Rodney P K Ford
University of Otago, Paediatrics, Department Member
Research Interests: Pediatrics, Incidence Geometry, Medicine, England, Humans, and 15 moreSmoking, Sleep, Infant, Incidence, Risk factors, Sudden Infant Death Syndrome, Newborn Infant, Public health systems and services research, Breast feeding, BMJ, Heating, Risk Factors, Psychology and Cognitive Sciences, Prone position, and Medical and Health Sciences
ABSTRACT. A simple method of obtaining duodenal juice in association with small bowel biopsy is described. A conventional adult feeding tube is attached to the semi‐stiff biopsy capsule tubing and carried into position by the capsule.... more
ABSTRACT. A simple method of obtaining duodenal juice in association with small bowel biopsy is described. A conventional adult feeding tube is attached to the semi‐stiff biopsy capsule tubing and carried into position by the capsule. This method enables several millilitres of duodenal fluid to be obtained in a few minutes and the biopsy to be taken with one intubation.
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To identify risk factors for preterm birth. A cross sectional study. The study population was 1800 infants selected randomly from all babies born over a three-year period. Of these, 85 (4.8%) were classified preterm (less than 37... more
To identify risk factors for preterm birth. A cross sectional study. The study population was 1800 infants selected randomly from all babies born over a three-year period. Of these, 85 (4.8%) were classified preterm (less than 37 completed weeks gestation). Data were collected from obstetric records and parental interviews. Risk factors associated with an increased risk of preterm birth after controlling for potential confounders included smoking during pregnancy (adjusted relative risk (RR) = 2.7, 95% confidence interval (CI) = 1.3, 5.4), and multiple birth (adjusted RR = 48.8, 95% CI = 18.1, 131.4). Urinary tract infection was significant at the 7% level (adjusted RR = 2.3, 95% CI = 1.0, 5.6). Alcohol intake in third trimester was associated with a reduced risk of preterm birth (adjusted RR = 0.4, 95% CI = 0.2, 0.7). Maternal smoking and multiple births were the most important modifiable risk factors in this study for preterm birth and may contribute to 17% and 11% of preterm birt...
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The New Zealand Cot Death Study, a multicentre case-control study, was set up to identify risk factors associated with sudden infant death syndrome (SIDS). In the 3 years of the study there were 485 infant deaths classified as SIDS in the... more
The New Zealand Cot Death Study, a multicentre case-control study, was set up to identify risk factors associated with sudden infant death syndrome (SIDS). In the 3 years of the study there were 485 infant deaths classified as SIDS in the study areas and 1800 infants who were randomly selected as controls. Data were collected by parent interviews and from obstetric notes. A full set of data for this analysis was available from 356 cases and 1529 control infants. The relationship between length of any breastfeeding and SIDS was examined: 92% of the controls were initially breastfed compared to 86% of the cases. As time went by, cases stopped breastfeeding sooner than controls: by 13 weeks, 67% controls were breastfed versus 49% cases. A reduced risk for SIDS in breastfed infants persisted during the first 6 months after controlling for confounding demographic, maternal and infant factors. Infants exclusively breastfed 'at discharge from the obstetric hospital' (odds ratio [OR] = 0.52, 95% confidence interval (CI): 0.35-0.71) and during the last 2 days (OR = 0.65, 95% CI: 0.46-0.91) had a significantly lower risk of SIDS than infants not breastfed after controlling for potential confounders. We have shown a substantial association of breastfeeding with a lowered risk for SIDS. This supports the need for more positive promotion and active community support to further enhance the level and length of exclusive breastfeeding.
