ability, and executive control. Our results showed that children with concurrent and persistent behavioural difficulties were at a greater risk of showing delays within specific cognitive domains relative to children with no difficulties and were also more likely to show comorbid delays across multiple cognitive domains.
Publisher: Springer Science and Business Media LLC
Date: 23-06-2016
DOI: 10.1007/S10802-016-0176-2
Abstract: The Strengths and Difficulties Questionnaire (SDQ) is a popular standardised instrument typically used for screening psychopathology in children and adolescents. However, peer reviewed studies evaluating the psychometric properties of the parent-rated preschool SDQ are lacking. The current study involved mothers of 5481 2 year olds (52 % male) from the Growing Up in New Zealand cohort, and investigated the psychometric properties of the preschool SDQ within this cohort. Confirmatory factor analysis was used to evaluate the SDQ's factor structure and test for measurement invariance of the factor model. Cronbach's alpha was used to measure the internal consistency of the subscales and total difficulties scale. We found support for a modified five-factor model, in which the prosocial factor was extended into a positive construal factor by allowing cross-loadings of reverse-scored items. Full measurement invariance was found across gender and socioeconomic status, and partial invariance was found across mother's ethnicity. Cronbach's alpha was satisfactory for all subscales (α range = 0.71-0.84), except peer problems (α = 0.54). Normative scores and bandings for normal, borderline and abnormal ranges are described for each subscale. Analyses revealed group differences in scores for child's gender, mother's ethnicity and socioeconomic status. Overall, satisfactory psychometric properties were found for the preschool SDQ in 2 year olds, indicating that that the questionnaire can be used in very young children.
Publisher: SAGE Publications
Date: 18-03-2017
Abstract: There is limited research on the preschool version of the Strengths and Difficulties Questionnaire (SDQ), and comparisons between mothers and fathers as informants and whether the factor structure shows measurement invariance across parents is lacking. Our study involved mothers ( n = 6,246) and fathers ( n = 3,759) of 2-year-old children from the Growing Up in New Zealand birth cohort. Confirmatory factor analysis was used to evaluate the factor structure of the SDQ and test for measurement invariance across mothers and fathers. For fathers, we found support for a modified five-factor model that accounts for a positive construal method effect. Internal consistency was good for measures except peer problems. Full measurement invariance of this modified model was found across mothers and fathers, and parents showed moderate agreement in their SDQ ratings (0.34 ≤ r ≤ 0.44). More research is needed on whether mother- and father-reports differ in sensitivity when screening for early childhood psychiatric disorders.
Publisher: CSIRO Publishing
Date: 2019
DOI: 10.1071/HC18102
Abstract: ABSTRACT INTRODUCTIONPacific women in New Zealand (NZ) have higher rates of antenatal depression than women from other ethnic groups. AIMTo identify factors that are significantly associated with depression symptoms in pregnant Pacific women living in NZ. METHODSData were collected from 5657 pregnant women, 727 of whom identified their ethnicity as Pacific Island. Antenatal depression symptoms were measured using the Edinburgh Depression Scale with scores above 12 indicating elevated antenatal depression symptoms (ADS). RESULTSPacific women had significantly higher rates of ADS than non-Pacific women, with 23% of pregnant Pacific women experiencing ADS. Factors associated with ADS for Pacific women included age & years, moderate to severe nausea during pregnancy, perceived stress, family stress and relationship conflict. Not seeing the importance of maintaining one’s Pacific culture and traditions and negative feelings towards NZ culture were also significantly associated with ADS in Pacific women. One in three Pacific women aged & years experienced ADS. Pregnant Pacific women without a family general practitioner (GP) before their pregnancy were 4.5-fold more likely to experience ADS than non-Pacific women with a regular GP. DISCUSSIONFurther attention is required to providing appropriate primary health care for Pacific women of child-bearing age in NZ. Better screening processes and a greater understanding of effective antenatal support for Pacific women is recommended to respond to the multiple risk factors for antenatal depression among Pacific women.
