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Household Food Insecurity Is Associated with Self-Reported Pregravid Weight Status, Gestational Weight Gain, and Pregnancy Complications



      Household food insecurity is positively associated with weight among women. The association between household food insecurity and pregnancy-related weight gain and complications is not well understood.


      To identify whether an independent association exists between household food insecurity and pregnancy-related complications.


      Data from the Pregnancy, Infection, and Nutrition prospective cohort study were used to assess household food insecurity retrospectively using the US Department of Agriculture 18-item Core Food Security Module among 810 pregnant women with incomes ≤400% of the income/poverty ratio, recruited between January 2001 and June 2005 and followed through pregnancy.

      Main outcome measures

      Self-reported pregravid body mass index, gestational weight gain, second trimester anemia, pregnancy-induced hypertension, and gestational diabetes mellitus.

      Statistical analyses performed

      Multivariate linear, multinomial logistic, and logistic regression analyses.


      Among 810 pregnant women, 76% were from fully food secure, 14% were from marginally food secure, and 10% were from food insecure households. In adjusted models, living in a food insecure household was significantly associated with severe pregravid obesity (adjusted odds ratio 2.97, 95% confidence intervals [CIs] 1.44 to 6.14), higher gestational weight gain (adjusted β coefficient 1.87, 95% CI 0.13 to 3.62), and with a higher adequacy of weight gain ratio (adjusted β .27, 95% CI 0.07 to 0.50). Marginal food security was significantly associated with gestational diabetes mellitus (adjusted odds ratio 2.76, 95% CI 1.00 to 7.66).


      This study highlights the possibility that living in a food insecure household during pregnancy may increase risk of greater weight gain and pregnancy complications.
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      B. A. Laraia is an assistant professor, Department of Medicine, Center for Health and Community, University of California, San Francisco; at the time of the study, she was a research assistant professor, University of North Carolina, and a fellow, Carolina Population Center, Chapel Hill.


      A. M. Siega-Riz is an associate professor, Department of Epidemiology and Nutrition, School of Public Health, University of North Carolina, Chapel Hill, NC.


      C. Gundersen is an associate professor, Department of Agricultural and Consumer Economics, University of Illinois, Urbana.