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Biomedical subjects

Gail M Williams

Publications and source records attributed to Gail M Williams.

At least 19 recordsLinked to original sources
PubMed2006

Epidemiologic evidence for the fetal overnutrition hypothesis: findings from the mater-university study of pregnancy and its outcomes.

The fetal overnutrition hypothesis proposes that greater maternal adiposity results in increased obesity throughout life in the offspring. The authors examined the associations between parental prepregnancy body mass index (BMI; weight (kg)/height (m)(2)), based on height and weight reported by the mother at her first antenatal clinic visit, and offspring BMI (height and weight measured at age 14 years) in 3,340 parent-offspring trios from a birth cohort based in Brisbane, Australia (mothers were recruited in 1981-1984). The maternal-offspring BMI association was stronger than the paternal-offspring BMI association. In the fully adjusted model, the increase in standardized offspring BMI at age 14 for a one-standard-deviation (SD) increase in maternal BMI was 0.362 SD (95% confidence interval: 0.323, 0.402), and the corresponding result for a one-SD increase in paternal BMI was 0.239 SD (95% confidence interval: 0.197, 0.282). There was statistical support for a difference in the magnitude of the association between maternal-offspring BMI and paternal-offspring BMI in all confounder-adjusted models tested (all p's < 0.0001). In sensitivity analyses taking account of different plausible levels of nonpaternity (up to 15%), the greater maternal effect remained. These findings provide some support for the fetal overnutrition hypothesis.

Adolescent↗
PubMed2006

Is there a fetal origin of depression? Evidence from the Mater University Study of Pregnancy and its outcomes.

It is unclear whether there is a fetal origin of adult depression. In particular, previous studies have been unable to adjust for the potential effect of maternal depression during pregnancy on any association. The association of birth weight with adult symptoms of depression was examined in an Australian prospective birth cohort, the Mater University Study of Pregnancy and its outcomes. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale among 3,719 participants at the 21-year follow-up in 2002-2005. In multivariable analyses, there were a weak inverse association between birth weight and symptoms of depression in the whole cohort and some evidence of sex differences in this association. Among females, there was a graded inverse association: In the fully adjusted model, the odds ratio for a high level of depressive symptoms for a 1-standard deviation increase in birth weight (gestational age-standardized z score) was 0.82 (95% confidence interval: 0.73, 0.92). Among males, there was no association (with sex in all models: p(interaction) < 0.004). Study results provide some support for a fetal origin of adult depression and suggest that the association is not explained by maternal mental health characteristics during pregnancy. Further research is needed to better understand the mechanisms underlying the association.

Adolescent↗
PubMed2006

Prolonged prevention of squamous cell carcinoma of the skin by regular sunscreen use.

Half of all cancers in the United States are skin cancers. We have previously shown in a 4.5-year randomized controlled trial in an Australian community that squamous cell carcinomas (SCC) but not basal cell carcinomas (BCC) can be prevented by regular sunscreen application to the head, neck, hands, and forearms. Since cessation of the trial, we have followed participants for a further 8 years to evaluate possible latency of preventive effect on BCCs and SCCs. After prolonged follow-up, BCC tumor rates tended to decrease but not significantly in people formerly randomized to daily sunscreen use compared with those not applying sunscreen daily. By contrast, corresponding SCC tumor rates were significantly decreased by almost 40% during the entire follow-up period (rate ratio, 0.62; 95% confidence interval, 0.38-0.99). Regular application of sunscreen has prolonged preventive effects on SCC but with no clear benefit in reducing BCC.

Australia↗
PubMed2006

Prenatal alcohol exposure and attention, learning and intellectual ability at 14 years: a prospective longitudinal study.

