Laraia Barbara A, Siega-Riz Anna Maria, Gundersen Craig, Dole Nancy
Department of Nutrition, Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA.
J Nutr. 2006 Jan;136(1):177-82. doi: 10.1093/jn/136.1.177.
Household food insecurity has been associated with several negative health outcomes, yet little is known about the prevalence and correlates of household food insecurity during pregnancy. This study was conducted as part of the Pregnancy, Infection, and Nutrition prospective cohort study to identify risk factors of preterm birth. The USDA 18-item scale was used to assess the prevalence of food insecurity among pregnant women with incomes <or= 400% of poverty. Descriptive statistics and logistic regression were used to identify socioeconomic, demographic, and psychosocial predictors of household food insecurity. Among 606 pregnant women, 75% were from fully food-secure, 15% from marginally food-secure, and 10% from food-insecure households. Women from marginally food-secure and food-insecure households had significantly less income, less education, and were older than women from fully food-secure households. In bivariate analysis, all psychosocial factors were significantly associated with household food insecurity and showed a dose-response relation with increasing food insecurity. Socioeconomic and demographic predictors for household food insecurity were income, black race, and age. After controlling for socioeconomic and demographic variables, psychosocial indicators of perceived stress, trait anxiety, and depressive symptoms, and a locus of control attributed to chance were positively associated with any household food insecurity. Conversely, self-esteem and mastery were inversely associated with any household food insecurity. Psychosocial factors as well as socioeconomic and demographic indicators are associated with household food insecurity among pregnant women; however, the direction of causation between psychosocial indicators and food insecurity cannot be determined in these data.
家庭粮食不安全与多种负面健康结果相关,但对于孕期家庭粮食不安全的患病率及其相关因素却知之甚少。本研究作为“妊娠、感染与营养”前瞻性队列研究的一部分开展,旨在确定早产的风险因素。采用美国农业部的18项量表来评估收入≤贫困线400%的孕妇中粮食不安全的患病率。运用描述性统计和逻辑回归来确定家庭粮食不安全的社会经济、人口统计学和心理社会预测因素。在606名孕妇中,75%来自粮食完全安全的家庭,15%来自粮食安全边际家庭,10%来自粮食不安全家庭。来自粮食安全边际家庭和粮食不安全家庭的女性收入显著更低、受教育程度更低,且比来自粮食完全安全家庭的女性年龄更大。在双变量分析中,所有心理社会因素均与家庭粮食不安全显著相关,并呈现出随着粮食不安全程度增加的剂量反应关系。家庭粮食不安全的社会经济和人口统计学预测因素为收入、黑人种族和年龄。在控制了社会经济和人口统计学变量后,感知压力、特质焦虑和抑郁症状等心理社会指标以及归因于机遇的控制点与任何家庭粮食不安全呈正相关。相反,自尊和掌控感与任何家庭粮食不安全呈负相关。心理社会因素以及社会经济和人口统计学指标与孕妇家庭粮食不安全相关;然而,在这些数据中无法确定心理社会指标与粮食不安全之间的因果方向。