Small-Hsiao test of IIA assumption for Model III.

Food insecurity (FI) remains a key priority for sustainable development. Despite the well-known consequences of food insecurity on health and well-being, evidence regarding the burden and determinants of FI among pregnant women in Nigeria is limited. Framed by the social-ecological model, this study aimed to determine the prevalence of FI, and its associations with individual-/household-level and contextual-level factors among pregnant women in Nigeria. A cross-sectional study based on the Nigerian Multiple Indicator Cluster Survey (2021 Nigerian MICS6) was conducted among a sample of 3519 pregnant women aged 15–49 years. Several weighted multilevel multinomial logistic regression models were fitted to assess the association between individual-/household-s level and community-level characteristics with FI. We estimated and reported both fixed effects and random effects to measure the associations and variations, respectively. Results: The prevalence of FI among pregnant women in Nigeria was high, with nearly 75% of the participants reporting moderate to severe FI in the past 12 months (95% CI = 71.3%-75.8%) in 2021. There were also significant differences in all the experiences of food insecurity due to lack of money or resources, as measured by the Food Insecurity Experience Scale (FIES), except for feeling hungry but not eating because of lack of money or resources (p < 0.0001). Multivariate analysis revealed that higher parity, households with 5 or more members, household wealth index, urban residence, and community-level poverty were significantly associated with FI. Our study demonstrates a significantly high prevalence of FI among pregnant women in Nigeria in 2021. Given the negative consequences of FI on maternal and child health, implementing interventions to address FI during pregnancy remains critical to improving pregnancy outcomes.

粮食不安全（Food Insecurity，以下简称FI）仍是可持续发展的核心优先议题。尽管粮食不安全对健康与福祉的负面影响已广为人知，但针对尼日利亚孕妇群体中FI的疾病负担与影响因素的相关研究证据仍较为有限。本研究以社会生态模型（social-ecological model）为理论框架，旨在明确尼日利亚孕妇群体中FI的患病率，及其与个体/家庭层面、背景层面相关因素的关联。本研究基于尼日利亚多指标类集调查（2021年尼日利亚MICS6）开展横断面研究，纳入了3519名年龄介于15至49岁的孕妇作为研究样本。本研究构建了多个加权多分类多层logistic回归模型，以评估个体/家庭层面与社区层面特征与FI之间的关联；我们分别估算并报告了固定效应与随机效应，以分别衡量相关关联与群体差异。研究结果显示，2021年尼日利亚孕妇群体的FI患病率较高，近75%的受访者在过去12个月内报告存在中度至重度FI（95%置信区间：71.3%~75.8%）。通过粮食不安全体验量表（Food Insecurity Experience Scale，FIES）评估发现，除“因缺乏资金或资源而感到饥饿但未进食”外，所有因资金或资源匮乏引发的粮食不安全体验均存在显著差异（p < 0.0001）。多变量分析结果显示，产次较高、家庭规模≥5人、家庭财富指数、城镇居住身份以及社区层面贫困程度均与FI存在显著关联。本研究证实，2021年尼日利亚孕妇群体的FI患病率显著偏高。鉴于FI对母婴健康的负面影响，在孕期开展针对FI的干预措施对改善妊娠结局仍具有重要意义。