BACKGROUND: A range of adverse birth outcomes is associated with heavy prenatal alcohol exposure. AIM: To examine the effects of moderate levels of alcohol consumption during pregnancy on children's intellectual ability, learning and attention at 14 years of age. STUDY DESIGN AND SUBJECTS: The Mater-University of Queensland Study of Pregnancy involves a prospective birth cohort of 7223 singletons whose mothers were enrolled at the first antenatal visit. At 14 years, 5139 mothers and adolescents completed attentional and learning questionnaires, and 3731 adolescents completed psychometric assessments. OUTCOME MEASURES: For adolescents, the Wide Range Achievement Test--Revised (WRAT-R) and Raven's Standard Progressive Matrices Test (Raven's) were administered. Mothers completed the Child Behaviour Checklist (CBCL) and adolescents completed the Youth Self Report (YSR). Learning was assessed by a series of questions in the mother and adolescent questionnaires. Maternal measures included the quantity and frequency of alcohol consumption, and the extent of binge drinking. RESULTS: For consumption of <1 glass/day in early or late pregnancy, there was no association with any attention, learning or cognitive outcomes. The strongest estimates of effect were found among those consuming > or =1 glasses/day. Exposure in late pregnancy was associated with increased prevalence of overall learning difficulty in the unadjusted, although not the adjusted analysis. Binge drinking was associated with a higher prevalence of Raven's score <85 (1 standard deviation). CONCLUSIONS: Although a number of study limitations need to be considered, the results suggest that consumption at the level of <1 drink/day does not lead to adverse outcomes in relation to attention, learning and cognitive abilities, as measured in the current research.

Adolescent↗
PubMed2006

Does maternal smoking during pregnancy have a direct effect on future offspring obesity? Evidence from a prospective birth cohort study.

The authors used a population-based birth cohort of 3,253 children (52% males) born in Brisbane, Australia, between 1981 and 1984 to prospectively examine whether maternal smoking during pregnancy was associated with offspring overweight and obesity. The authors compared mean body mass indexes (weight (kg)/height (m)2) and levels of overweight and obesity at age 14 years among offspring by patterns of maternal smoking (never smoked, smoked before and/or after pregnancy but not during pregnancy, or smoked during pregnancy). Adolescent body mass index and prevalences of overweight and obesity were greater in offspring whose mothers had smoked during pregnancy than in those whose mothers had never smoked. Body mass index and levels of overweight and obesity among adolescent offspring whose mothers stopped smoking during pregnancy but smoked at other times in the child's life were similar to those among offspring whose mothers had never smoked. These results were independent of a range of potentially confounding factors and suggest a direct effect of maternal smoking during pregnancy on adolescent overweight and obesity. They provide yet another incentive for pregnant women to be persuaded not to smoke and for young women to be encouraged to never take up smoking.

Adolescent↗
PubMed2006

Participants who left a multiple-wave cohort study had similar baseline characteristics to participants who returned.

PURPOSE: Research on determinants of an individual's pattern of response, considered as a profile across time, for cohort studies with multiple waves is limited. In this prospective population-based pregnancy cohort, we investigated baseline characteristics of participants after partitioning them according to their history of response to different interview waves. METHODS: Data are from the Mater-University of Queensland Study of Pregnancy 1981 to 1983 cohort, Brisbane, Australia. Complete baseline information was collected for 7223 of 7535 eligible individuals (95.9%). Follow-up occurred at 6 months, 5 years, and 14 years. Response rates were 93.0%, 72.5%, and 71.8%. Participants were allowed to leave and reenter the study. Participants were categorized as always, intermittent, or never responders. Intermittent responders were categorized further as leavers (responded at least once before leaving the study) or returners (left the study before reentering). RESULTS: Participants who always responded were older, more educated, married, Caucasian, and nonsmokers and had higher incomes. Intermittent responders shared similar baseline characteristics. Relative risk for being an intermittent responder was located between risks for always or never responding. CONCLUSIONS: Participants who left and reentered the study had baseline characteristics similar to participants who responded at least once and then left the study.

Adolescent↗
PubMed2006

Correcting for numerator/denominator bias when assessing changing inequalities in occupational class mortality, Australia 1981 -2002.

