Impact of Maternal Stress on Infant Stunting

Sponsor

McGill University (Other)

Overall Status

Completed

CT.gov ID

NCT02755012

Collaborator

Center for Studies of Sensory Impairment, Aging and Metabolism (Other)

271

Enrollment

Duration (Months)

Study Details

Study Description

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.

Condition or Disease	Intervention/Treatment	Phase
Maternal; Malnutrition Infant Malnutrition Physiological Stress Emotional Stress Life Stress Domestic Violence Infection Breast Feeding Mastitis

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 Design

Study Type:

Observational

Actual Enrollment :

271 participants

Observational Model:

Cohort

Time Perspective:

Prospective

Official Title:

Reducing Maternal Stress Due to Infection, Malnutrition and Psychosocial Conditions of Poverty: A New Paradigm for Tackling Infant Stunting

Study Start Date :

Jun 1, 2012

Actual Primary Completion Date :

Nov 1, 2013

Actual Study Completion Date :

Nov 1, 2013

Arms and Interventions

Arm	Intervention/Treatment
Longitudinal 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 60 women enrolled at 0-6 wk postpartum and seen once with their infant (cross-sectional)
Later Postpartum 56 women enrolled at 0-6 wk postpartum and seen once with their infant (cross-sectional)

Outcome Measures

Primary Outcome Measures

Infant stunting (Infant height-for-age score) [0-6 wk]
Infant height-for-age score measured at 0-6 wk
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