Power Madeleine, Uphoff Eleonora, Kelly Brian, Pickett Kate E
Department of Health Sciences, University of York, York, UK.
Bradford Institute For Health Research, Bradford Royal Infirmary, Bradford, UK.
J Epidemiol Community Health. 2017 Apr;71(4):324-328. doi: 10.1136/jech-2016-207799. Epub 2016 Oct 7.
Since 2008, use of food banks has risen sharply in the UK; however, evidence on the epidemiology of UK food insecurity is sparse. The aim of this study was to describe the trajectory of common mental disorder across the pre-pregnancy, pregnancy and postnatal period for food secure compared with food insecure women.
Data from the Born in Bradford (BiB) cohort, the nested BiB1000 study and primary care records were linked based on National Health Service (NHS) numbers. Data linkage was completed for 1297, and primary care records were available from 18 months prior to 40 months after birth of the cohort child. Incidence rates of common mental disorders per 1000 patient years at risk were compared between food secure and insecure women, and for Pakistani compared with white British women, in 10 6-month periods around pregnancy. Poisson regression was used to calculate incidence rate ratios, adjusted for ethnicity and exposure.
Food insecurity was significantly associated with an increased risk of common mental disorder before and during pregnancy (incidence rate ratio 1.9, 95% confidence interval 1.3 to 2.8, p=0.001) and after giving birth (incidence rate ratio 1.3, 95% confidence interval 1.0 to 1.7, p=0.029).
Our study shows that food insecure women have worse mental health than food secure women, and that this difference is most pronounced for white British pregnant women. These findings provide evidence for concerns expressed by public health experts that food insecurity may become the next public health emergency.
自2008年以来，英国食品银行的使用量急剧上升；然而，关于英国粮食不安全流行病学的证据却很少。本研究的目的是描述粮食安全与粮食不安全的女性在孕前、孕期和产后常见精神障碍的发展轨迹。
基于国民健康服务（NHS）编号，将来自布拉德福德出生队列（BiB）、嵌套的BiB1000研究和初级保健记录的数据进行关联。完成了1297例的数据关联，并且可获得队列儿童出生前18个月至出生后40个月的初级保健记录。在孕期前后的10个6个月时间段内，比较了粮食安全和不安全女性每1000患者年的常见精神障碍发病率，以及巴基斯坦裔与英国白人女性的发病率。使用泊松回归计算发病率比，并对种族和暴露因素进行调整。
粮食不安全与怀孕前和怀孕期间常见精神障碍风险增加显著相关（发病率比1.9，95%置信区间1.3至2.8，p = 0.001），产后也相关（发病率比1.3，95%置信区间1.0至1.7，p = 0.029）。
我们的研究表明，粮食不安全的女性心理健康状况比粮食安全的女性更差，这种差异在英国白人孕妇中最为明显。这些发现为公共卫生专家所表达的担忧提供了证据，即粮食不安全可能成为下一个公共卫生紧急事件。