OBJECTIVE: Comparisons of the changing patterns of inequalities in occupational mortality provide one way to monitor the achievement of equity goals. However, previous comparisons have not corrected for numerator/denominator bias, which is a consequence of the different ways in which occupational details are recorded on death certificates and on census forms. The objective of this study was to measure the impact of this bias on mortality rates and ratios over time. METHODS: Using data provided by the Australian Bureau of Statistics, we examined the evidence for bias over the period 1981 -2002, and used imputation methods to adjust for this bias. We compared unadjusted with imputed rates of mortality for manual/non-manual workers. FINDINGS: Unadjusted data indicate increasing inequality in the age-adjusted rates of mortality for manual/non-manual workers during 1981 -2002. Imputed data suggest that there have been modest fluctuations in the ratios of mortality for manual/non-manual workers during this time, but with evidence that inequalities have increased only in recent years and are now at historic highs. CONCLUSION: We found that imputation for missing data leads to changes in estimates of inequalities related to social class in mortality for some years but not for others. Occupational class comparisons should be imputed or otherwise adjusted for missing data on census or death certificates.

Adolescent↗
PubMed2006

Changes in maternal marital status are associated with young adults' cannabis use: evidence from a 21-year follow-up of a birth cohort.

BACKGROUND: Relatively little is known about why almost half of young adults in Australia have used cannabis. Because the upwards trend in use of cannabis has been coincident with an increase in marital breakdown, this study examines the relationship between marital status, marital changes, and the onset of cannabis use. METHODS: Data are from the Mater-University Study of Pregnancy (MUSP), a 21-year prospective study in Brisbane, Australia. The present study is based on the 3008 mothers and their children for whom there were complete follow-up data at 21 years. Outcomes were self-reported cannabis use at age 21 and early onset (before age 15) cannabis use as judged from a retrospective report obtained at 21 years. Analyses were conducted using multivariate binomial and multinomial logistic regression. RESULTS: Change in maternal marital status when the child was aged between 5 and 14 years was significantly associated with increased risk of cannabis use [odds ratio (OR) = 1.7; 95% confidence interval (95% CI) 1.4-2.0 for one or two marital changes and OR = 2.3; 95% CI 1.5-3.4 for three or more marital changes], after adjustment for a range of potential confounders. CONCLUSION: Experience of changes in maternal marital status in mid- to late-childhood is a significant predictor of subsequent and early use of cannabis by the child. This holds true even after allowing for certain possible causes and consequences of marital breakdown.

Adolescent↗
PubMed2006

In utero alcohol exposure and prediction of alcohol disorders in early adulthood: a birth cohort study.

CONTEXT: Little is known about the contribution of fetal alcohol exposure to the development of alcohol disorders in early adulthood. OBJECTIVE: To examine the independent effect of maternal alcohol use during early vs late periods in pregnancy on the time of onset of alcohol disorders in offspring. DESIGN: Follow-up study of the Mater-University of Queensland Study of Pregnancy and Its Outcomes (MUSP), a population-based birth cohort study commenced in Brisbane, Australia, in 1981 and designed to examine the association of maternal alcohol exposure with the onset of alcohol disorders. Mothers and children were followed up at birth, 6 months, and 5, 14, and 21 years after the initial interview. Maternal alcohol use was assessed before pregnancy, in early and late pregnancy, and at the 5- and 14-year follow-up visits. Alcohol disorders in early adulthood were assessed at age 21 years using the lifetime version of the Composite International Diagnostic Interview-computerized version. SETTING: Population-based birth cohort study. PARTICIPANTS: A subsample of 2138 participants for whom complete data were available at the 21-year follow-up. MAIN OUTCOME MEASURE: Onset of alcohol disorder from adolescence to 21 years of age. RESULTS: In utero alcohol exposure of 3 or more glasses was associated with alcohol disorders. The fully adjusted odds ratios (95% confidence intervals) of developing early-onset alcohol disorders at age 21 years were 2.95 (1.62-5.36) for those exposed to maternal drinking in early pregnancy and 1.35 (0.69-2.63) for those exposed in late pregnancy. There was also a strong association between alcohol exposure in early pregnancy and late-onset alcohol disorders (odds ratio, 3.29 [95% confidence interval, 1.74-6.24]). CONCLUSIONS: Our results provide support for a biological origin of adult alcohol disorders and suggest that the association is not explained solely by maternal drinking or smoking during childhood and adolescence or other intervening factors. Further research is needed to understand the mechanisms underlying the association.

