Download PDF
CC BY-NC-ND 4.0 · AJP Rep 2022; 12(03): e131-e138
DOI: 10.1055/s-0042-1751082
Case Report

The Relationship between Food Security and Gestational Diabetes among Pregnant Women

Shontreal Cooper 
1   Department of Maternal-Fetal Medicine, Obstetrics and Gynecology, UConn Health, Farmington, Connecticut
,
Maura Graham
1   Department of Maternal-Fetal Medicine, Obstetrics and Gynecology, UConn Health, Farmington, Connecticut
,
Chia-Ling Kuo
1   Department of Maternal-Fetal Medicine, Obstetrics and Gynecology, UConn Health, Farmington, Connecticut
,
Raminder Khangura
1   Department of Maternal-Fetal Medicine, Obstetrics and Gynecology, UConn Health, Farmington, Connecticut
,
Adrienne Schmidt
1   Department of Maternal-Fetal Medicine, Obstetrics and Gynecology, UConn Health, Farmington, Connecticut
,
Stephanie Bakaysa
1   Department of Maternal-Fetal Medicine, Obstetrics and Gynecology, UConn Health, Farmington, Connecticut
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

The objective were to: (1) evaluate associations between food security and women diagnosed with gestational diabetes mellitus (GDM) and (2) evaluate if women in food insecure (FI) households had adverse maternal and neonatal outcomes. This was an observational study from October 2018 until September 2019. Postpartum resident clinic patients who delivered term, singleton infant at 37 weeks' or longer gestation were screened. Participants completed a survey using the U.S. Household Food Security Survey Module (US HFSSM). Survey responses were classified as: food secure (FS) and FI (marginal, low, very low FS). The primary outcome was GDM. Our secondary outcome was neonatal intensive care unit (NICU) admissions for hypoglycemia. We evaluated the rate of GDM in FS and FI groups. Demographic data included: prepregnancy body mass index, total weight gain during pregnancy, birth weight, and mode of delivery. A logistic regression model was used to analyze the association between food insecurity and GDM. A p-value of less than 0.05 was considered statistically significant. There were 150 patients screened to participate; of these, 70 patients were enrolled (36 GDM and 34 without GDM [NGDM]). More patients in FI households, 71% (n = 17), were diagnosed with GDM, compared with 33% (n = 15) in the FS (FS) households (adjusted odds ratio 7.05; p < 0.01). Of patients who reported FI, 50% (n = 12) were black, 46% (n = 11) Hispanic, and 4% (n = 1) Caucasian, compared with 13% (n = 6) black, 30% (n = 14) Hispanic, and 57% (n = 26) Caucasian in patients who reported FS (p < 0.001). Although not significant, 25% (n = 6) of neonates from an FI household had an NICU admission for hypoglycemia compared with 7% (n = 3) from an FS household (p = 0.054). Pregnant women with GDM are more likely to experience FI than those with NGDM. Infants of mothers in FI households also had increased rates of NICU admission for hypoglycemia.

Keywords

food insufficiency - food security - gestational diabetes mellitus - pregnant - diabetes


