Impact of Maternal Stress on Infant Stunting

Completed

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

• Registration Number: NCT02755012
• Lead Sponsor: McGill University

Brief Summary

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.

Detailed 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.

Study Timeline

• Study Start: 2012-06
• Primary Completion: 2013-11
• Study Completion: 2013-11
• Status Verified: 2016-04
• Study First Submitted: 2016-04-19
• Study First Submitted QC: 2016-04-26
• Last Update Submitted: 2016-04-26
• Study First Posted: 2016-04-28
• Last Update Posted: 2016-04-28

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 271

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

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Infant stunting (Infant height-for-age score)	4-6 mo postpartum	Infant height-for-age score measured at 4-6 mo postpartum
Change in infant HAZ per month	Change over time (between 0-6wk and 4-6mo)	Change in infant HAZ score between 1st (0-6 wk) and 2nd (4-6 mo) visits