Basurko Célia, Lyonnais Elisabeth, Proquot Maëlys, Forsans Glwadys, Hcini Najeh, Camara Nfassory, Galindo Muriel Suzanne, Gatti Claire, Adenis Antoine, Nacher Mathieu, Savy Mathilde
CIC INSERM 1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana.
Amazonian Population Health UA17, Cayenne, French Guiana.
BMC Public Health. 2025 May 23;25(1):1910. doi: 10.1186/s12889-025-23173-6.
The post-COVID international situation, wars and food price inflation are hampering access to food for the most vulnerable households who have no safety net against unforeseen events. While pregnant women are particularly vulnerable to food shortages and nutritional imbalances, data on food insecurity during pregnancy and associated risk factors are scarce.
A 2023 multicenter, cross-sectional study was conducted among a representative sample of 730 women during the third trimester of pregnancy in French Guiana. Food insecurity (USDA Food Security Survey Module), diet quality indicators derived from a qualitative 24-h recall (Minimum Dietary Diversity for Women MDD-W, All-5 indicator, NCD risk foods), pre-conceptional nutritional status (body mass index - BMI) and gestational weight gain (GWG), and women's self-esteem were collected. Data were weighted to ensure sample representativeness, and modified Poisson regression was used to identify risk factors for FI during pregnancy.
Overall, 32.3% [95% CI: 28.8-35.9] of the women lived in a food-insecure household during pregnancy and only 45.6% [95% CI: 42.0-49.2] of the women had reached the MDD-W set at 5 food groups. More than 80% of the women had consumed sweetened beverages and 25.1% were obese before conception. According to the multivariate model, the factors positively associated with food insecurity included living in substandard housing, living alone with children, having low self-esteem and being born abroad (with or without a residence permit). On the other hand, having a stable and declared income and social support were protective factors against food insecurity after adjusting for the other variables.
This study highlights a frequently overlooked situation in French Guiana that is likely to affect the health of children at the very beginning of their lives. Peer-based programs or government financial assistance programs could help strengthen the ability of the poorest households with pregnant women to cope with food insecurity.
新冠疫情后的国际形势、战争以及食品价格通胀，正阻碍着最脆弱家庭获取食物，这些家庭没有应对意外事件的安全保障。孕妇尤其容易受到粮食短缺和营养失衡的影响，但关于孕期粮食不安全及相关风险因素的数据却很匮乏。
2023年，在法属圭亚那对730名孕晚期妇女的代表性样本进行了一项多中心横断面研究。收集了粮食不安全情况（美国农业部粮食安全调查模块）、通过定性24小时膳食回顾得出的饮食质量指标（妇女最低膳食多样性MDD-W、全5指标、非传染性疾病风险食物）、孕前营养状况（体重指数 - BMI）和孕期体重增加（GWG）以及妇女的自尊。对数据进行加权以确保样本代表性，并使用修正泊松回归来确定孕期粮食不安全的风险因素。
总体而言，32.3% [95%置信区间：28.8 - 35.9] 的妇女在孕期生活在粮食不安全家庭中，只有45.6% [95%置信区间：42.0 - 49.2] 的妇女达到了MDD-W设定的5个食物组标准。超过80%的妇女饮用过含糖饮料，25.1%的妇女孕前肥胖。根据多变量模型，与粮食不安全呈正相关的因素包括居住在不合标准的住房中、与孩子单独生活、自尊水平低以及在国外出生（有无居留许可）。另一方面，在对其他变量进行调整后，拥有稳定且申报的收入和社会支持是预防粮食不安全的保护因素。
本研究凸显了法属圭亚那一个常被忽视的情况，这可能在儿童生命伊始就影响其健康。基于同伴的项目或政府财政援助项目有助于增强最贫困的有孕妇家庭应对粮食不安全的能力。