Research Interests: Pediatrics, Statistics, Epidemiology, Medicine, Breastfeeding, and 15 moreHumans, Female, New Zealand, Regression Analysis, Infant, Risk factors, Sudden Infant Death Syndrome, Newborn Infant, Public health systems and services research, Time Factors, Breast feeding, Risk Factors, Proportional Hazards Models, Case Control Studies, and Infant food
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that there is burgeoning scientific knowledge about food allergy; 3 but despite this, strong medical scepticism persists about the existence of illness caused by food allergy. 4 They wrote: “Some medical practitioners remain sceptical... more
that there is burgeoning scientific knowledge about food allergy; 3 but despite this, strong medical scepticism persists about the existence of illness caused by food allergy. 4 They wrote: “Some medical practitioners remain sceptical about the role of food allergies in a number of clinical syndromes, such as atopic dermatitis, colic and gastro-oesophageal reflux in infancy, despite an increasing body of evidence that food allergy can contribute to these conditions.”
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Research Interests: Human Geography, Epidemiology, Medicine, Humans, Atmosphere, and 14 moreEffect size, New Zealand, Temperature, Infant, Wind, Sudden Infant Death Syndrome, Newborn Infant, Public health systems and services research, Retrospective Studies, Seasons, Epidemiologic Studies, Poisson Distribution, Ions, and Confidence Interval
To examine infant feeding patterns during the first 6 months of life in Canterbury. A random sample of 10% of all births over a 12 month period in Canterbury was taken from birth notifications (n = 520). Information on the type of feeding... more
To examine infant feeding patterns during the first 6 months of life in Canterbury. A random sample of 10% of all births over a 12 month period in Canterbury was taken from birth notifications (n = 520). Information on the type of feeding was recorded prospectively at three time periods and extracted from available Plunket nursing notes. The participation rate was 81%. Data from nonparticipants on the method of feeding at discharge was obtained from obstetric records. Overall, 90.7% were breastfed at discharge. There was no difference between breastfeeding rates of the participants (91%) compared to the nonparticipants. For participants, 88% were exclusively breastfed at discharge which steadily declined to 36% at 24 weeks. However, some breastmilk was still being given to 70% at 24 weeks. Breastfeeding rates are good in comparison to other nations. However, there is room for improvement particularly maintaining exclusive breastfeeding to at least four months. This could be stimulat...
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This study was done to see whether any association between SIDS and respiratory viruses might be more obvious in Canterbury where the cot death rate is so high (about seven per thousand live births). The numbers of common respiratory... more
This study was done to see whether any association between SIDS and respiratory viruses might be more obvious in Canterbury where the cot death rate is so high (about seven per thousand live births). The numbers of common respiratory virus identifications for the eight year period July 1981 to June 1989 were analysed for associations with cot death. The identifications were from inpatients at the Christchurch Public Hospital and other community sources in Canterbury. Weak associations were found with respiratory syncytial virus (r = 0.3), influenza A (r = 0.3) and influenza B (r = 0.2). However, the associations are overwhelmed by the effect of the month of the year. A high rate of respiratory virus infection cannot be invoked as the explanation for our high SIDS rate.
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New Zealand's high mortality rate from the sudden infant death syndrome (SIDS) prompted the development of the New Zealand cot death study. This report of the preliminary analysis of the first year of the data gives the major... more
New Zealand's high mortality rate from the sudden infant death syndrome (SIDS) prompted the development of the New Zealand cot death study. This report of the preliminary analysis of the first year of the data gives the major identified risk factors. One hundred and sixty-two infants who died from SIDS were compared with 589 control infants, who were a representative sample of all hospital births in the study region. Obstetric records were examined and parental interviews were completed in 96% and 89% of subjects respectively. Data were available for all the variables in this study in 95% of those interviewed, thus 128 cases and 503 controls make up the subjects of this report. As expected we confirmed many risk factors for SIDS including: lower socioeconomic status, unmarried mother, young mother, younger school leaving age of mother, younger age of mother at first pregnancy, late attendance at antenatal clinic, nonattendant at antenatal classes, Maori, greater number of previo...