Publisher: Elsevier BV
Date: 10-2023
Publisher: Informa UK Limited
Date: 09-05-2018
Publisher: American Medical Association (AMA)
Date: 04-2017
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.EARLHUMDEV.2018.06.011
Abstract: High levels of alcohol exposure during pregnancy can damage developing brains and influence child behavior and learning. To examine the effects of lower levels of alcohol and very early exposure to alcohol on infant temperament and child behavior. The Growing Up in New Zealand study involves a prospective birth cohort of 6822 pregnant women of whom 6156 provided information on their child's temperament using the Infant Behavior Questionnaire-Revised (IBQ-R VSF) at 9 months and their child's behavior using the Strengths and Difficulties Questionnaire at 2 years. A series of adjusted linear regression models controlling for socio-demographic factors found alcohol consumption during pregnancy was most consistently related to Lower Positive Affect, Affiliation/Regulation, and Orienting Capacity temperament scores. Mothers who stopped drinking after becoming aware of their pregnancy, but had an unplanned pregnancy (hence may have a baby exposed to alcohol for longer), also reported infants with lower Orienting Capacity, Affiliation/Regulation, and Fear temperament scores compared to those that did not drink. Children whose mothers drank four or more drinks per week during pregnancy were more likely to report their child as having conduct problems, with higher total difficulties scores at age 2. Alcohol consumption during pregnancy has a negative effect especially on infant temperament, even if small amounts of alcohol are consumed. Our findings have implications for men and women who drink, medical professionals, and for the availability of contraception to those who drink, but do not plan to get pregnant.
Publisher: Springer Science and Business Media LLC
Date: 26-07-2019
Publisher: Elsevier BV
Date: 04-2022
DOI: 10.1016/J.JAD.2022.01.076
Abstract: Young people who experience depression are at an increased risk of adverse psychosocial and developmental outcomes that can persist over the lifecourse. Identifying maternal prenatal risk factors that may contribute to childhood depressive symptoms can be useful when considering mental health intervention. The current study included 3,925 children from the Growing Up in New Zealand (GUiNZ) study who had complete data for self-reported depressive symptoms and mothers' antenatal information. Depressive symptoms were measured at age 8 using the Centre for Epidemiological Studies Depression Scale for Children (CESD-10) short form questionnaire. Hierarchical linear regression was used to determine the relationship between prenatal factors and depressive symptoms at age 8. When controlling for sociodemographic characteristics, our hierarchical linear regression revealed that the most significant maternal prenatal predictors of high depressive symptoms at age 8 were maternal perceived stress, smoking during pregnancy, body mass index (BMI) in the overweight/obese range, and paracetamol intake. One limitation with the current study was a reduction in the s le due to attrition. This may have affected our statistical power, reflected in our modest effect sizes. The s le remained both socioeconomically and ethnically erse, however our results should be interpreted with respect to the s le and not the whole New Zealand population. A combination of maternal mental health and lifestyle factors contribute to depressive symptoms for children, possibly through foetal programming. Our results emphasise the importance of mental and physical health support for expectant mothers.
Publisher: Springer Science and Business Media LLC
Date: 17-06-2021
DOI: 10.1186/S12887-021-02652-W
Abstract: Children who are high priority candidates for early intervention need to be identified to reduce their risk for experiencing problems in development. Those exposed to multiple risk factors are more likely to exhibit problems in development than those exposed to a single or no risk factor. We examined the longitudinal associations between persistence and timing of exposure to cumulative risk (CR) on three occasions by age 2 and problems in development at age 4.5 in health, behavior, and education-related domains. Data are from Growing Up in New Zealand (NZ), a prospective longitudinal study of a birth cohort first assessed during their last trimester in 2009–10 and followed at ages 9 months and 2 and 4.5 years. All women with an expected delivery date in a 12-month period who resided within a defined region were invited to participate, with no additional eligibility criteria. Exposure was measured for 12 sociodemographic and maternal health risk factors at third trimester and ages 9 months and 2 years, from which developmental trajectories were constructed capturing persistence and timing of CR exposure. Ten developmental outcomes were measured at age 4.5 to classify problems in overall health status, obesity, and injuries internalizing and externalizing behavior problems and letter naming, counting forward and backward, and expectations for starting school and completing education. Analyses of data from 6156 children (49% female, 33% Non-European ethnicity) who participated in the 4.5-age assessment uniformly showed associations between exposure to more than consistently zero CR across early development and higher prevalence of being classified with problems for 9 of 10 outcomes. Persistent exposure to a CR ≥ 4 was generally associated with a higher prevalence of problems for 7 of 10 outcomes, whereas the timing of first exposure to CR ≥ 4 showed a less consistent association with problem outcomes. These findings are concerning because over 50% of NZ children are exposed to at least one of these risk factors at some point in early development. Routine screening of most of these risk factors during pregnancy is feasible and can identify priority candidates for intervention.