Publication History

Received: 29 July 2020

Accepted: 08 October 2021

Article published online:
25 August 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Kirkpatrick SI, Tarasuk V. Food insecurity is associated with nutrient inadequacies among Canadian adults and adolescents. J Nutr 2008; 138 (03) 604-612
    CrossrefPubMedGoogle Scholar
  • 2 United States Department of Agriculture Economic Research Service. “Food Security in the U.S.”. Available at: https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/
    Google Scholar
  • 3 Vozoris NT, Tarasuk VS. Household food insufficiency is associated with poorer health. J Nutr 2003; 133 (01) 120-126
    CrossrefPubMedGoogle Scholar
  • 4 Seligman HK, Schillinger D. Hunger and socioeconomic disparities in chronic disease. N Engl J Med 2010; 363 (01) 6-9
    CrossrefPubMedGoogle Scholar
  • 5 Seligman HK, Bindman AB, Vittinghoff E, Kanaya AM, Kushel MB. Food insecurity is associated with diabetes mellitus: results from the National Health Examination and Nutrition Examination Survey (NHANES) 1999-2002. J Gen Intern Med 2007; 22 (07) 1018-1023
    PubMedGoogle Scholar
  • 6 Correa A, Bardenheier B, Elixhauser A, Geiss LS, Gregg E. Trends in prevalence of diabetes among delivery hospitalizations, United States, 1993-2009. Matern Child Health J 2015; 19 (03) 635-642
    CrossrefPubMedGoogle Scholar
  • 7 Caughey AB, Cheng YW, Stotland NE, Washington AE, Escobar GJ. Maternal and paternal race/ethnicity are both associated with gestational diabetes. Am J Obstet Gynecol 2010; 202 (06) 616.e1-616.e5
    CrossrefPubMedGoogle Scholar
  • 8 Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999-2008. JAMA 2010; 303 (03) 235-241
    CrossrefPubMedGoogle Scholar
  • 9 England LJ, Dietz PM, Njoroge T. et al. Preventing type 2 diabetes: public health implications for women with a history of gestational diabetes mellitus. Am J Obstet Gynecol 2009; 200 (04) 365.e1-365.e8
    CrossrefPubMedGoogle Scholar
  • 10 National Center for Health Statistics. NCHS obesity data. Hyattsville (MD): NCHS;. 2014 . Retrieved October 9, 2018 at: http://www.cdc.gov/nchs/data/factsheets/factsheet_obesity.pdf
    Google Scholar
  • 11 Dhurandhar EJ. The food-insecurity obesity paradox: a resource scarcity hypothesis. Physiol Behav 2016; 162: 88-92
    CrossrefPubMedGoogle Scholar
  • 12 Gucciardi E, Vahabi M, Norris N, Del Monte JP, Farnum C. The intersection between food insecurity and diabetes: a review. Curr Nutr Rep 2014; 3 (04) 324-332
    CrossrefPubMedGoogle Scholar
  • 13 Drewnowski A. Obesity and the food environment: dietary energy density and diet costs. Am J Prev Med 2004; 27 (3, Suppl): 154-162
    CrossrefPubMedGoogle Scholar
  • 14 Laraia BA. Food insecurity and chronic disease. Adv Nutr 2013; 4 (02) 203-212
    CrossrefPubMedGoogle Scholar
  • 15 Seligman HK, Bindman AB, Vittinghoff E, Kanaya AM, Kushel MB. Food insecurity is associated with diabetes mellitus: results from the National Health Examination and Nutrition Examination Survey (NHANES) 1999-2002. J Gen Intern Med 2007; 22 (07) 1018-1023
    CrossrefPubMedGoogle Scholar
  • 16 Sholeye O, Catherine A, Olubukunola A. Dietary habits of pregnant women in Ogun-East Senatorial Zone, Ogun State, Nigeria: a comparative study. Int J Nutr Metab 2014; 6: 42-49 DOI: 10.5897/IJNAM2014.0170.
    CrossrefPubMedGoogle Scholar
  • 17 Kahr MK, Suter MA, Ballas J. et al. Geospatial analysis of food environment demonstrates associations with gestational diabetes. Am J Obstet Gynecol 2016; 214 (01) 110.e1-110.e9
    CrossrefPubMedGoogle Scholar
  • 18 Banner G, Weaver K, Rushovich T, York S, Yee L. Association between food deserts and gestational diabetes in a large metropolitan area. Am J Perinatol 2021; 38 (S 01): e39-e45
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Matthews L, Morris M, Neyman M, Schneider J, Goto K. The relationship between food security and poor health among female WIC participants. J Hunger Environ Nutr 2010; (05) 1,-85–99 DOI: 10.1080/19320240903582679.
    CrossrefPubMedGoogle Scholar
  • 20 Laraia B, Vinikoor-Imler LC, Siega-Riz AM. Food insecurity during pregnancy leads to stress, disordered eating, and greater postpartum weight among overweight women. Obesity (Silver Spring) 2015; 23 (06) 1303-1311
    CrossrefPubMedGoogle Scholar
  • 21 Olson CM, Strawderman MS. The relationship between food insecurity and obesity in rural childbearing women. J Rural Health 2008; 24 (01) 60-66
    CrossrefPubMedGoogle Scholar
  • 22 Glasgow MJ, Harding JE, Edlin R. Children with Hypoglycemia and Their Later Development (CHYLD) Study Team. Cost analysis of treating neonatal hypoglycemia with dextrose gel. J Pediatr 2018; 198: 151-155.e1
    Google Scholar