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孕妇的粮食不安全状况与心血管健康:马萨诸塞州切尔西家庭食品计划的结果,2013 - 2015年

Food Insecurity and Cardiovascular Health in Pregnant Women: Results From the Food for Families Program, Chelsea, Massachusetts, 2013-2015.

作者信息

Morales Mary E, Epstein Michael H, Marable Danelle E, Oo Sarah A, Berkowitz Seth A

机构信息

Harvard Medical School, Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts.

Center for Community Health Improvement, Massachusetts General Hospital.

出版信息

Prev Chronic Dis. 2016 Nov 3;13:E152. doi: 10.5888/pcd13.160212.

Abstract

BACKGROUND

Food insecurity, uncertainty about the ability to acquire adequate food, is associated with cardiometabolic disease in pregnant women. Whether food insecurity interventions improve cardiometabolic health is unknown.

METHODS

We conducted a retrospective analysis of women who visited the obstetrics clinic in a community health center from 2013 through 2015. Patients could be referred to the Food for Families (Food for Families) program, which connects food insecure women to food resources. We hypothesized that participation in Food for Families would be associated with better blood pressure and blood glucose trends during pregnancy. We used a propensity score-matched design to reduce bias from differential entry into Food for Families.

RESULTS

Eleven percent of women who visited the obstetrics clinic were referred to Food for Families. In propensity score-matched analyses, we found no difference in baseline systolic blood pressure (SBP) between those who were referred and enrolled in Food for Families (113.5 mm Hg), those who were referred and did not enroll in Food for Families (113.9 mm Hg), and those who were not referred to Food for Families (114 mm Hg) (P = .79). However, during pregnancy, women who were referred to and enrolled in Food for Families had a better SBP trend (0.2015 mm Hg/wk lower, P = .006). SBP trends did not differ between women who were referred and did not enroll in Food for Families and those who were not referred. We observed no differences in blood glucose trends between groups (P = .40).

CONCLUSIONS

Food for Families participation was associated with better blood pressure trends in pregnant women but no differences in blood glucose trends. Food insecurity reduction programs may improve cardiovascular health for vulnerable pregnant women, and this topic deserves further study incorporating randomized program entry.

摘要

背景

粮食不安全,即获取足够食物能力的不确定性,与孕妇的心血管代谢疾病有关。粮食不安全干预措施是否能改善心血管代谢健康尚不清楚。

方法

我们对2013年至2015年在社区卫生中心产科诊所就诊的女性进行了回顾性分析。患者可被转介至“家庭食物”(家庭食物)项目,该项目将粮食不安全的女性与食物资源联系起来。我们假设参与“家庭食物”项目与孕期更好的血压和血糖趋势相关。我们采用倾向评分匹配设计以减少因不同进入“家庭食物”项目而产生的偏差。

结果

在产科诊所就诊的女性中有11%被转介至“家庭食物”项目。在倾向评分匹配分析中,我们发现被转介并加入“家庭食物”项目的女性(收缩压113.5毫米汞柱)、被转介但未加入“家庭食物”项目的女性(收缩压113.9毫米汞柱)和未被转介至“家庭食物”项目的女性(收缩压114毫米汞柱)之间的基线收缩压无差异(P = 0.79)。然而,在孕期,被转介并加入“家庭食物”项目的女性收缩压趋势更好(每周降低0.2015毫米汞柱,P = 0.006)。被转介但未加入“家庭食物”项目的女性与未被转介的女性之间的收缩压趋势无差异。我们观察到各组之间血糖趋势无差异(P = 0.40)。

结论

参与“家庭食物”项目与孕妇更好的血压趋势相关,但血糖趋势无差异。减少粮食不安全项目可能会改善弱势孕妇的心血管健康,这一主题值得纳入随机项目进入的进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5b7/5094858/69c63ac91f28/PCD-13-E152s01.jpg

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