The high negative predictive value of the ASQ supports its use as a screening tool for cognitive and motor delays in the follow up of ex-premature infants. This would need to be combined with other strategies as part of a comprehensive follow up program for ex-premature infants.

Objective: It is uncertain to what degree the relationship between breastfeeding and later cognitive development is a true biological effect, or is confounded by psychosocial factors. The study aim was to further investigate this relationship and the effect of duration of breast feeding on cognitive development. Methods:A total of 3880 children were followed from birth. Breastfeeding duration was measured by questionaire at 6 months of age and a Peabody Picture Vocabulary Test Revised (PPVT-R) was administered at 5 years. PPVT-R scores were adjusted for the effects of a large array of biological and psychosocial confounders. The relationship between breastfeeding and the mean PPVT-R scores were examined using analysis of variance and multiple linear regression. Results:A strong positive relationship was demonstrated between breastfeeding and the PPVT-R scores with increasing scores with increased duration of breastfeeding. After adjusting for a wide range of biological and social factors, the adjusted mean for those breastfed for 6 months or more was 8.2 points higher for females and 5.8 points for males when compared to those never breastfed. Conclusion:These findings suggest a significant benefit to child development is conferred by breastfeeding and is related independently to longer periods of breastfeeding. Keywords: breastfeeding; child development; intelligence; Peabody; cohort studies A substantial body of evidence suggests a benefit on cognitive development in infants as a result of breastfeeding. [1][2][3][4][5][6][7] Several population studies have been conducted in term infants, the majority of which show a positive effect on cognitive development in breastfed infants. [2][3][4][5] This positive association is by no means universal or necessarily indicative of a causal association. Several studies have shown that a large number of social and parental educational factors that could reasonably be expected to influence child development independently effect the incidence of breastfeeding. [2-4] Studies by Silva et al. [8] Jacobson et al.,[9] and Wigg et al. [10] suggest that once con-founders such as social advantage, maternal education and intelligence, and the quality of a child's developmental experiences were taken into account, the differences between bottle and breastfed groups were no longer statistically significant. A number of criticisms including lack of statistical power, [8] populations initially selected for other exposures [9,10] and the timing and quality of measurement of intervening variables [9] can be made of these studies. Pollock [4] selected a cohort of relatively advantaged mothers, and after controlling for factors associated with the likelihood of breastfeeding, demonstrated that infants breastfed for at least 3 months had small though statistically significant improvements in mean picture vocabulary scores at 5 years and ability scores at 10 years.If the association between breastfeeding and infant cognitive development is causal, two possible explanations have been su...

Background:Obesity and asthma are common disorders, and the prevalence of both has increased in recent decades. It has been suggested that increases in the prevalence of obesity might in part explain the increase in asthma prevalence. This study aims to examine the prospective association between change in body mass index (BMI) z-score between ages 5 and 14 years and asthma symptoms at 14 years. Methods: Data was taken from the Mater University Study of Pregnancy and its outcomes (MUSP), a birth cohort of 7223 mothers and children started in Brisbane (Australia) in 1981. BMI was measured at age 5 and 14 years. Asthma was assessed from maternal reports of symptoms at age 5 and 14 years. In this study analyses were conducted on 2911 participants who had information on BMI and asthma at both ages. Results: BMI z-score at age 14 and the change in BMI z-score from age 5 to 14-years were positively associated with asthma symptoms at age 14 years, whereas BMI z-score at age 5 was not associated with asthma at age 14. Adjustment for a range of early-life exposures did not substantially alter these findings. The association between change in BMI z-score with asthma symptoms at 14 years appeared stronger for male subjects compared with female subjects but there was no statistical evidence for a sex difference (P=0.36). Conclusions: Increase in BMI z-score between age 5 and 14 years is associated with increased risk of asthma symptoms in adolescence.

Objective: To examine concurrent physical, educational, behavioural, social and family factors associated with cigarette smoking in adolescents at 14 years.Methodology: This study reports cross-sectional data on 14-year-old adolescents and their mothers, drawn from a prospective cohort study commencing at the time of the first antenatal visit. At 14 years, 5247 adolescents completed questionnaires on current cigarette smoking. Adolescents and mothers completed health, psychological, school and social questionnaires relating to the youth. A total of 3864 adolescents were assessed physically, and undertook the Wide Range Achievement Test (WRAT) and Ravens Progressive Matrices Test.Results: Cigarette smoking at 14 years was associated with externalizing and internalizing behaviour problems, school suspension, contact with children's services and alcohol/illicit drug use. Apart from internalizing behaviour problems, these problems were more prevalent in boys. Poor school performance on maternal/adolescent reports was associated with increased smoking quantity for both genders, though WRAT scores were only decreased in male smokers. The Ravens Progressive Matrices Test scores were lower for boys with greater smoking quantity. The trend was less marked in girls. Body mass index and exercise frequency were not associated with cigarette smoking at 14 years, though girls who smoked had a higher reported prevalence of asthma. Parental smoking, marital conflict, maternal depression, lower income, and mothers aged in their teens and with a lower level of education at the time of this pregnancy were also positively associated with adolescent tobacco use. Conclusion:Findings of this study indicate that cigarette smoking, at this critical time of smoking initiation, is associated with a broad spectrum of personal and social disadvantage that needs to be considered in intervention strategies.

Objective: To investigate the issues that confront women when addressing overweight and obesity before conception. Design: Questionnaire‐based study of 412 unselected women in early pregnancy. Setting and participants: 255 women who attended a public, antenatal “first visit” clinic at a major urban obstetric hospital in Brisbane and 157 women who presented to a private obstetrician in Brisbane for a routine ultrasound scan during a 6‐week period in 2006 were surveyed. Main outcome measures: Preconception health activities, prepregnancy body mass index (BMI), self‐reported weight category, attempts to lose weight before pregnancy, and weight loss advice received before pregnancy. Results: Folic acid supplementation was reported by 56% of participants, and 53% attended a preconception health check. Of women who provided details of height and prepregnancy weight, 30% were overweight or obese before pregnancy. However, 23 of 65 women with a BMI in the overweight range categorised themselves as normal weight (36%), and only 8 of 50 women with a BMI in the obese range categorised themselves as obese (16%). As BMI increased, more women reported trying to lose weight (P < 0.001) and reported receiving advice regarding weight loss (P < 0.001). Prepregnancy weight loss was reported by 52 of 115 overweight and obese women (45%). Conclusions: Potential barriers to addressing overweight and obesity before pregnancy include poor uptake of routine prepregnancy health activities, inaccurate self‐categorisation of weight, unsuccessful weight loss attempts and inadequate advice regarding prepregnancy weight loss.