Clinical Trial: Impact of Maternal Stress on Infant Stunting

Study Status: Completed
Recruit Status: Completed
Study Type: Observational

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

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 Summary:

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.


Sponsor: McGill University

Current Primary Outcome:

  • Infant stunting (Infant height-for-age score) [ Time Frame: 0-6 wk ]
    Infant height-for-age score measured at 0-6 wk
  • Infant stunting (Infant height-for-age score) [ Time Frame: 4-6 mo postpartum ]
    Infant height-for-age score measured at 4-6 mo postpartum
  • Change in infant HAZ per month [ Time Frame: 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


Original Primary Outcome: Same as current

Current Secondary Outcome:

Original Secondary Outcome:

Information By: McGill University

Dates:
Date Received: April 19, 2016
Date Started: June 2012
Date Completion:
Last Updated: April 26, 2016
Last Verified: April 2016