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Food insecurity during pregnancy in high-income countries, and maternal weight and diet: A systematic review and meta-analysis

Lookup NU author(s): Dr Gina NguyenORCiD, Zoe Bell, Dr Steph Scott, Letitia Sermin-Reed, Professor Nicola HeslehurstORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2024 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation.Food insecurity is a well-established obesity driver. Less is known about food insecurity during pregnancy. This review (PROSPERO:CRD42022311669) aimed to explore associations between food insecurity, maternal obesity, gestational weight gain (GWG), and nutrition. Searches included seven databases, gray literature, references, citations, and contacting authors. Observational studies reporting data from January 1st, 2008 to 21 November 2023 in high-income countries were included. Duplicate screening, data extraction, and quality assessments were performed. Random effects meta-analysis estimated odds ratios (OR), mean difference (MD), and 95% confidence intervals (CI). Narrative synthesis was conducted when data could not be pooled. Database searches identified 22,272 results; 20 studies were included (n = 19 North America, n = 1 Europe; n = 32,803 women). Food insecurity significantly increased obesity (OR 1.53 95%CI 1.39, 1.66), but not underweight (OR 1.12 95%CI 0.89, 1.34) or overweight (OR 1.18 95%CI 0.90, 1.46). Food insecurity significantly reduced GWG (MD -0.42 kg 95%CI -0.62, −0.22) and increased inadequate GWG (OR 1.16 95%CI 1.05, 1.28), but not excessive GWG (OR 1.04 95%CI 0.96, 1.13). Diet outcomes were inconsistent, with some evidence of reduced vitamin E and diet quality and increased red/processed meat consumption. Further studies outside of North America are needed to inform practice and policy to support maternal health.


Publication metadata

Author(s): Nguyen G, Bell Z, Andreae G, Scott S, Sermin-Reed L, Lake AA, Heslehurst N

Publication type: Review

Publication status: Published

Journal: Obesity Reviews

Year: 2024

Volume: 25

Issue: 7

Print publication date: 01/07/2024

Online publication date: 01/05/2024

Acceptance date: 26/03/2024

ISSN (print): 1467-7881

ISSN (electronic): 1467-789X

Publisher: John Wiley and Sons Inc

URL: https://doi.org/10.1111/obr.13753

DOI: 10.1111/obr.13753

PubMed id: 38693587


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