Adolescent↗
PubMed2006

In utero and postnatal maternal smoking and asthma in adolescence.

BACKGROUND: Asthma in early childhood has been associated with maternal smoking during pregnancy and parental smoking soon after birth. However, less is known about these exposures and the development of asthma symptoms in adolescence. METHODS: Data were taken from the Mater University Study of Pregnancy, a large birth cohort study of mothers and children enrolled in Brisbane, Australia, beginning in 1981. Smoking was assessed at 2 stages during pregnancy and at the 6-month and 5-year follow-up visits. Asthma was assessed from maternal reports that were provided when the child was age 14 years. We conducted multivariable multinomial logistic regression analyses to assess the effect of maternal smoking on asthma symptoms. RESULTS: There was a strong sex interaction such that girls whose mothers had smoked heavily (20 or more cigarettes per day) in pregnancy and at the 6-month follow up had increased odds of experiencing asthma symptoms at age 14 (odds ratio = 1.96; 95% confidence interval = 1.25-3.08). The contribution of heavy smoking during pregnancy appeared to be stronger than heavy smoking after the birth. No similar associations were seen for boys. CONCLUSION: Female adolescents whose mothers smoked heavily during the fetal period and the early months of life have increased risk of asthma symptoms in adolescence. In utero exposure to heavy smoking was found to have a stronger effect than postnatal environmental tobacco exposure.

Adolescent↗
PubMed2006

Prediction of adolescent smoking from family and social risk factors at 5 years, and maternal smoking in pregnancy and at 5 and 14 years.

AIMS: This study examines associations between maternal smoking and family, social or child risk factors when the child is aged 5 and adolescent smoking. The influence of mothers who smoke in pregnancy or continue to smoke at 14 years was also examined. DESIGN: The Mater-University of Queensland Study of Pregnancy is a prospective cohort study. PARTICIPANTS: Participants included 8556 women enrolled between 1981 and 1984 at their first antenatal visit. Completed questionnaires were obtained for 7223 offspring, comprising the study birth cohort. Of the 7223 eligible children a total of 4541 had information on both maternal smoking when the child was aged 5 years and adolescent smoking at 14 years. MEASUREMENTS: Measures included maternal smoking during pregnancy and when the child was aged 5 and 14 years, child smoking at 14 years, maternal alcohol use, child behaviour problems and social and demographic variables. FINDINGS: Adolescent smoking was predicted by a risk score at 5 years involving maternal smoking and alcohol use, non-married status, having a partner who had ever been arrested, having four or more children in the household, and child aggression at 5 years. Continued maternal smoking from 5 to 14 years was associated strongly with adolescent smoking. There was also evidence that smoking in late pregnancy may exert an independent effect on adolescent smoking. CONCLUSIONS: The results suggest the possibility of a direct effect of prenatal smoking on adolescent smoking and highlight a set of environmental risk factors in the development of adolescent smoking. These risk factors may be used as early warning signs that intervention may be needed, and given the similarities with risk factors for other adverse childhood outcomes, the benefits of early intervention may extend beyond smoking to other problem behaviours. The possibility of being able to predict other disorders, because of these associations, also warrants further investigation.

Adolescent↗
PubMed2006

Early life predictors of childhood intelligence: findings from the Mater-University study of pregnancy and its outcomes.

Growing evidence linking childhood intelligence with adult health outcomes suggests a need to identify predictors of this psychological characteristic. In this study, we have examined the early life determinants of childhood intelligence in a population-based birth cohort of individuals born in Brisbane, Australia between 1981 and 1984. In univariable analyses, family income in the year of birth, maternal and paternal education, maternal age at birth, maternal ethnicity, maternal smoking during pregnancy, duration of labour, birthweight, breast feeding and childhood height, and body mass index were all associated with intelligence at age 14. In multivariable analyses, the strongest and most robust predictors of intelligence were family income, parental education and breast feeding, with these three variables explaining 7.5% of the variation in intelligence at age 14. Addition of other variables added little further explanatory power. Our results demonstrate the importance of indicators of socio-economic position as predictors of intelligence, and illustrate the need to consider the role of such factors in generating the association of childhood intelligence with adult disease risk.