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A mathematical model of the human respiratory system that is sensitive to body temperature is presented. The model has been developed as an aid for investigating the link between respiratory and thermal control systems. The temperature... more
A mathematical model of the human respiratory system that is sensitive to body temperature is presented. The model has been developed as an aid for investigating the link between respiratory and thermal control systems. The temperature dependence of the respiratory system in this model is a result of the sensitivity of the respiratory controller, blood dissociation, blood flows, and metabolic
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This study was done to see whether any association between SIDS and respiratory viruses might be more obvious in Canterbury where the cot death rate is so high (about seven per thousand live births). The numbers of common respiratory... more
This study was done to see whether any association between SIDS and respiratory viruses might be more obvious in Canterbury where the cot death rate is so high (about seven per thousand live births). The numbers of common respiratory virus identifications for the eight year period July 1981 to June 1989 were analysed for associations with cot death. The identifications were from inpatients at the Christchurch Public Hospital and other community sources in Canterbury. Weak associations were found with respiratory syncytial virus (r = 0.3), influenza A (r = 0.3) and influenza B (r = 0.2). However, the associations are overwhelmed by the effect of the month of the year. A high rate of respiratory virus infection cannot be invoked as the explanation for our high SIDS rate.
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Research Interests: Psychology, Cognitive Science, Social Support, Medicine, Humans, and 15 moreNew Zealand, Infant, Mothers, Risk factors, Sudden Infant Death Syndrome, Clinical Sciences, Family Health, Analysis of Variance, Odds ratio, Risk Factors, Psychological Stress, Logistic Models, Life Change Events, LIFE EVENT, and Socioeconomic Factors
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Research Interests: Health Care, Medicine, Humans, New Zealand, Infant, and 13 moreImmunization, Risk factors, Sudden Infant Death Syndrome, Clinical Sciences, Public health systems and services research, Time Factors, Risk Factors, Case Control Study, Confidence Interval, Case Control Studies, Relative Risk, Immunization Schedule, and Paediatrics and reproductive medicine
New Zealand's high mortality rate from the sudden infant death syndrome (SIDS) prompted the development of the New Zealand cot death study. This report of the preliminary analysis of the first year of the data gives the... more
New Zealand's high mortality rate from the sudden infant death syndrome (SIDS) prompted the development of the New Zealand cot death study. This report of the preliminary analysis of the first year of the data gives the major identified risk factors. One hundred and sixty-two infants who died from SIDS were compared with 589 control infants, who were a representative sample of all hospital births in the study region. Obstetric records were examined and parental interviews were completed in 96% and 89% of subjects respectively. Data were available for all the variables in this study in 95% of those interviewed, thus 128 cases and 503 controls make up the subjects of this report. As expected we confirmed many risk factors for SIDS including: lower socioeconomic status, unmarried mother, young mother, younger school leaving age of mother, younger age of mother at first pregnancy, late attendance at antenatal clinic, nonattendant at antenatal classes, Maori, greater number of previous pregnancies, lower birth weight, shorter gestation, male infant, admission to neonatal intensive care unit. In addition, however, we identified three risk factors which are potentially amenable to modification. These were the prone sleeping position of baby (odds ratio = 3.53, 95% confidence interval 2.26, 5.54), maternal smoking (1-9 cigarettes/day OR = 1.87, 95% CI = 0.98, 3.54; 10-19/day OR = 2.64, 95% CI = 1.47, 4.74; 20+/day OR = 5.06, 95% CI = 2.86, 8.95) and breast feeding (OR = 2.93, 95% CI = 1.84, 4.67).(ABSTRACT TRUNCATED AT 250 WORDS)
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Maternal smoking has been shown to be a risk factor for sudden infant death syndrome (SIDS). The effect of smoking by the father and other household members has not previously been examined. A large nationwide case-control study. Four... more
Maternal smoking has been shown to be a risk factor for sudden infant death syndrome (SIDS). The effect of smoking by the father and other household members has not previously been examined. A large nationwide case-control study. Four hundred eighty-five SIDS deaths in the postneonatal age group were compared with 1800 control infants. Infants of mothers who smoked during pregnancy had a 4.09 (95% confidence interval [CI] = 3.28, 5.11) greater risk of death than infants of mothers who did not smoke. Infants of mothers who smoked postnatally also had an increased risk of SIDS compared with infants of nonsmokers and, furthermore, the risk increased with increasing levels of maternal smoking. Smoking by the father and other household members increased the risk (odds ratio [OR] = 2.41, 95% CI = 1.92, 3.02 and OR = 1.54, 95% CI = 1.20, 1.99, respectively). Smoking by the father increased the risk of SIDS if the mother smoked, but had no effect if she did not smoke. In analyses controlled for a wide range of potential confounders, smoking by the mother and father was still significantly associated with an increased risk of SIDS. Passive tobacco smoking is causally related to SIDS.
