The relationship between maternal stress during pregnancy and up to two years after birth and risk of child overweight and obesity: Protocol for a Systematic Review

Background:   Childhood obesity presents a significant public health challenge globally. The period from conception to two years after birth, the first 1000 days, represents a critical period during which the experience of maternal stress may be related to the development of childhood obesity.  Research to date suggests some positive associations between maternal stress during the first 1000 days and childhood obesity, but findings are inconsistent and have not yet been comprehensively synthesised. The purpose of this review is to systematically examine the association between maternal stress during the first 1000 days and the risk of child overweight and obesity. Methods: :  The following electronic databases will be searched from inception using a detailed search strategy: the Cochrane Library, MEDLINE, PsycINFO, EMBASE, CINAHL, Maternity and Infant Care, and Web of Science. Cohort, case-control, and cross-sectional studies examining maternal stress during the first 1000 days and child overweight and obesity up to the age of 10 years will be included. Titles, abstracts and full articles will be screened by two investigators independently to identify eligible studies. A standardised data extraction form will be used to extract data including: study design; maternal stress exposure; child outcome; exclusion criteria; participant characteristics; and assessment methods. The Cochrane Collaboration’s bias classification tool for observational studies will be used to assess study quality. This protocol is reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol (PRISMA-P) checklist, and the systematic review will be conducted and reported following the PRISMA checklist. If possible, random effects models will be used to perform meta-analyses. Ethics and dissemination:  Ethical approval is not required for this study as it will not involve conducting experimental research, nor include identifying personal data.  The systematic review will be disseminated in peer-reviewed journals. PROSPERO registration number: CRD42018100363