Adolescent↗
PubMed2006

Breastfeeding and obesity at 14 years: a cohort study.

AIM: To determine the influence of breastfeeding on overweight and obesity in early adolescence. METHODS: Data about breastfeeding duration, BMI of children at 14 years, and confounding variables, were collected from an ongoing longitudinal study of a birth cohort of 7776 children in Brisbane. Prevalence of overweight and obesity at 14 years was assessed according to duration of breastfeeding, with logistic regression being used to adjust for the influence of confounders. RESULTS: Data were available for 3698 children, and those not included were significantly different in age, educational level, income, race, birthweight, and small-for-gestational-age status. Breastfeeding for longer than six months was protective of obesity (OR 0.6, 95% CI 0.4, 0.96) though not of overweight. When confounding variables were considered the effect size diminished and lost statistical significance OR 0.8 (95% CI 0.5, 1.3). Breastfeeding for less than 6 months had no effect on either obesity or overweight though a trend was found for increased prevalence of overweight at 14 years with shorter periods of breastfeeding. CONCLUSION: This investigation contributes to the gathering body of evidence that breastfeeding for longer than 6 months has a modest protective effect against obesity in adolescence.

Adolescent↗
PubMed2006

Does maternal smoking during pregnancy predict the smoking patterns of young adult offspring? A birth cohort study.

OBJECTIVE: To examine the association between maternal smoking during pregnancy and the development of smoking behaviour patterns among young adult offspring. METHOD: Data were from the Mater-University of Queensland Study of Pregnancy (MUSP), a birth cohort of 7223 mothers and children enrolled in Brisbane, Australia, in 1981. The development of smoking behaviours (early or late onset, or combination of onset and prevalence patterns) among offspring at age 21 years with different patterns of maternal smoking (never smoked, smoked before or after pregnancy but not during pregnancy, or smoked during pregnancy) were compared. Maternal smoking information was derived from the prospectively collected data from the beginning of pregnancy until the child was 14 years of age. Analyses were restricted to the 3058 mothers and children whose smoking status was reported. RESULTS: The proportion of young adults who smoked regularly, either with early onset or late onset, was greater among those whose mothers had smoked during pregnancy compared with those whose mothers had never smoked. The smoking patterns among those adolescent offspring whose mothers stopped smoking during pregnancy, but who then smoked at other times during the child's life, were similar to those whose mothers had never smoked. This association was robust to adjustment for a variety of potential covariates. CONCLUSIONS: The findings provide some evidence for a direct effect of maternal smoking in utero on the development of smoking behaviour patterns of offspring and provide yet another incentive to persuade pregnant women not to smoke.

Adolescent↗
PubMed2006

The effects of air pollution on hospitalizations for cardiovascular disease in elderly people in Australian and New Zealand cities.

OBJECTIVE: The goal of this study was to estimate the associations between outdoor air pollution and cardiovascular hospital admissions for the elderly. DESIGN: Associations were assessed using the case-crossover method for seven cities: Auckland and Christchurch, New Zealand; and Brisbane, Canberra, Melbourne, Perth, and Sydney Australia. Results were combined across cities using a random-effects meta-analysis and stratified for two adult age groups: 15-64 years and >/= 65 years of age (elderly). Pollutants considered were nitrogen dioxide, carbon monoxide, daily measures of particulate matter (PM) and ozone. Where multiple pollutant associations were found, a matched case-control analysis was used to identify the most consistent association. RESULTS: In the elderly, all pollutants except O3 were significantly associated with five categories of cardiovascular disease admissions. No associations were found for arrhythmia and stroke. For a 0.9-ppm increase in CO, there were significant increases in elderly hospital admissions for total cardiovascular disease (2.2%) , all cardiac disease (2.8%), cardiac failure (6.0%), ischemic heart disease (2.3%), and myocardial infarction (2.9%). There was some heterogeneity between cities, possibly due to differences in humidity and the percentage of elderly people. In matched analyses, CO had the most consistent association. CONCLUSIONS: The results suggest that air pollution arising from common emission sources for CO, NO2, and PM (e.g., motor vehicle exhausts) has significant associations with adult cardiovascular hospital admissions, especially in the elderly, at air pollution concentrations below normal health guidelines. Relevance to clinical and professional practice: Elderly populations in Australia need to be protected from air pollution arising from outdoor sources to reduce cardiovascular disease.

