Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN 47405, USA.
Department of Environmental Health, School of Public Health, Indiana University, Bloomington, IN 47405, USA.
J Public Health (Oxf). 2021 Sep 22;43(3):558-566. doi: 10.1093/pubmed/fdaa093.
Household food insecurity (HFI) and gestational diabetes mellitus (GDM) are both common during pregnancy, yet it is unknown if these two factors are related. We aimed to determine the independent and joint associations between HFI, gestational weight gain (GWG) and GDM among pregnant women in the USA.
We used data from 592 women in the National Children's Study, Initial Vanguard Study from 2009 to 2014. HFI was assessed using the Household Food Security Survey Module at the first study visit; GDM was assessed through questionnaires and medical chart review. Logistic regression models were used to investigate the exposures of HFI, GWG and their joint effect on GDM.
Among participants, 20.1% were marginally food secure or food insecure and 7.4% were diagnosed with GDM. The elevated unadjusted association between HFI and GDM was attenuated after adjustment (aOR: 1.12; 95%CI: 0.47, 2.66). There was an elevated risk of GDM associated with inadequate GWG, (aOR: 2.42; 95%CI: 0.97, 6.00), but results were imprecise. There were no statistically significant associations in the joint exposure analysis.
The relationship between HFI and GDM is mostly explained by other covariates, but there is some evidence that inadequate GWG is a possible risk factor for GDM.
家庭食物不安全(HFI)和妊娠糖尿病(GDM)在怀孕期间都很常见,但尚不清楚这两个因素是否相关。我们旨在确定美国孕妇中 HFI、妊娠体重增加(GWG)和 GDM 之间的独立和联合关联。
我们使用了 2009 年至 2014 年期间来自国家儿童研究、初始先锋研究的 592 名女性的数据。在第一次研究访问时使用家庭食物安全调查模块评估 HFI;通过问卷调查和病历审查评估 GDM。使用逻辑回归模型研究 HFI、GWG 及其对 GDM 的联合作用的暴露情况。
在参与者中,20.1%的人处于边缘性食物安全或不安全状态,7.4%的人被诊断患有 GDM。在调整后,HFI 与 GDM 之间的未经调整的关联减弱(调整后的比值比:1.12;95%置信区间:0.47,2.66)。与 GWG 不足相关的 GDM 风险增加(调整后的比值比:2.42;95%置信区间:0.97,6.00),但结果不精确。在联合暴露分析中没有统计学意义上的关联。
HFI 与 GDM 之间的关系主要由其他协变量解释,但有证据表明 GWG 不足可能是 GDM 的一个风险因素。