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Impact of Maternal Stress on Infant Stunting

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ClinicalTrials.gov Identifier: NCT02755012
Recruitment Status : Completed
First Posted : April 28, 2016
Last Update Posted : April 28, 2016
Sponsor:
Collaborator:
Center for Studies of Sensory Impairment, Aging and Metabolism
Information provided by (Responsible Party):
Anne Marie Chomat, 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.

Condition or disease
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.

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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 : June 2012
Actual Primary Completion Date : November 2013
Actual Study Completion Date : November 2013

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Growth Disorders

Group/Cohort
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)



Primary Outcome Measures :
  1. Infant stunting (Infant height-for-age score) [ Time Frame: 0-6 wk ]
    Infant height-for-age score measured at 0-6 wk

  2. Infant stunting (Infant height-for-age score) [ Time Frame: 4-6 mo postpartum ]
    Infant height-for-age score measured at 4-6 mo postpartum

  3. 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


Biospecimen Retention:   Samples Without DNA
Stool sample (mother and infant) Urine sample (mother) Saliva sample (mother) Breast milk sample (mother)


Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
Indigenous Mam-Mayan women living in 8 rural hamlets (or communities) in the municipality of San Juan Ostuncalco, in the department of Quetzaltenango, Guatemala.
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

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02755012


Sponsors and Collaborators
McGill University
Center for Studies of Sensory Impairment, Aging and Metabolism
Investigators
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Principal Investigator: Anne Marie Chomat, MD, PhD, MPH McGill University

Publications of Results:
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Responsible Party: Anne Marie Chomat, Postdoctoral Fellow, McGill University
ClinicalTrials.gov Identifier: NCT02755012    
Other Study ID Numbers: A04-B01-12A
First Posted: April 28, 2016    Key Record Dates
Last Update Posted: April 28, 2016
Last Verified: April 2016
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided
Keywords provided by Anne Marie Chomat, McGill University:
Maternal Health
Guatemala
Indigenous Population
Stunting
Food Insecurity
Poverty
Social Support
Maternal Autonomy
Paternal Support
Cortisol Rhythm
Additional relevant MeSH terms:
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Infection
Mastitis
Malnutrition
Infant Nutrition Disorders
Growth Disorders
Stress, Psychological
Nutrition Disorders
Pathologic Processes
Puerperal Disorders
Pregnancy Complications
Breast Diseases
Skin Diseases
Behavioral Symptoms