Impact of Maternal Stress on Infant Stunting

McGill University

Status: Completed

Conditions: Infant Malnutrition; Breast Feeding; Infection; Domestic Violence; Emotional Stress; Life Stress; Physiological Stress; Maternal; Malnutrition; Mastitis

Study type: Observational

Funder types: Other

Identifiers

NCT02755012

A04-B01-12A

Details and patient eligibility

About

This study takes place in rural Mam-Mayan communities of Guatemala characterized by high rates of childhood stunting. It aims to characterize women's exposure to nutrition, infection and psychosocial stressors vs. resilience factors, to evaluate the cumulative impact of maternal-level factors (nutritional, infectious, psychosocial), social factors (autonomy, social support, domestic violence), and household factors (socioeconomic status, food security) on early infant growth, and to evaluate whether maternal cortisol may be a mediator in the vertical transmission of stress.

Full description

Grounded in participatory action research and a socio-ecological framework, this mixed-methods, observational study enrolled a longitudinal cohort of 155 women, seen during pregnancy (6-9 mo), early (0-6 wks) and later (4-6 mo) postpartum, and two cross-sectional cohorts (60 early, 56 later postpartum).

Maternal and infant anthropometry was recorded, maternal fecal, urine and saliva samples were collected, and questionnaires were used to explore household factors (socioeconomic status, food security), social factors (autonomy, paternal/social support, domestic violence), and maternal-level factors (nutrition, infection, emotional distress).

Analyses focused on (1) characterizing women's exposure to nutrition, infection and psychosocial stressors vs. resilience factors, (2) describing the maternal diurnal salivary cortisol rhythm in pregnancy and postpartum and explore its association with psychosocial variables, (3) assessing the cumulative impact of maternal-level factors (nutritional, infectious, psychosocial), social factors (autonomy, social support, domestic violence), and household factors (socioeconomic status, food security) on early infant growth, and (4) evaluating whether maternal cortisol may be a mediator in the vertical transmission of stress.

In addition, Photovoice activities involved giving a camera to 23 women from study communities, who documented sources of stress vs. resilience for local women, and shared photo-elicited narratives through six group sessions.

Enrollment: 271 patients

Sex: Female

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Woman from study communities
• Either pregnant or 0-6 wk postpartum or 4-6 mo postpartum
• Consenting to participate

Exclusion criteria

• Twin pregnancy
• Not consenting to participate

Trial design

271 participants in 3 patient groups

Longitudinal

Description:

155 women enrolled in 2nd or 3rd trimester of pregnancy, and seen again, with their infant, at 0-6 wk postpartum, and 4-6 mo postpartum

Early Postpartum

Description:

60 women enrolled at 0-6 wk postpartum and seen once with their infant (cross-sectional)

Later Postpartum

Description:

56 women enrolled at 0-6 wk postpartum and seen once with their infant (cross-sectional)