Maternal distress and child inflammation in a high stress setting

• In Event: 1-037 - Developmental Influences on Cardiometabolic Risk in the Early Lifespan

Integrative Statement

Low-grade inflammation is an important marker of cardiometabolic risk that has been studied mainly among adults. Recent research suggests, however, that disparities in low-grade inflammation begin in childhood. Low-grade inflammation (measured by C-Reactive Protein, CRP) is associated with multiple health outcomes in U.S. children, including cardiometabolic risk factors (Cook et al., 2000; Slopen et al., 2012). Psychosocial stress has been posited as one cause of higher CRP due to dysregulation of the immune system under conditions of chronic stress. This has been empirically supported by studies of U.S. children (Fuligni et al., 2009; Goosby et al., 2015; Slopen et al., 2013).

Building on prior research, we expand our understanding of psychosocial determinants of inflammation by assessing whether maternal distress is associated with CRP in young children. Children with distressed mothers may develop chronic inflammation due to pregnancy exposures, or due to difficult socioemotional conditions and compromised parenting that result in child psychosocial stress. This is more likely to occur in settings where household resources are scarce and gender inequalities place women with most of the responsibility for childcare. Thus, we address this research question using data from rural Nicaragua.

Using biosocial data collected in 2015, we assessed high-sensitivity CRP levels through analysis of dried blood spots in 110 children ages 3-12 years. Their mothers provided survey and biomarker data we use to assess various aspects of maternal distress and household socioeconomic and demographic characteristics. We define elevated inflammation as a CRP level above the median due to the lack of clear cutoffs for CRP levels that contribute to cardiometabolic risk among children. We measured maternal distress as: allostatic load, perceived household food insecurity and mental health problems. Allostatic load is a cumulative measure of dysregulation in physiological systems calculated here using the five biomarkers collected from the mothers: CRP (above 1mg/L), obesity (BMI>=30), waist circumference (above 88 cm), systolic blood pressure (SBP>=130) and glucose levels (mean blood glucose above 140). Perceived food insecurity was measured by maternal responses to the Latin American and Caribbean Food Security Scale. We assessed maternal mental distress using the SRQ20 (Harding et al., 1980).

Using multiple regression analysis, we found significantly higher odds of elevated inflammation among children whose mothers had higher allostatic load scores and for those whose mothers reported that adults in their household had reduced food intake due to a lack of money. Maternal mental distress was not associated with child inflammation. These results hold net of multiple confounders, including maternal education, children’s recent illnesses and BMI z-scores.

Evidence of low-grade inflammation among children indicates the potential development of cardiometabolic disease risk factors early in the life course in this high-poverty and nutrition transition setting. Further, our study is one of the few to find maternal biosocial stress associated with higher risk for inflammation in young children. Further research is needed to substantiate these findings in other settings and to address the mechanisms through which maternal stress may result in increased risk of inflammation in young children in high-poverty contexts.

Authors

• Kammi Schmeer, Department of Sociology, The Ohio State University
  Presenting Author

• Jason DeCaro, University of Alabama
  Non-Presenting Author

• Barbara Piperata, Department of Anthropology, The Ohio State University
  Non-Presenting Author

• Warren Wilson, Department of Anthropology and Archaeology, University of Calgary
  Non-Presenting Author