Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA.
Department of Medicine, University of California, San Francisco, CA, USA.
Transl Behav Med. 2022 Nov 16;12(10):1009-1017. doi: 10.1093/tbm/ibac063.
Proper nutrition is critical for maternal and neonatal health. In January 2017, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in San Francisco, California, began providing an additional $40 per month in fruit and vegetable (F&V) benefits to pregnant clients with the goal of improving food security and nutrition-related outcomes. We evaluated whether pregnant women on WIC who received this additional F&V benefit exhibited better perinatal and birth outcomes compared with those who received standard WIC benefits. We used 2010-2019 birth certificate data from the National Center for Health Statistics. The intervention group consisted of WIC participants living in San Francisco (SF) County (intervention county) and whose first trimester started after January 2017. We used a quasi-experimental synthetic control method to compare trends between the intervention and control groups (a weighted sample of other California counties that did not distribute additional F&V benefits). Outcomes included low birth weight, preterm birth, small-for-gestational-age, gestational diabetes, and gestational weight gain. No significant differences in maternal and neonatal outcomes among WIC recipients in SF and synthetic control group were observed after the F&V benefits were distributed. Prior studies have shown that additional F&V benefits have positive effects on maternal and infant outcomes, indicating that F&V vouchers are a promising strategy for supporting equitable health outcomes. Our null results suggest that more rigorous research is needed to determine their optimal dose and duration, especially in high-cost-of-living areas, and to examine more upstream and structural interventions.
适当的营养对于母婴健康至关重要。2017 年 1 月，加利福尼亚州旧金山的妇女、婴儿和儿童特别补充营养计划（WIC）开始向孕妇每月额外提供 40 美元的水果和蔬菜（F&V）福利，旨在改善粮食安全和营养相关结果。我们评估了接受这种额外的 F&V 福利的 WIC 孕妇是否与接受标准 WIC 福利的孕妇相比表现出更好的围产期和出生结局。我们使用了国家卫生统计中心的 2010-2019 年出生证明数据。干预组由居住在旧金山（SF）县（干预县）的 WIC 参与者组成，他们的孕早期始于 2017 年 1 月之后。我们使用拟实验合成控制法来比较干预组和对照组之间的趋势（加利福尼亚州其他未分发额外 F&V 福利的县的加权样本）。结果包括低出生体重、早产、小于胎龄儿、妊娠期糖尿病和妊娠期体重增加。在分发 F&V 福利后，在 SF 和合成对照组的 WIC 接受者中，母亲和新生儿结局没有观察到显著差异。先前的研究表明，额外的 F&V 福利对母婴结局有积极影响，这表明 F&V 代金券是支持公平健康结果的有前途的策略。我们的阴性结果表明，需要进行更严格的研究来确定其最佳剂量和持续时间，特别是在高生活成本地区，并研究更多的上游和结构性干预措施。
