Is Maternal Stress and Morbidity Associated with Infant Malnutrition?

Abstract

Aim: To examine the relationship between maternal stress,maternal morbidity, social support and infant malnutrition, among mothers living in the semi-formal and formal settlements served by the Gold Fields Nutrition Centre (the Centre) at the Medical University of Southern Africa (MEDUNSA) Study design: Case control study of mothers with malnourished infants (the cases) and mothers with well-nourished infants (the controls). Exposure: Maternal morbidity was assessed using a combination of tests, medical consultation, laboratory tests and health questionnaire. For maternal stress a questionnaire based on the Life Experiences Survey was used. The amount of social support that a mother received was assessed using a list of hypothetical circumstances in which they might seek help or support. In addition a detailed questionnaire was used to collect information on a variety of socio-demographic variables considered to be potential confounders. Statistical Analysis: Variables were compared between cases and controls using paired t-tests (for continuous variables) and McNemar's Chi squared test (for binary data). In addition conditional multiple logistic regression analyses were conducted to assess whether there was an independent association between maternal stress, social support and morbidity on the one hand, and infant malnutrition on the other. Results: Mothers with mdnourished children were more likely to have greater stress and illness than mothers with well-nourished children. However the cases and controls did not differ much in their social support system. Using a conditional multiple logistic regression model it was found that malnutrition was significantly related to maternal illness (p=0.008) and maternal stress (p=0.013). lllmothers (odds ratio = 3.37) and stressed mothers (odds ratio = 1.097) were more likely to have malnourished infants. Conclusion: The study showed a strong association between maternal illness and child mdnutrition and between maternal stress and child mdnutrition, There was also no evidence of an association between social support and child malnutrition. In view of the high number of ill mothers,mothers of malnourished children need extra support and attention to care for their children.