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To biochemically measure and compare the prevalence of maternal smoking by trimester in a cross-section of pregnant women residing in Christchurch, New Zealand, during 1997. Residual sera from routinely collected blood samples drawn in... more
To biochemically measure and compare the prevalence of maternal smoking by trimester in a cross-section of pregnant women residing in Christchurch, New Zealand, during 1997. Residual sera from routinely collected blood samples drawn in early and late pregnancy over a 12-month period, 1 January 1997 to 31 December 1997, was accumulated and anonymously assayed. Cotinine levels were measured by an ELISA test with a result greater than 14 ng/mL indicative of active smoking. Analysis was conducted upon 4,178 samples collected from 3,082 women. Adjusted cotinine validated smoking rates in the first, second and third trimesters were 26.8% (95% CI 24.5-29.2%), 25.0% (95% CI 22.3-27.8%) and 23.0% (95% CI 20.8-25.2%), respectively. This represents an absolute reduction in smoking rates of 4.7% (p = 0.02), 6.6% (p = 0.04) and 3.8% (p = 0.04) for the first, second and third trimesters, respectively, among pregnant women in Christchurch since 1994. Smoke reduction and cessation programs implemented locally and nationally have been effective in significantly reducing the biochemically measured prevalence of maternal smoking in pregnancy within a three-year period. Cigarette smoking during pregnancy is an important yet preventable factor affecting rates of prenatal, perinatal and paediatric morbidity and mortality. Reliable and repeated surveys of pregnant women are necessary to accurately measure changes in the maternal smoking prevalence and determine the efficacy of smoke reduction and cessation programs.
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To determine whether New Zealand's goals for immunisation coverage are being met in Christchurch and to assess whether scheduled vaccinations are being delivered in a timely fashion. A cohort of all infants born in Christchurch... more
To determine whether New Zealand's goals for immunisation coverage are being met in Christchurch and to assess whether scheduled vaccinations are being delivered in a timely fashion. A cohort of all infants born in Christchurch during June, July and August 1995 were matched with immunisation benefit claim information for the 6-week, 3-month, 5-month and 15-month immunisation events. Those with incomplete reports were traced for amendment or verification of their immunisation status. The cohort contained 1002 infants. The full complement of scheduled immunisations was delivered to an estimated 95.8% (95% CI: 94.5, 97.2) of infants within the cohort by two years of age. Infants who presented late for their 6-week immunisation visits were significantly more likely to be late for their next visits (chi 2 log rank = 8.2, df = 1, p < 0.01), as were those late for their 3-month visits (chi 2 = 20.9, df = 1, p < 0.01), and their 5-month visits (chi 2 = 52.5, df = 1, p < 0.01). Infants were significantly less likely to receive their full complement of immunisations by two years of age if they presented late for their 6-week (Fisher's exact test, p = 0.01), 3-month (p < 0.01) or 5-month (p = 0.01) immunisation visits. The Immunisation 2000 target of 95% full immunisation coverage by two years of age was met by this cohort. However, infants who were late for any immunisation visits were more likely to be late for subsequent visits and incompletely vaccinated by two years of age, compared to those infants who presented on time.
