Association of Living in a Food Desert With Pregnancy Morbidity

Abstract

OBJECTIVE: To evaluate whether women living in areas deemed food deserts had higher rates of pregnancy morbidity, specifically preeclampsia, gestational hypertension, gestational diabetes, prelabor rupture of membranes, preterm labor, than women who did not live in food deserts at the time of their pregnancy and delivery. METHODS: This was a retrospective observational study in which we reviewed electronic medical records of all patients who delivered at Loyola University Medical Center in Maywood, Illinois in 2014. The Economic Research Service of the U.S. Department of Agriculture publishes the Food Access Research Atlas, which presents a spatial overview of food access indicators for low-income and other Census tracts using different measures of supermarket accessibility. A spatial join between the Food Access Research Atlas and patient coordinates was performed to identify patient point locations and determine whether each patient was located within or outside of a food desert. RESULTS: Data for 1,003 deliveries at Loyola University Medical Center in 2014 were provided by the Loyola University Chicago Clinical Research Database. Two deliveries were excluded owing to inability to map address coordinates; thus 1,001 deliveries were analyzed. Of the 1,001 patients, 195 (19.5%) women were designated to food deserts. Multivariable analysis was done by adjusting for age, race, and medical insurance class. Having at least one morbid condition was the only variable that demonstrated a significant association with the food desert in multivariable analyses (47.2% vs 35.6%) (odds ratio [OR] 1.62, 95% CI 1.18–2.22) (adjusted OR 1.64, 95% CI 1.18–2.29). CONCLUSION: The odds of having at least one of the studied morbid conditions in pregnancy were greater for patients living in a food desert. As there is an association of morbidity in pregnancy with living in a food desert, intervention trials to improve the built food environment or mitigate the effect otherwise are needed.

Environmental and individual factors associated with gestational weight gain

“…Also, those who live in food deserts greater risk for developing preeclampsia and preterm labor [ 31 ]. On the other hand, another study showed that built environments with more healthful food availability were associated with a lower odd of excessive or insufficient GWG [ 32 ]…”

Association between food environments and fetal growth in pregnant Brazilian women

“…The industry is known to be the mediator for calorie increases, and consequent excessive gains in gestational weight [33][34][35][36] . Increased access to supermarkets is associated with less prevalence of overweight and obesity, and improved consumption of fruit and vegetables 27 .…”

Understanding Food Security as a Social Determinant of Diabetes-Related Health during Pregnancy

“…35 Fast food and supermarket density have been linked to adverse obstetrical outcomes; Tipton et al reported that the odds of having at least one morbidity condition in pregnancy was greater for patients living in food deserts. 36 Limited data on food security during pregnancy have demonstrated that living in a food-insecure household during pregnancy was significantly associated with severe pregravid obesity, higher gestational weight gain, and higher adequacy of weight gain ratio, which is defined as the ratio of observed total weight gained over expected weight gain. 37 Although previous research has suggested an association between food insecurity and adverse health outcomes in nonpregnant individuals with T2DM and among a general population of pregnant individuals, minimal research has investigated this relationship specifically among pregnant individuals with diabetes.…”