Adolescent↗
PubMed2006

Does particulate matter modify the association between temperature and cardiorespiratory diseases?

BACKGROUND: A number of studies have shown that both temperature and air pollution are associated with health outcomes. In assessing air pollution effects, temperature is usually considered a confounder. However, only a few recent studies considered air pollution as confounders while assessing temperature effects. Few studies are available on whether or not air pollution modifies the temperature-disease relationship. METHODS: In this study, we used three parallel Poisson generalized additive models to examine whether particulate matter < 10 mum in aerodynamic diameter (PM10) modified the effects of minimum temperature on cardiorespiratory morbidity and mortality in Brisbane, Australia. RESULTS: Results show that PM10 statistically significantly modified the effects of temperature on respiratory and cardiovascular hospital admissions, all nonexternal-cause mortality, and cardiovascular mortality at different lags. The enhanced adverse temperature effects were found at higher levels of PM10, but no clear evidence emerged for interactive effects on respiratory and cardiovascular emergency visits. Three parallel models produced similar results, which strengthened the validity of findings. CONCLUSION: We conclude that it is important to evaluate the modification role of air pollution in the assessment of temperature-related health impacts.

Air Pollutants↗
PubMed2006

Community surveys and risk factor analysis of human alveolar and cystic echinococcosis in Ningxia Hui Autonomous Region, China.

OBJECTIVE: To determine the true community prevalence of human cystic (CE) and alveolar (AE) echinococcosis (hydatid disease) in a highly endemic region in Ningxia Hui, China, by detecting asymptomatic cases. METHODS: Using hospital records and "AE-risk" landscape patterns we selected study communities predicted to be at risk of human echinococcosis in Guyuan, Longde and Xiji counties. We conducted community surveys of 4773 individuals from 26 villages in 2002 and 2003 using questionnaire analysis, ultrasound examination and serology. FINDINGS: Ultrasound and serology showed a range of prevalences for AE (0-8.1%; mean 2%) and CE (0-7.4%; mean 1.6%), with the highest prevalence in Xiji (2% for CE, 2.5% for AE). There were significant differences in the prevalence of CE, AE and total echinococcosis between the three counties and villages (with multiple degrees of freedom). While hospital records showed 96% of echinococcosis cases attributable to CE, our survey showed a higher prevalence of human AE (56%) compared to CE (44%). Questionnaire analysis revealed that key risk factors for infection were age and dog ownership for both CE and AE, and Hui ethnicity and being female for AE. Drinking well-water decreased the risk for both AE and CE. CONCLUSION: Echinococcosis continues to be a severe public health problem in this part of China because of unhygienic practices/habits and poor knowledge among the communities regarding this disease.

Adolescent↗
PubMed2006

A drug-based intervention study on the importance of buffaloes for human Schistosoma japonicum infection around Poyang Lake, People's Republic of China.

Schistosomiasis japonica is a zoonosis of major public health importance in southern China. We undertook a drug intervention to test the hypothesis that buffalo are major reservoirs for human infection in the marshlands/lake areas, where one million people are infected. We compared human and buffalo infection rates and intensity in an intervention village (Jishan), where humans and buffalo were treated with praziquantel, and a control village (Hexi), where only humans were treated, in the Poyang Lake region. Over the four-year study, human incidence in Jishan decreased but increased in Hexi. Adjustment of incidence by age, sex, water exposure, year, and village further confirmed the decreased human infection in Jishan. Chemotherapy for buffaloes resulted in a decrease in buffalo infection rates in Jishan, which coincided with the reduction in human infection rates there in the last two years of the study. Mathematical modeling predicted that buffalo are responsible for 75% of human transmission in Jishan.

Adolescent↗