Household Food Insecurity Is Associated with Self-Reported Pregravid Weight Status, Gestational Weight Gain, and Pregnancy Complications

Abstract

Background Household food insecurity is positively associated with weight among women. The association between household food insecurity and pregnancy related weight gain and complications is not well understood. Objective To identify if an independent association exists between household food insecurity and pregnancy related complications. Design Data from the Pregnancy, Infection and Nutrition prospective cohort study were used to assess household food insecurity retrospectively using the United States Department of Agriculture (USDA) 18-item Core Food Security Module (CFSM) among 810 pregnant women with incomes ≤ 400% of the income/poverty ratio, recruited between January 2001 and June 2005 and followed through pregnancy. Main outcome measures Self-reported pregravid body mass index, gestational weight gain, second trimester anemia, pregnancy-induced hypertension, and gestational diabetes mellitus. Statistical analyses performed: Multivariate linear, multinomial logistic and logistic regression analyses. Results Among 810 pregnant women, 76% were from fully food secure, 14% were from marginally food secure, and 10% were from food insecure households. In adjusted models, living in a food insecure household was significantly associated with severe pregravid obesity [adjusted odds ratio (AOR) 2.97, 95% confidence intervals (CI) 1.44, 6.14], higher gestational weight gain [adjusted β coefficient 1.87, 95% CI 0.13, 3.62] and with a higher adequacy of weight gain ratio [adjusted β 0.27, CI 0.07, 0.50]. Marginal food security was significantly associated with gestational diabetes mellitus [AOR 2.76, 95% CI 1.00, 7.66]. Conclusions This study highlights the possibility that living in a food insecure household during pregnancy may increase risk of greater weight gain and pregnancy complications.

Prevalence and Factors Associated with Food Insecurity among Women Aged 18-49 Years in Kampala Slums Uganda; A Mixed Methods Study

“…Food insecurity among women of reproductive age (WRA) is a serious public health problem with adverse effects on the women, pregnancy outcomes and child survival; as well as on the economic development of the country ultimately negatively impacting the country's gross domestic product [6]. WRA who are food insecure are susceptible to poor health and nutritional status which reduces their economic productivity/employment opportunities [7], propagates the intergenerational cycle of malnutrition, leading to increased risk of maternal and child morbidity and mortality [8,9] and poor cognitive and physical development among surviving children [10,11]. Studies indicate that food insecure women are more likely to suffer from poor nutritional, health and psychosocial consequences.…”

Food Insecurity during the Gestational Period and Factors Associated with Maternal and Child Health

“…12 In this review the prevalence of food insecurity in women during the gestational period ranged from 9.0% to 87.9% (Table 1), with the lowest prevalence found in developed countries and the highest prevalence in underdeveloped or developing countries. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Although there are some studies on food insecurity during the gestational period, there is still little knowledge about the effects of this insecurity on maternal and child health. Food insecurity in the gestational period is associated with anemia, pre-gestational and gestational anthropometric nutritional status, birth defects, maternal depression/anxiety disorders in pregnancy, gestational complications (diabetes, hypertension and obesity), gestational weight gain, food intake, low birth weight and postpartum depression and suicide.…”

Reliability and validity of an individually focused food insecurity access scale for assessing inadequate access to food among pregnant Ugandan women of mixed HIV status

“…Women's responsibilities in managing family feeding (7) , gender bias in the experience of FI (8) and unequal control over household resources make them particularly vulnerable to FI and its consequences (3) . Data from the USA indicate that, when faced with FI, women suffer a range of negative nutritional (9) and psychosocial consequences (10,11) .Pregnant women are more likely to experience greater FI than non-pregnant women because they have higher nutrient demands, less physical ability to obtain and prepare food (especially later in pregnancy and early postpartum) and less ability to engage in income-generating labour (10) . The three studies to date about FI among pregnant women have shown that FI has serious negative nutritional and psychosocial impacts on women's health (9)(10)(11) .…”

“…Data from the USA indicate that, when faced with FI, women suffer a range of negative nutritional (9) and psychosocial consequences (10,11) .…”

“…The three studies to date about FI among pregnant women have shown that FI has serious negative nutritional and psychosocial impacts on women's health (9)(10)(11) . However, all of these studies were done in the USA and contextual differences between resource-rich and resource-poor settings make the generalizability of these findings questionable.…”