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Impact of Maternal Stress on Infant Stunting

26. april 2016 opdateret af: Anne Marie Chomat, McGill University

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

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.

Studieoversigt

Detaljeret beskrivelse

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.

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

271

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Barn
  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Kvinde

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Indigenous Mam-Mayan women living in 8 rural hamlets (or communities) in the municipality of San Juan Ostuncalco, in the department of Quetzaltenango, Guatemala.

Beskrivelse

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

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
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)

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Infant stunting (Infant height-for-age score)
Tidsramme: 0-6 wk
Infant height-for-age score measured at 0-6 wk
0-6 wk
Infant stunting (Infant height-for-age score)
Tidsramme: 4-6 mo postpartum
Infant height-for-age score measured at 4-6 mo postpartum
4-6 mo postpartum
Change in infant HAZ per month
Tidsramme: 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
Change over time (between 0-6wk and 4-6mo)

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Efterforskere

  • Ledende efterforsker: Anne Marie Chomat, MD, PhD, MPH, McGill University

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. juni 2012

Primær færdiggørelse (Faktiske)

1. november 2013

Studieafslutning (Faktiske)

1. november 2013

Datoer for studieregistrering

Først indsendt

19. april 2016

Først indsendt, der opfyldte QC-kriterier

26. april 2016

Først opslået (Skøn)

28. april 2016

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

28. april 2016

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

26. april 2016

Sidst verificeret

1. april 2016

Mere information

Begreber relateret til denne undersøgelse

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

UBESLUTET

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Amning

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