Cooper Shontreal, Graham Maura, Kuo Chia-Ling, Khangura Raminder, Schmidt Adrienne, Bakaysa Stephanie
Department of Maternal-Fetal Medicine, Obstetrics and Gynecology, UConn Health, Farmington, Connecticut.
AJP Rep. 2022 Aug 25;12(3):e131-e138. doi: 10.1055/s-0042-1751082. eCollection 2022 Jul.
The objective were to: (1) evaluate associations between food security and women diagnosed with gestational diabetes mellitus (GDM) and (2) evaluate if women in food insecure (FI) households had adverse maternal and neonatal outcomes. This was an observational study from October 2018 until September 2019. Postpartum resident clinic patients who delivered term, singleton infant at 37 weeks' or longer gestation were screened. Participants completed a survey using the U.S. Household Food Security Survey Module (US HFSSM). Survey responses were classified as: food secure (FS) and FI (marginal, low, very low FS). The primary outcome was GDM. Our secondary outcome was neonatal intensive care unit (NICU) admissions for hypoglycemia. We evaluated the rate of GDM in FS and FI groups. Demographic data included: prepregnancy body mass index, total weight gain during pregnancy, birth weight, and mode of delivery. A logistic regression model was used to analyze the association between food insecurity and GDM. A -value of less than 0.05 was considered statistically significant. There were 150 patients screened to participate; of these, 70 patients were enrolled (36 GDM and 34 without GDM [NGDM]). More patients in FI households, 71% ( = 17), were diagnosed with GDM, compared with 33% ( = 15) in the FS (FS) households (adjusted odds ratio 7.05; < 0.01). Of patients who reported FI, 50% ( = 12) were black, 46% ( = 11) Hispanic, and 4% ( = 1) Caucasian, compared with 13% ( = 6) black, 30% ( = 14) Hispanic, and 57% ( = 26) Caucasian in patients who reported FS ( < 0.001). Although not significant, 25% ( = 6) of neonates from an FI household had an NICU admission for hypoglycemia compared with 7% ( = 3) from an FS household ( = 0.054). Pregnant women with GDM are more likely to experience FI than those with NGDM. Infants of mothers in FI households also had increased rates of NICU admission for hypoglycemia.
（1）评估粮食安全状况与被诊断为妊娠期糖尿病（GDM）的女性之间的关联；（2）评估粮食不安全（FI）家庭中的女性是否有不良的母婴结局。这是一项从2018年10月至2019年9月的观察性研究。对在妊娠37周或更长时间分娩足月单胎婴儿的产后住院门诊患者进行了筛查。参与者使用美国家庭粮食安全调查模块（US HFSSM）完成了一项调查。调查回复被分类为：粮食安全（FS）和FI（边缘、低、极低粮食安全）。主要结局是GDM。次要结局是因低血糖入住新生儿重症监护病房（NICU）。我们评估了FS组和FI组中GDM的发生率。人口统计学数据包括：孕前体重指数、孕期总增重、出生体重和分娩方式。使用逻辑回归模型分析粮食不安全与GDM之间的关联。P值小于0.05被认为具有统计学意义。共有150名患者被筛查以参与研究；其中，70名患者被纳入（36名GDM患者和34名非GDM[NGDM]患者）。FI家庭中更多患者（71%，n = 17）被诊断为GDM，而FS家庭中这一比例为33%（n = 15）（调整后的优势比为7.05；P < 0.01）。报告有FI的患者中，50%（n = 12）为黑人，46%（n = 11）为西班牙裔，4%（n = 1）为白种人，而报告有FS的患者中，这一比例分别为13%（n = 6）为黑人，30%（n = 14）为西班牙裔，57%（n = 26）为白种人（P < 0.001）。虽然不显著，但FI家庭中有25%（n = 6）的新生儿因低血糖入住NICU，而FS家庭中这一比例为7%（n = 3）（P = 0.054）。患有GDM的孕妇比患有NGDM的孕妇更有可能经历粮食不安全。FI家庭中母亲的婴儿因低血糖入住NICU的比例也有所增加。
