Predictors of Allostatic Load in Mothers and Children: Biological Evidence from a High-Stress Setting

Each year millions of pregnant women, mothers, and children experience severe illness or death, largely from preventable or treatable causes. Of these, 99% occur in the developing world. In these settings mothers and children, as the most vulnerable member of society, experience multiple sources of deprivation, contributing to cascading declines in health across multiple physiological systems. However, international attempts to address maternal/child health (MCH) remain ineffective, as proved by Millenium Development Goals related to reducing child mortality and improving maternal health being the furthest from being met by the 2015 deadline. We propose an innovative research model of assessing maternal and child health in a high poverty setting through the use of biomarkers and the concept of allostatic load (AL). AL reflects the multiple, interactive insults to women and children’s biological systems and is able to capture the interconnected physical consequences of poor diets, high burden of infection, and psychosocial stress common in these settings. Biological markers of these conditions allow us to overcome cultural and other factors that hinder health assessments based on self or maternal reports. Importantly, we consider the economic, social and cultural contexts that may produce these health insults, and whether mothers’ AL and children’s AL are affected by the same dimensions of deprivation and related psychosocial stressors. The results of this study will advance our understanding of deprivation effects on mothers and children and models that may be replicated to better assess MCH and its determinants across settings.