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To measure measles-mumps-rubella (MMR) immunisation status of a birth cohort at 18 months of age. All children born in Christchurch in June, July and August 1995 who were alive at 18 months of age (n = 999), were matched with MMR... more
To measure measles-mumps-rubella (MMR) immunisation status of a birth cohort at 18 months of age. All children born in Christchurch in June, July and August 1995 who were alive at 18 months of age (n = 999), were matched with MMR immunisation benefit claims. Those not listed were traced. The final immunisation coverage rate was estimated at 85%. An 85% coverage rate at 18 months fell well short of the Immunisation 2000 target of 95% coverage by two years of age.
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This paper examined factors relating to the infants' place of domicile to see whether they increased the risk of sudden infant death syndrome (SIDS) beyond social and environmental effects previously published. A case control... more
This paper examined factors relating to the infants' place of domicile to see whether they increased the risk of sudden infant death syndrome (SIDS) beyond social and environmental effects previously published. A case control study was undertaken in New Zealand between the years 1987-90. From all sudden infant death syndrome diagnoses over this time, parents of 393 (81%) sudden infant death syndrome infants consented to participate and these derive the cases. Controls were ascertained by randomly sampling 1800 infants from all babies born over 78% of the country. Parents of 1592 (88%) control infants consented to participate in the study. The relative risk of sudden infant death for infants usually residing in houses rented from the government (State houses) was 1.73 (95% CI: 1.13, 2.66) times that of infants with parents owning their house, after adjusting for likely social, economic and environmental confounding factors. However, the type of housing, construction of housing, heating and age of housing was not associated with sudden infant death syndrome. Although house size, measured in terms of bedroom numbers, was similar for sudden infant death syndrome and control infants (chi 2 = 0.40, df = 2, p = 0.82), the number of people normally residing within these houses was different. Sudden infant death syndrome infants' houses were less likely to have two adults and more likely to have more children normally resident. Density calculations (derived by calculating the children and/or adult numbers divided by bedroom numbers) revealed a non significant increase in relative risk, suggesting that housing overcrowding was not associated with sudden infant death syndrome in New Zealand. Infants domiciled in State houses are more likely to experience sudden infant death syndrome. However, this increased relative risk for sudden infant death syndrome appears to have little to do with the house per se and, perhaps, more to do with socioeconomic characteristics.
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We carried out a nationwide case-control study, comparing 393 case patients with sudden infant death syndrome (SIDS) with 1592 control subjects, in order to examine sheepskin bedding as a risk factor. Sheepskin use was similar for case... more
We carried out a nationwide case-control study, comparing 393 case patients with sudden infant death syndrome (SIDS) with 1592 control subjects, in order to examine sheepskin bedding as a risk factor. Sheepskin use was similar for case patients and control subjects (both, 42%; adjusted odds ratio [OR] = 1.28; 95% CI = 0.92, 1.79). Sheepskin use among the control subjects was associated with socioeconomic advantage. The relative risk for SIDS with sheepskin use was significantly increased in the infants placed prone to sleep (adjusted OR = 1.70; 95% CI = 1.08, 2.67), but not for infants placed in the supine or lateral position (adjusted OR = 0.82; 95% CI = 0.45, 1.48). An interaction between sheepskin use and bed sharing was also found. Sheepskin use was associated with a decreased risk of SIDS among infants sharing beds (adjusted OR = 0.61; 95% CI = 0.38, 0.99), but an increased risk among infants not bed sharing (adjusted OR = 2.25; 95% CI = 1.32, 3.86). We conclude that if an infant needs to be placed prone to sleep for medical reasons, a sheepskin should not be used as underbedding. However, for infants placed supine to sleep, sheepskins are not associated with an increased risk of SIDS.
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To describe the symptoms of illness reported by the parents of infants who have died of sudden infant death syndrome (SIDS) compared with those reported by community controls. A nationwide case-control study involving regions of New... more
To describe the symptoms of illness reported by the parents of infants who have died of sudden infant death syndrome (SIDS) compared with those reported by community controls. A nationwide case-control study involving regions of New Zealand with 78% of all births between 1987 and 1990. Home interviews were completed with parents of 393 (81% of total) infants who died from SIDS in the post neonatal age group, and 1592 (88.4% of total) controls who were a representative sample of all hospital births in the study region. Symptoms of infection were common in both cases and controls, but were not significantly different. Infants dying of SIDS, however, were likely to have symptoms suggestive of more severe illness in the 2 days before death (odds ratio [OR] = 3.02, 95% confidence interval [CI] 1.69-5.38). After adjusting for potential confounding this was still statistically significant (adjusted OR 2.36, 95% Cl 1.14-4.90). Also, babies dying of SIDS were more likely to have been less re...
