Food insecurity in pregnant women is associated with social determinants and nutritional outcomes: a systematic review and meta-analysis

Abstract The association between FI, social determinants, and nutritional outcomes for pregnant women are analyzed. A systematic review was conducted through a search of articles in five electronic databases. Social determinants (race, education, participation in social programs) and nutritional status (pre-gestational BMI, gestational weight gain, anemia) were analyzed in relation to the FI situation. For each article, the frequency of food insecurity was collected in order to calculate the summary measure, prevalence ratio (PR). 26 articles were selected. An elevated occurrence of FI was associated with black pregnant women (PR: 1.83, 95% CI 1.08-3.10), participation in social protection programs (PR = 1.43, 1.02-2.01), and with low education levels on the part of pregnant women (PR = 2.73, 1.68-4.43). FI increased the chances of being overweight (PR = 1.57, 95% CI = 1.29-1.91) and obese (PR = 1.47, 95% CI = 1.15-1.87) in pregnant women, as well as excessive weight gain (PR = 1.42, 95% CI = 1.10-1.82) and inadequate weight gain (PR = 1.47; 95% CI = 1.09-1.97) during pregnancy. Anemia was not associated with FI. Social inequities are associated with food and nutritional insecurity in pregnant women.

摘要：本研究分析了孕产妇食物不安全（Food Insecurity, FI）、社会决定因素与营养结局之间的关联。研究通过检索五个电子数据库中的文献开展系统综述，针对食物不安全状况，分析了相关社会决定因素（种族、教育水平、社会项目参与情况）与营养状态（孕前体质量指数、妊娠期体重增长、贫血）。本研究收集每篇纳入文献中食物不安全的发生频率，以计算汇总指标患病率比（Prevalence Ratio, PR）。最终共纳入26篇文献。结果显示，孕产妇食物不安全发生率升高与黑人孕产妇（PR=1.83，95%置信区间CI:1.08~3.10）、参与社会保护项目（PR=1.43，95%CI:1.02~2.01）以及低教育水平的孕产妇（PR=2.73，95%CI:1.68~4.43）显著相关。食物不安全会提升孕产妇发生超重（PR=1.57，95%CI:1.29~1.91）与肥胖（PR=1.47，95%CI:1.15~1.87）的风险，同时也与妊娠期体重增长过多（PR=1.42，95%CI:1.10~1.82）及体重增长不足（PR=1.47，95%CI:1.09~1.97）相关。贫血与食物不安全无显著关联。社会不平等与孕产妇食物及营养不安全密切相关。