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多伦多加拿大产前营养计划注册的产后妇女群体中,普遍存在家庭食物不安全的问题。

Household food insecurity is prevalent in a cohort of postpartum women who registered in the Canada Prenatal Nutrition Program in Toronto.

机构信息

Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ONM5S 1A8, Canada.

Translational Medicine Program, The Hospital for Sick Children, Toronto, ON, Canada.

出版信息

Public Health Nutr. 2023 Jul;26(7):1468-1477. doi: 10.1017/S1368980023000459. Epub 2023 Mar 15.

Abstract

OBJECTIVE

To assess the prevalence, severity and socio-demographic predictors of household food insecurity among vulnerable women accessing the Canada Prenatal Nutrition Program (CPNP) and to examine associations between household food insecurity and breastfeeding practices to 6 months.

DESIGN

Cohort investigation pooling data from two studies which administered the 18-item Household Food Security Survey Module at 6 months postpartum and collected prospective infant feeding data at 2 weeks and 2, 4 and 6 months. Household food insecurity was classified as none, marginal, moderate or severe. Logistic regression analyses were performed to assess predictors of household food insecurity and associations between household food security (any and severity) and continued and exclusive breastfeeding.

SETTING

Three Toronto sites of the CPNP, a federal initiative targeting socially and/or economically vulnerable women.

PARTICIPANTS

316 birth mothers registered prenatally in the CPNP from 2017 to 2020.

RESULTS

Household food insecurity at 6 months postpartum was highly prevalent (44 %), including 11 % in the severe category. Risk of household food insecurity varied by CPNP site ( < 0·001) and was higher among multiparous participants (OR 2·08; 95 % CI 1·28, 3·39). There was no association between the prevalence or severity of food insecurity and continued or exclusive breastfeeding to 6 months postpartum in the adjusted analyses.

CONCLUSIONS

Household food insecurity affected nearly half of this cohort of women accessing the CPNP. Further research is needed on household food insecurity across the national CPNP and other similar programmes, with consideration of the implications for programme design, service delivery and policy responses.

摘要

目的

评估在加拿大产前营养计划(CPNP)中接受服务的弱势妇女的家庭粮食不安全的流行率、严重程度和社会人口预测因素,并研究家庭粮食不安全与母乳喂养至 6 个月的做法之间的关联。

设计

对两项研究的数据进行了队列研究,这两项研究在产后 6 个月时使用了 18 项家庭粮食安全调查模块,并在 2 周、2、4 和 6 个月时收集了前瞻性婴儿喂养数据。家庭粮食不安全被分为无、边缘、中度或严重。进行逻辑回归分析以评估家庭粮食不安全的预测因素,以及家庭粮食安全(任何和严重程度)与持续和纯母乳喂养之间的关联。

地点

CPNP 的三个多伦多地点,这是一项针对社会和/或经济弱势妇女的联邦倡议。

参与者

2017 年至 2020 年期间在 CPNP 注册的 316 名产妇。

结果

产后 6 个月的家庭粮食不安全发生率很高(44%),其中 11%属于严重类别。CPNP 地点的家庭粮食不安全风险差异很大(<0·001),多胎产妇的风险更高(OR 2·08;95%CI 1·28,3·39)。在调整后的分析中,粮食不安全的流行率或严重程度与持续或纯母乳喂养至产后 6 个月之间没有关联。

结论

家庭粮食不安全影响了接受 CPNP 服务的妇女群体中的近一半。需要对全国 CPNP 及其他类似计划中的家庭粮食不安全问题进行进一步研究,考虑对方案设计、服务提供和政策应对的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926d/10346032/e0078de5aec9/S1368980023000459_fig1.jpg

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