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

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

Volume 110, Issue 5, Pages 692-701 (May 2010) http://www.adajournal.org/article/S0002-8223(10)00115-X/abstract

Barbara A. Laraia, PhD, MPH, RD, Anna Maria Siega-Riz, PhD, RD, Craig Gundersen, PhD

Accepted 4 November 2009.

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 whether 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 US Department of Agriculture 18-item Core Food Security Module 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 2.97, 95% confidence intervals [CIs] 1.44 to 6.14), higher gestational weight gain (adjusted β coefficient 1.87, 95% CI 0.13 to 3.62), and with a higher adequacy of weight gain ratio (adjusted β .27, 95% CI 0.07 to 0.50). Marginal food security was significantly associated with gestational diabetes mellitus (adjusted odds ratio 2.76, 95% CI 1.00 to 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.

© 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.