Infection Clinical Trial
Official title:
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.
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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Observational Model: Cohort, Time Perspective: Prospective
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