Impact of Maternal Stress on Infant Stunting

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

Sponsors

Lead Sponsor: McGill University

Collaborator: Center for Studies of Sensory Impairment, Aging and Metabolism

Source 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.

Overall Status Completed
Start Date June 2012
Completion Date November 2013
Primary Completion Date November 2013
Study Type Observational
Primary Outcome
Measure Time Frame
Infant stunting (Infant height-for-age score) 0-6 wk
Infant stunting (Infant height-for-age score) 4-6 mo postpartum
Change in infant HAZ per month Change over time (between 0-6wk and 4-6mo)
Enrollment 271
Condition
Eligibility

Sampling Method: Non-Probability Sample

Criteria:

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

Gender: Female

Minimum Age: N/A

Maximum Age: N/A

Healthy Volunteers: Accepts Healthy Volunteers

Overall Official
Last Name Role Affiliation
Anne Marie Chomat, MD, PhD, MPH Principal Investigator McGill University
Verification Date

April 2016

Responsible Party

Type: Principal Investigator

Investigator Affiliation: McGill University

Investigator Full Name: Anne Marie Chomat

Investigator Title: Postdoctoral Fellow

Keywords
Has Expanded Access No
Condition Browse
Arm Group

Label: 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

Label: Early Postpartum

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

Label: Later Postpartum

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

Patient Data Undecided
Study Design Info

Observational Model: Cohort

Time Perspective: Prospective

Source: ClinicalTrials.gov