Division of Community Health Sciences, Public Health Nutrition Program, 2121 Berkeley Way West #6126, Berkeley, CA, USA.
School of Public Health, University of California, Berkeley, CA, USA.
BMC Pregnancy Childbirth. 2022 Feb 19;22(1):138. doi: 10.1186/s12884-022-04464-x.
Assess the associations between ten severe maternal hardships and food insecurity experienced during pregnancy.
Data on 14,274 low-income/lower-income women (below 400% of the income to federal poverty guideline ratio) from the statewide-representative 2010-2012 California Maternal and Infant Health Assessment were used to estimate food security status prevalence. Prevalence of severe maternal hardships by food security status was estimated. Multinomial logistic regression was used to assess the associations between severe maternal hardship and food security status, adjusting for sociodemographic characteristics.
Food insecurity was common among low- and lower-income pregnant women in California; 23.4% food insecure and an additional 11.5% marginally secure. In adjusted analysis, nine of ten hardships were associated with food security status. Only the respondent or someone close to the respondent having a problem with alcohol or drugs was not associated with food security status after adjusting for socioeconomic factors. Husband/partner losing a job, depressive symptoms, not having practical support and intimate partner violence were consistently associated with marginal, low and very low food security status. Each additional severe maternal hardship a woman experienced during pregnancy was associated with a 36% greater risk of reporting marginal food security (Relative Risk Ratio 1.36, 95% CI: 1.27, 1.47), 54% for low food security (Relative Risk Ratio 1.54, 95% CI: 1.44, 1.64), and 99% for very low food security (Relative Risk Ratio 1.99, 95% CI: 1.83, 2.15).
Food security status was strongly linked with several maternal hardships that could jeopardize maternal and/or infant health. Services-including prenatal care and nutritional assistance-for a large proportion of pregnant women should address a wide range of serious unmet social needs including food insecurity.
评估十种严重的孕产妇困难与怀孕期间经历的粮食不安全之间的关联。
使用来自全州代表性的 2010-2012 年加利福尼亚母婴健康评估的 14274 名低收入/较低收入妇女（低于联邦贫困线收入的 400%）的数据来估计粮食安全状况的流行率。按粮食安全状况估计严重孕产妇困难的流行率。使用多项逻辑回归来评估严重孕产妇困难与粮食安全状况之间的关联，同时调整社会人口统计学特征。
加利福尼亚州的低收入和较低收入孕妇中粮食不安全现象很普遍；23.4%的孕妇粮食不安全，另有 11.5%的孕妇处于边缘安全状态。在调整分析中，十种困难中有九种与粮食安全状况有关。在调整社会经济因素后，只有受访者或接近受访者的人有酗酒或吸毒问题与粮食安全状况无关。丈夫/伴侣失业、抑郁症状、缺乏实际支持和亲密伴侣暴力与边缘、低和极低粮食安全状况始终相关。孕妇在怀孕期间经历的每增加一种严重的孕产妇困难，报告边缘粮食安全的风险就会增加 36%（相对风险比 1.36，95%置信区间：1.27，1.47），报告低粮食安全的风险增加 54%（相对风险比 1.54，95%置信区间：1.44，1.64），报告极低粮食安全的风险增加 99%（相对风险比 1.99，95%置信区间：1.83，2.15）。
粮食安全状况与多种可能危及母婴健康的孕产妇困难密切相关。包括产前保健和营养援助在内的服务，应针对很大一部分孕妇广泛存在的严重未满足的社会需求，包括粮食不安全问题。
