Trial reportBMC pregnancy and childbirth2015
Maternal cortisol and stress are associated with birth outcomes, but are not affected by lipid-based nutrient supplements during pregnancy: an analysis of data from a randomized controlled trial in rural Malawi.
Trial report in BMC pregnancy and childbirth, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01239693 (A Research Plan for a Randomised, Single-blind, Parallel Group Controlled Trial in Rural Malawi, Testing the Health Effects of Supplementing Maternal Diet During Pregnancy and Lactation and Infant Diet From 6 to 18 Months of Age With High-energy, Micronutrient Fortified Lipid-based Nutrient Supplements), which is not on this map. Cited by 19 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Research Plan for a Randomised, Single-blind, Parallel Group Controlled Trial in Rural Malawi, Testing the Health Effects of Supplementing Maternal Diet During Pregnancy and Lactation and Infant Diet From 6 to 18 Months of Age With High-energy, Micronutrient Fortified Lipid-based Nutrient Supplements (LNS)
Who cites it
19 citing papers in PubMed, 4 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Community-Based Child Food Interventions/Supplements for the Prevention of Wasting in Children Up to 5 Years at Risk of Wasting and Nutritional Oedema: A Systematic Review and Meta-Analysis.Nutrition reviews · 2025Pooled it
- Neonatal Hair Cortisol and Birth Outcomes: An Empirical Study and Meta-Analysis.Psychosomatic medicine · 2024Pooled it
- Multiple-micronutrient supplementation for women during pregnancy.The Cochrane database of systematic reviews · 2019Pooled it
- Lipid-based nutrient supplements for maternal, birth, and infant developmental outcomes.The Cochrane database of systematic reviews · 2018Pooled it
- Association of high cortisol levels in pregnancy and altered fetal growth. Results from the MAASTHI, a prospective cohort study, Bengaluru.The Lancet regional health. Southeast Asia · 2023Article
- A framework for testing pathways from prenatal stress-responsive hormones to cardiovascular disease risk.Frontiers in endocrinology · 2023Review
- Associations between maternal awakening salivary cortisol levels in mid-pregnancy and adverse birth outcomes.Archives of gynecology and obstetrics · 2022Article
- Increased risk of preterm delivery with high cortisol during pregnancy is modified by fetal sex: a cohort study.BMC pregnancy and childbirth · 2022Article
- Effects of vitamin and mineral supplementation during pregnancy on maternal, birth, child health and development outcomes in low- and middle-income countries: A systematic review.Campbell systematic reviews · 2021Article
- Antepartum Depression and Preterm Birth: Pathophysiology, Epidemiology, and Disparities due to structural racism.Current psychiatry reports · 2021Review
- Maternal Microbiota, Cortisol Concentration, and Post-Partum Weight Recovery are Dependent on Mode of Delivery.Nutrients · 2020Article
- Association of Early Interventions With Birth Outcomes and Child Linear Growth in Low-Income and Middle-Income Countries: Bayesian Network Meta-analyses of Randomized Clinical Trials.JAMA network open · 2019Article
- Population-Based Estimation of Dental Caries and Periodontal Disease Rates of Gravid and Recently Postpartum Women in Lilongwe, Malawi.AJP reports · 2019Article
- Path analyses of risk factors for linear growth faltering in four prospective cohorts of young children in Ghana, Malawi and Burkina Faso.BMJ global health · 2019Article
- Co-causation of reduced newborn size by maternal undernutrition, infections, and inflammation.Maternal & child nutrition · 2018Article
- Prenatal stress and child development: A scoping review of research in low- and middle-income countries.PloS one · 2018Article
- Predictors and pathways of language and motor development in four prospective cohorts of young children in Ghana, Malawi, and Burkina Faso.Journal of child psychology and psychiatry, and allied disciplines · 2017Article
- Stress and the HPA Axis: Balancing Homeostasis and Fertility.International journal of molecular sciences · 2017Review
- The Interplay between Maternal Nutrition and Stress during Pregnancy: Issues and Considerations.Annals of nutrition & metabolism · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrenatal micronutrient supplements have been found to increase birth weight, but mechanisms for increased growth are poorly understood. Our hypotheses were that 1) women who receive lipid-based nutrient supplements (LNS) during pregnancy would have lower mean salivary cortisol concentration at 28 wk and 36 wk gestation compared to the multiple micronutrient (MMN) and iron-folic acid (IFA) supplement groups and 2) both salivary cortisol and perceived stress during pregnancy would be associated with shorter duration of gestation and smaller size at birth.
methodsWomen were enrolled in the trial in early pregnancy and randomized to receive LNS, MMN, or iron-folic acid (IFA) supplements daily throughout pregnancy. At enrollment, 28 wk and 36 wk gestation, saliva samples were collected and their cortisol concentration was measured. Self-report of perceived stress was measured using questionnaires. Gestation duration was indicated by ultrasound dating and newborn anthropometric measurements (weight, length, head circumference) provided indicators of intrauterine growth.
resultsOf the 1391 women enrolled in the trial, 1372, 906 and 1049 saliva samples were collected from women at baseline, 28 wk and 36 wk, respectively. There were no significant differences in mean cortisol concentrations by intervention group at 28 wk or 36 wk gestation. Cortisol concentrations were negatively associated with duration of gestation (Baseline: β = -0.05, p = 0.039; 36 wk: β = -0.04, p = 0.037) and birth weight (28 wk: β = -0.08, p = 0.035; 36 wk: β = -0.11, p = 0.003) but not associated with length-for-age or head circumference-for-age z-scores. Perceived stress at 36 wk was significantly associated with shorter newborn LAZ (p = 0.001). There were no significant associations with the risk of small for gestational age, preterm birth, or low birth weight.
conclusionsMaternal salivary cortisol concentration was strongly associated with birth weight and duration of gestation in rural Malawi, but these data do not support the hypothesis that LNS provision to pregnant women would influence their salivary cortisol concentrations.
trial registrationClinicaltrials.gov identifier NCT01239693.
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