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Prevalence of Food Insecurity Among Pregnant Women: A Canadian Study in a Large Urban Setting

Published:April 22, 2021DOI:https://doi.org/10.1016/j.jogc.2021.03.016

      ABSTRACT

      Objective

      Nutritional and financial needs increase during pregnancy, making pregnant women particularly vulnerable to food insecurity. Our objective was to document the prevalence of food insecurity among pregnant women receiving prenatal care in an urban centre in Canada and to identify factors associated with food insecurity.

      Methods

      This cross-sectional study recruited pregnant women receiving prenatal care at one of two Toronto hospitals: Site 1 and Site 2 (serving a more disadvantaged population) between October 1, 2018 and October 1, 2019. Demographic information was collected, and the U.S. Household Food Security Survey Module was used to assess food security. Comparisons were made using χ2 tests, two-tailed t tests, or Mann-Whitney tests for categorical and continuous variables, as appropriate. Binary logistic regression and multivariate analyses were performed to assess associations with food insecurity and differences between hospitals sites.

      Results

      We recruited 626 participants (316 at Site 1 and 310 at Site 2). Prevalence of food insecurity was 12.8% among all participants with Site 2 having nearly 5 times the prevalence of Site 1 (66/310 [21.3%] vs. 14/316 [4.4%]; P = 0.001). Several factors were associated with food insecurity, with non-White ethnicity (OR 2.04; 95% CI 0.98–4.25, P = 0.055] and lower household income (OR 37.53; 95% CI 14.04–100, P < 0.001 when less than CAD $23 000/y) being the most robust.

      Conclusion

      This Canadian study documented the prevalence of and factors associated with food insecurity in pregnancy. Targeted interventions to help low-income women and programs geared towards non-White women may be beneficial in addressing food insecurity among pregnant women.

      RÉSUMÉ

      Objectif

      Les besoins nutritionnels et financiers augmentent pendant la grossesse, ce qui rend les femmes enceintes particulièrement vulnérables à l'insécurité alimentaire. Notre objectif était de documenter la prévalence de l'insécurité alimentaire chez les femmes enceintes recevant des soins prénataux dans un centre urbain au Canada et de déterminer les facteurs associés.

      Méthodologie

      Dans cette étude transversale, les chercheurs ont recruté les femmes enceintes recevant des soins prénataux dans l'un de deux hôpitaux de Toronto, désignés site 1 et site 2 et desservant une population défavorisée, pour la période du 1er octobre 2018 au 1er octobre 2019. Les caractéristiques démographiques ont été recueillies et le module d'enquête sur la sécurité alimentaire des ménages des États-Unis a été utilisé pour évaluer la sécurité alimentaire. Des comparaisons ont été effectuées au moyen de tests du χ2, de test t pour deux échantillons ou de tests de Mann-Whitney pour des variables catégorielles et continues, selon le cas. Des analyses de régression logistique binaire et multivariées ont été réalisées pour évaluer les associations avec l'insécurité alimentaire et les différences entre les sites hospitaliers.

      Résultats

      Nous avons recruté 626 participantes (316 au site 1 et 310 au site 2). Globalement, la prévalence de l'insécurité alimentaire était de 12,8 %, mais la prévalence chez les participantes du site 2 était près de 5 fois celle des participantes du site 1 (66/310 [21,3 %] vs 14/316 [4,4 %]; p = 0,001). Plusieurs facteurs ont été associés à l'insécurité alimentaire, chez les personnes non caucasiennes (RC : 2,04; IC à 95 % : 0,98-4,25, p = 0,055) et celles ayant un revenu familial inférieur (RC : 37,53; IC à 95 % : 14,04-100, p < 0,001 lorsque le revenu était de < 23 000 $ CA/an).

      Conclusion

      Cette étude canadienne a documenté la prévalence et les facteurs associés à l'insécurité alimentaire pendant la grossesse. Les interventions ciblées visant à aider les femmes à faible revenu et les programmes destinés aux femmes non caucasiennes peuvent être utiles pour remédier à l'insécurité alimentaire chez les femmes enceintes.

      Keywords

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