Association Between Mother-Infant Hair Cortisol Levels, Perinatal Stressors, and Adverse Birth Outcomes Among Kenyan Mother-Infant Pairs

Abstract

Background: Few data on maternal-infant hair cortisol are available from HIV high-burden settings. We evaluated maternal hair cortisol and its relationship with infant hair cortisol, perinatal stressors, and pregnancy outcomes in Kenya. Materials and Methods: We analyzed data from an HIV prevention trial (NCT03070600). Pregnant women without HIV were enrolled and followed through 9 months postpartum. We utilized hair samples collected at 6 weeks postpartum from mother-infant pairs to quantify hair cortisol concentrations (HCC) reflecting cortisol levels over the prior ?3 months. HCC was measured by enzyme immunoassay. We tested whether mean maternal HCC was associated with infant HCC, stressors, and/or birth outcomes using linear regression. Results: Overall, 153 women had HCC available at 6 weeks postpartum. Median maternal age was 25 years (Interquartile range [IQR] 22?30), median completed education was 12 years (IQR: 8?12), and 95% were married. Median birthweight was 3.4 kilograms (IQR: 3.1?3.7), 13% of women experienced preterm birth (PTB), and 2% of infants had low birthweight (LBW); 11% were small-for-gestational age (SGA). Median maternal HCC was 12.0?pg/mg (IQR: 6.3?20.4); and median infant HCC was 10.4?pg/mg (IQR: 5.5?23.7). Infant HCC was correlated with maternal HCC (r?=?0.498, p?<?0.001). Stressors associated with maternal HCC (p?<?0.05) included having a partner living with HIV or of unknown HIV status, relationship instability, and having high behavioral risk for HIV. Maternal HCC was not significantly associated with PTB, LBW, or SGA. Conclusion: In conclusion, peripartum maternal HCC was correlated with infant HCC and associated with experiencing HIV acquisition-related stressors.

Keywords

• HIV
• postpartum
• prenatal
• stress