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Universal Newborn Hearing Screening (UNHS) is being implemented worldwide as an effective method of early identification of hearing loss. The impact of delayed detection of sensorineural hearing loss is a major lifelong impairment. The... more
Universal Newborn Hearing Screening (UNHS) is being implemented worldwide as an effective method of early identification of hearing loss. The impact of delayed detection of sensorineural hearing loss is a major lifelong impairment. The aim of the study was to assess the feasibility of introducing universal newborn hearing screening over the 12-month period in the Neonatal Intensive Care Unit (NICU) at Christchurch Women's Hospital, and to assess the costs, and resources required. Universal Newborn Hearing Screening was conducted over a 12 month period in the Neonatal Service of Christchurch Women's Hospital. Throughout the implementation period, data were collected to monitor and benchmark against World's best practice. During the 12 months of the study, 435 babies were screened for hearing loss in the Neonatal Service at Christchurch Women's Hospital. Of these babies, 19 (4.37%) were referred for diagnostic 'auditory brainstem response' ABR testing to confir...
Research Interests: Language Acquisition, Community Development, Humans, Sensorineural Hearing Loss, Best practice, and 12 moreLanguage Skills, New Zealand, Cost effectiveness, Hearing Loss, Risk factors, Newborn Infant, Early Detection, Hearing Impaired, Risk Factors, Neonatal Intensive Care Unit, Pilot Projects, and Early Diagnosis
ABSTRACT Breathing signals are one set of physiological data that may provide information regarding the mechanisms that cause SIDS. Isolated breathing pauses have been implicated in fatal events. Other features of interest include slow... more
ABSTRACT Breathing signals are one set of physiological data that may provide information regarding the mechanisms that cause SIDS. Isolated breathing pauses have been implicated in fatal events. Other features of interest include slow amplitude modulation of the breathing signal, a phenomenon whose origin is unclear, and periodic breathing. The latter describes a repetitive series of apnea, and may be considered an extreme manifestation of amplitude modulation with successive cessations of breathing. Rhythmicity is defined to assess the impact of amplitude modulation on breathing signals and describes the extent to which frequency components remain constant for the duration of the signal. The wavelet transform was used to identify sections of constant frequency components within signals. Rhythmicity can be evaluated for all the frequency components in a signal, for individual frequencies. The rhythmicity of eight breathing epochs from sleeping infants at high and low risk for SIDS was calculated. Initial results show breathing from infants at high risk for SIDS exhibits greater rhythmicity of modulating frequencies than breathing from low risk infants.
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Universal Newborn Hearing Screening (UNHS) is being implemented worldwide as an effective method of early identification of hearing loss. The impact of delayed detection of sensorineural hearing loss is a major lifelong impairment. The... more
Universal Newborn Hearing Screening (UNHS) is being implemented worldwide as an effective method of early identification of hearing loss. The impact of delayed detection of sensorineural hearing loss is a major lifelong impairment. The aim of the study was to assess the feasibility of introducing universal newborn hearing screening over the 12-month period in the Neonatal Intensive Care Unit (NICU) at Christchurch Women's Hospital, and to assess the costs, and resources required. Universal Newborn Hearing Screening was conducted over a 12 month period in the Neonatal Service of Christchurch Women's Hospital. Throughout the implementation period, data were collected to monitor and benchmark against World's best practice. During the 12 months of the study, 435 babies were screened for hearing loss in the Neonatal Service at Christchurch Women's Hospital. Of these babies, 19 (4.37%) were referred for diagnostic 'auditory brainstem response' ABR testing to confir...