Publisher: Springer Science and Business Media LLC
Date: 11-11-2016
DOI: 10.1007/S10995-016-2191-X
Abstract: Objectives Antenatal and postnatal depression can lead to poor outcomes for women and their children. The aim of this study was to explore whether risk factors differ for depression symptoms that are present during pregnancy and/or after childbirth. Methods An ethnically and socioeconomically erse s le of 5301 women completed interviews during the third trimester of pregnancy and 9 months after childbirth. Depression symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Depression symptoms (defined as EPDS >12) among participants and associations with pre-pregnancy and pregnancy maternal characteristics were explored using logistic regression. Results The rate of antenatal depression symptoms (ADS) only was 8.5, 5% of women had depression symptoms at 9 months postpartum (PDS) only and 3% experienced depression symptoms at both time points. Perceived stress and Pacific or Asian ethnicity were risk factors for ADS and PDS. Anxiety during and before pregnancy was a risk factor for ADS only while having a pre-pregnancy diagnosis of depression was a risk factor for PDS only. Having ADS increased the odds ratio of PDS by 1.5 (95% CI 1.01-2.30). Conclusions The results supported evidence from previous longitudinal studies that depression symptoms appear to be higher during pregnancy than in the first year following childbirth. The study found that PDS may often be a continuation or recurrence of ADS.
Publisher: Springer Science and Business Media LLC
Date: 21-02-2019
DOI: 10.1007/S10802-019-00521-W
Abstract: Exposure to cumulative risk (CR) has important implications for child development, yet little is known about how frequency, persistence, and timing of CR exposure during early childhood predict behavioral problems already before school start. We examine prospective longitudinal associations between patterns of CR exposure from third trimester through 2 years and subsequent behavior problems at 4.5 years. In 6156 erse children in the Growing Up in New Zealand longitudinal study, the presence of 12 risk factors, spanning maternal health, social status, and home and neighborhood environment, defined CR and were assessed at last trimester and 9 months and 2 years of age. At child age 4.5 years, mothers completed the Strengths and Difficulties Questionnaire, where a score ≥ 16 indicated an abnormal level of problem behaviors (ALPB). Children exposed to a CR ≥ 1 at least once in early development, compared to those with consistent CR = 0, showed a significantly higher likelihood of ALPB at 4.5 years. Consistent high exposure to CR ≥ 4 across all three assessments had the highest prevalence (44%) of ALPB at age 4.5. Children with high CR exposure on two of three, compared to on all three, time points in early development did not evidence a significantly reduced prevalence (32%-41%) of ALPB. The common co-occurrence of risk factors and their significant developmental impact when accumulated early in life underscore the need for systematic multisector intervention and policy implementation during pregnancy and shortly after birth to improve outcomes for vulnerable children.
Publisher: Springer Science and Business Media LLC
Date: 02-06-2018
DOI: 10.1007/S10578-018-0816-6
Abstract: Behavioural difficulties during early childhood have significant implications for multiple outcomes later in life. Child behavioural difficulties at 2 years of age (N = 6246) were assessed by mothers enrolled in a longitudinal, population-based New Zealand cohort study. 10.1% of children had total difficulties scores in the abnormal range on the preschool version of the Strengths and Difficulties Questionnaire. After controlling for maternal education, poverty, and child's birth age/weight, several antenatal and postnatal maternal health and family risk factors were significant for: (i) emotional problems (antenatal maternal perceived stress, lack of periconceptional folate, and moderate to severe maternal postnatal anxiety) (ii) hyperactivity-inattention (antenatal maternal perceived stress, mothers' antenatal exposure to secondhand smoke, moderate to severe maternal postnatal anxiety, and low maternal self-evaluation) (iii) conduct problems and total difficulties (antenatal maternal perceived stress, verbal inter-parental conflict and low maternal self-evaluation). The identification of risk and protective factors associated with early childhood difficulties are vital for guiding intervention and prevention efforts.
No related grants have been discovered for Stephanie D'Souza.