Systematic Review of Interventions Addressing Food Insecurity in Pregnant Women and New Mothers

Abstract

Purpose of the Review Food insecurity can have a negative health impact for women during pregnancy and the postpartum period; however, there are a range of barriers to meeting nutritional guidelines during pregnancy. Food insecurity is associated with an increased risk of pregnancy complications and mental and physical health outcomes. This review aims to provide insight into programmes and interventions which have targeted food insecurity in pregnant and early postpartum women. The central research question for this review is as follows: What programmes and interventions have sought to address food insecurity among pregnant and postpartum women? A systematic search of five electronic databases including Medline, CINAHL, Global Health, Embase, and Cochrane was undertaken on August 2021. Key thematic areas searched were food insecurity, pregnancy, nutritional outcomes, and interventions or programmes. Only studies that were published since 2000 in English were considered. Recent Findings Eleven studies were included in this review. Studies employed a range of methods and outcomes measures. They were conducted in mostly low- and middle-income countries, and in general, focused on nutritional supplementation, with some studies also incorporating nutrition education or counselling. Summary The findings of this review suggest that while there are a range of possible interventions that seek to address food insecurity and hunger among pregnant and postpartum women, the limited number of robust evaluations or long-term interventions mean that evidence for any one intervention type is limited. Furthermore, the programmes and interventions that do exist are generally embedded within a single context or structure, and as such, may not be able to be widely implemented. (Prospero Registration CRD42022245787)

Views and preferences of food‐insecure pregnant women regarding food insecurity screening and support within routine antenatal care

“…51 The consolidated reporting criteria for qualitative studies were used to design and report this study. 52 Ethics approval was granted by Royal Women's Hospital (RWH) Hospital HREC (02773/ [22][23][24][25][26][27][28][29][30][31][32][33] and Deakin University HREC (2023-016).…”

“…24 There are also few interventions that address food insecurity during pregnancy within healthcare settings, beyond the screening process. [25][26][27] Government-level food assistance programmes have been established in some high-income countries, to improve dietary quality of priority groups such as pregnant and postpartum women. The Special Supplemental Nutrition Program for women, infants and children (WIC) in the United States 28 and the Healthy Start program in the United Kingdom 29 provide access to nutritious foods and micronutrient supplements to low-income pregnant women who have been deemed to be at nutritional risk.…”

Consensus from an expert panel on how to identify and support food insecurity during pregnancy: A modified Delphi study

“…As a result, it is not necessary to continue rounds until all items reach consensus, but only until a clear pattern is discerned. In the current study, round one consisted of suggestions for practice based on current evidence [15] and asked participants to make suggestions on actions they considered useful in responding to food insecurity and hunger during pregnancy. The inclusion of open-ended question in the first round is consistent with previous research suggesting that the first round be as exploratory as possible [35], the subsequent round followed, where these suggestions were ranked and refined, a common feature of Delphi approaches as described in the literature [23,36,37].…”

“…Round 2: Participants who completed round one were sent a summary via email of the current research that seeks to address food insecurity in pregnancy. This summary was based on a systematic review [15] completed by the authors and describes the current situation of food insecure pregnant women and current evidence-based interventions. The summary of previous evidence was provided in round two, rather than earlier, to discourage the bandwagon effect [43], a common limitation of Delphi, allowing for free flowing ideas to be generated in round one.…”

“…Approximately 1 in 10 pregnant women are food insecure in Australia [14]. A recent systematic review of interventions specifically focused on addressing food insecurity during pregnancy found that the main interventions are nutritional supplementation and/or nutrition education, [15] however, the limited number of robust evaluations or long-term interventions mean that evidence for any one intervention type is limited. Recent research has found that while health care providers in one Australian antenatal setting were aware of the importance of maternal nutrition for the short-and long-term health of both the mother and baby, they were uncertain how to broach issues surrounding food insecurity, and when they do, they have few strategies to assist the hungry or food insecure parent [16].…”