Food insecurity in pregnant women is associated with social determinants and nutritional outcomes: a systematic review and meta-analysis

Abstract

The association between FI, social determinants, and nutritional outcomes for pregnant women are analyzed. A systematic review was conducted through a search of articles in five electronic databases. Social determinants (race, education, participation in social programs) and nutritional status (pre-gestational BMI, gestational weight gain, anemia) were analyzed in relation to the FI situation. For each article, the frequency of food insecurity was collected in order to calculate the summary measure, prevalence ratio (PR). 26 articles were selected. An elevated occurrence of FI was associated with black pregnant women (PR: 1.83, 95% CI 1.08-3.10), participation in social protection programs (PR = 1.43, 1.02-2.01), and with low education levels on the part of pregnant women (PR = 2.73, 1.68-4.43). FI increased the chances of being overweight (PR = 1.57, 95% CI = 1.29-1.91) and obese (PR = 1.47, 95% CI = 1.15-1.87) in pregnant women, as well as excessive weight gain (PR = 1.42, 95% CI = 1.10-1.82) and inadequate weight gain (PR = 1.47; 95% CI = 1.09-1.97) during pregnancy. Anemia was not associated with FI. Social inequities are associated with food and nutritional insecurity in pregnant women.

Dietary Practices during Pregnancy in a Marshallese Community: A Mixed Methods Analysis

“…While participants discussed autonomy over their diet, they also discussed significant food insecurity; about 82% percent said that they struggled to pay for necessities such as food, and almost half reported that they sometimes or often did not have enough to eat and had used food assistance in the past year. This level of food insecurity among pregnant women is much higher than it has been documented in other populations [ 30 , 31 , 32 ]. The previous qualitative literature with the Marshallese in Arkansas has identified a strong desire for both healthy and traditional foods and financial barriers to obtaining them [ 19 , 33 ].…”

Determinants of Suboptimal Gestational Weight Gain among Antenatal Women Residing in the Highest Gross Domestic Product (GDP) Region of Malaysia

“…This study employed a Malay version of the USDA-developed 6-item Household Food Security Survey Module (6-item HFSSM), which has been widely used internationally to assess household food insecurity among women and pregnant women [ 24 ]. The Malay version of the 6-item HFSSM was translated and validated by Mesbah et al [ 25 ] with a Cronbach’s alpha (α) of 0.749.…”

HIV Infections and Food Insecurity Among Pregnant Women from Low- and Middle-Income Countries: A Systematic Review and Meta-analysis

“…Food insecurity: this covers any type of violation of the human right to adequate food. A lack of adequate food, in both quantitative and qualitative terms, can deny people their right to life [6]. 1.1 Mild FI: household sometimes or often worries about not having enough food, and/or is unable to eat preferred foods, and/or eats a more monotonous diet than desired and/or some foods considered undesirable, but only rarely.…”

“…FI can be conceptualised as the violation of the human right to adequate food [6]. When there is a lack of adequate food, in both quantitative and qualitative terms, it denies people their right to life through limited or uncertain opportunities to acquire acceptable foods in socially acceptable ways, or through limited or uncertain availability of nutritionally adequate and safe foods [1,5].…”