Household food insecurity is associated with self-reported pregravid weight status, gestational weight gain, and pregnancy complications

J Am Diet Assoc. 2010 May;110(5):692-701. doi: 10.1016/j.jada.2010.02.014.


Background: Household food insecurity is positively associated with weight among women. The association between household food insecurity and pregnancy-related weight gain and complications is not well understood.

Objective: To identify whether an independent association exists between household food insecurity and pregnancy-related complications.

Design: Data from the Pregnancy, Infection, and Nutrition prospective cohort study were used to assess household food insecurity retrospectively using the US Department of Agriculture 18-item Core Food Security Module among 810 pregnant women with incomes < or =400% of the income/poverty ratio, recruited between January 2001 and June 2005 and followed through pregnancy.

Main outcome measures: Self-reported pregravid body mass index, gestational weight gain, second trimester anemia, pregnancy-induced hypertension, and gestational diabetes mellitus.

Statistical analyses performed: Multivariate linear, multinomial logistic, and logistic regression analyses.

Results: Among 810 pregnant women, 76% were from fully food secure, 14% were from marginally food secure, and 10% were from food insecure households. In adjusted models, living in a food insecure household was significantly associated with severe pregravid obesity (adjusted odds ratio 2.97, 95% confidence intervals [CIs] 1.44 to 6.14), higher gestational weight gain (adjusted beta coefficient 1.87, 95% CI 0.13 to 3.62), and with a higher adequacy of weight gain ratio (adjusted beta .27, 95% CI 0.07 to 0.50). Marginal food security was significantly associated with gestational diabetes mellitus (adjusted odds ratio 2.76, 95% CI 1.00 to 7.66).

Conclusions: This study highlights the possibility that living in a food insecure household during pregnancy may increase risk of greater weight gain and pregnancy complications.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Anemia / epidemiology
  • Anemia / etiology
  • Body Mass Index
  • Cohort Studies
  • Confidence Intervals
  • Diabetes, Gestational / epidemiology
  • Diabetes, Gestational / etiology
  • Female
  • Food Supply* / statistics & numerical data
  • Humans
  • Hypertension, Pregnancy-Induced / epidemiology
  • Hypertension, Pregnancy-Induced / etiology
  • Logistic Models
  • Multivariate Analysis
  • Obesity / complications*
  • Obesity / epidemiology*
  • Odds Ratio
  • Poverty*
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Pregnancy Complications / etiology
  • Prevalence
  • Self Disclosure
  • Socioeconomic Factors
  • Weight Gain*