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Am J Perinatol 2019; 36(13): 1405-1411
DOI: 10.1055/s-0038-1677478
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Association of Fast Food and Supermarket Density with Neonatal Outcomes of Pregnancies Affected by Gestational Diabetes

Ashley N. Battarbee 
1   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
,
Lynn M. Yee
2   Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern Feinberg School of Medicine, Chicago, Illinois
› Author Affiliations
Funding Research reported in this publication was supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences (Grant Number UL1TR001422) through the Northwestern University Clinical and Translational Sciences Institute Enterprise Data Warehouse Pilot program. Additionally, Lynn M. Yee is supported by the NICHD K12 HD050121–11. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Further Information

Publication History

09 September 2018

28 November 2018

Publication Date:
15 January 2019 (online)

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Abstract

Objective To measure the association of fast food density (FFD) and supermarket density (SD) with adverse neonatal outcomes in pregnancies with gestational diabetes mellitus (GDM).

Study Design This was a retrospective cohort study of women with GDM who delivered at a tertiary care center in a large metropolitan area (1/2010–2/2016). ZIP codes were used to link women with surrounding food environment. FFD and SD were calculated as the number of establishments per 100,000 residents for each ZIP code and classified into quartiles. Quartile 1 represented lowest FFD or SD. Four neonatal outcomes were assessed: large for gestational age (LGA) neonate, shoulder dystocia, neonatal hypoglycemia, and neonatal intensive care unit admission > 3 days. Bivariable and multivariable analyses estimated associations of FFD and SD with outcomes.

Results A total of 2,373 women met eligibility criteria. Insurance, race/ethnicity, language, and body mass index differed between quartiles, although GDM type did not. High FFD was associated with lower odds of LGA but not with other outcomes. Low SD and FFD:SD ratios were not associated with any outcomes.

Conclusion Among women with GDM, high FFD was associated with some neonatal outcomes, but low SD and FFD:SD ratio was not. Food environment may not be the only social determinant of neonatal outcomes in pregnancies with GDM.

Keywords

food density - food environment - geospatial - gestational diabetes - neonatal

Note

This study was presented in poster format at the 38th annual meeting of the Society for Maternal–Fetal Medicine, Dallas, TX, January 29 to February 3, 2018.